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Initiation treatment on treatment outcome MDR TB

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https://www.readbyqxmd.com/read/28068907/hospitalized-care-for-mdr-tb-in-port-harcourt-nigeria-a-qualitative-study
#1
Kingsley Lezor Bieh, Ralf Weigel, Helen Smith
BACKGROUND: In Nigeria multidrug-resistant tuberculosis (MDR-TB) is prevalent in 2.9% of new TB cases and 14% of retreatment cases, and the country is one of 27 with high disease burden globally. Patients are admitted and confined to one of ten MDR-TB treatment facilities throughout the initial 8 months of treatment. The perspectives of MDR-TB patients shared on social media and in academic research and those of providers are limited to experiences of home-based care. In this study we explored the views of hospitalised MDR-TB patients and providers in one treatment facility in Nigeria, and describe how their experiences are linked to accessibility of care and support services, in line with international goals...
January 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28043620/implementation-of-new-tools-for-multidrug-resistant-tuberculosis-detection-and-control
#2
Robin M Warren
Contrary to classical dogma, molecular epidemiological studies and mathematical modeling clearly show that the global drug-resistant tuberculosis (TB) epidemic is driven by transmission. Furthermore, there is mounting evidence demonstrating that amplification of resistance occurs during treatment, possibly as a result of insufficient active drugs being administered. To control the drug-resistant TB epidemic, it will be essential to implement new, rapid, and highly sensitive and specific diagnostic methods to decrease the diagnostic delay associated with culture-based testing...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043598/investigation-of-isoniazid-and-ethionamide-cross-resistance-by-whole-genome-sequencing-and-association-with-poor-treatment-outcomes-of-multidrug-resistant-tuberculosis-patients-in-south-africa
#3
L Malinga, J Brand, C Jansen van Rensburg, G Cassell, M van der Walt
OBJECTIVE/BACKGROUND: Ethionamide (ETH) and isoniazid (INH) are part of the backbone regimen used for the treatment of multidrug-resistant tuberculosis (MDR-TB). Both ETH and INH are structurally similar and are activated by ethA and katG gene products. Resistance to INH among MDR-TB patients may cause ETH to be ineffective, as both target nicotinamide adenine dinucleotide-dependent enoyl-acyl carrier protein reductase inhA protein and mutations within inhA gene may lead to their cross-resistance...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043597/impact-of-genotypic-and-phenotypic-resistance-to-second-line-anti-tuberculosis-drugs-on-treatment-outcomes-in-multidrug-resistant-tuberculosis-in-china
#4
Yi Hu, Xubin Zheng, Zhu Ning, Qun Li, Zhengdong Zhang, Sven Hoffner
BACKGROUND: Despite the strong association between drug resistance and genetic mutations, the value of molecular diagnosis of drug resistance to guide the treatment of multidrug-resistant tuberculosis (MDR-TB) remains unclear. This is particularly relevant in resource-limited areas, in which it is difficult to implement the drug susceptibility test. Here, we focused on the association of drug susceptibility phenotype and genotype with treatment outcomes in patients with MDR-TB. METHODS: In a prospective cohort study, we enrolled 252 consecutive patients with confirmed MDR-TB between 2010 and 2013, and outcomes were followed-up over the 24-month treatment course in terms of clinical manifestation and sputum conversion...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043522/changes-in-nitric-oxide-synthase-and-nitrite-and-nitrate-serum-levels-in-patients-with-or-without-multidrug-resistant-tuberculosis-undergoing-the-intensive-phase-of-antituberculosis-therapy
#5
Dmytro O Butov, Mykhailo Kuzhko, Tatyana Butova, Ganna Stepanenko
OBJECTIVE/BACKGROUND: There is a paucity of published data on the effect of tuberculosis (TB) chemotherapy on nitric oxide (NO) synthesis and metabolism in newly diagnosed and relapsed patients with or without multidrug-resistant TB (MDR-TB). METHODS: The pattern of NO response in 140 patients with pulmonary TB, including 74 with MDR-TB (1st group) and 66 without MDR-TB (2nd group) has been studied and compared with the NO status of 30 healthy donors (3rd group)...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043521/interleukin-10-gene-polymorphism-is-associated-with-multi-drug-resistant-tuberculosis-during-the-intensive-phase-of-standard-chemotherapy
#6
Butov Dmytro, Kuzhko Mykhailo, Butova Tetyana Kuzhko
OBJECTIVE/BACKGROUND: To study whether interleukin (IL)-10 gene polymorphism is associated with multi-drug resistant tuberculosis (MDR TB) during the intensive phase of standard chemotherapy. METHODS: The study comprised 170 individuals in Kharkiv region of Ukraine including 74 patients with pulmonary MDR TB (Group 1), 66 patients without MDR TB (Group 2), and 30 healthy donors (Group 3). Serum level of IL-10 was evaluated by enzyme-linked immunosorbent assay (pg/L)...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/27998752/drug-resistant-tb-uk-multicentre-study-drums-treatment-management-and-outcomes-in-london-and-west-midlands-2008-2014
#7
Amber Arnold, Graham S Cooke, Onn Min Kon, Martin Dedicoat, Marc Lipman, Angela Loyse, Philip D Butcher, Irina Chis Ster, Thomas Stephen Harrison
OBJECTIVES: Detailed information regarding treatment practices and outcomes of MDR-TB treatment in the UK is required as a baseline for care improvements. METHODS: 100 consecutive cases between 2008 and 2014 were reviewed retrospectively at 4 MDR-TB treatment centres in England to obtain information on drug treatment choices, hospital admission duration and outcomes for MDR-TB. RESULTS: Initial hospital admission was long, median 62.5 (IQR 20-106, n = 92) days, and 13% (12/92) of patients lost their home during this period...
December 18, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27998730/tuberculosis-cases-caused-by-heterogeneous-infection-in-eastern-europe-and-their-influence-on-outcomes
#8
Irina Kontsevaya, Vladyslav Nikolayevskyy, Alexander Kovalyov, Olga Ignatyeva, Anna Sadykhova, Tatiana Simak, Olesya Tikhonova, Yulia Dubrovskaya, Edita Vasiliauskiene, Edita Davidaviciene, Girts Skenders, Olga Makurina, Yanina Balabanova, Francis Drobniewski
INTRODUCTION: Mycobacterium tuberculosis superinfection is known to occur in areas with high rates of tuberculosis (TB) and has a significant impact on overall clinical TB management. AIM: We aimed to estimate the superinfection rate in cohorts of drug sensitive and multi-drug resistant tuberculosis (MDR TB) patients from Eastern Europe and the potential role of a second MDR TB strain infecting a patient with active non-MDR TB in treatment outcome. METHODS: The study population included 512 serial M...
December 18, 2016: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/27931345/factors-associated-with-sputum-culture-conversion-in-multidrug-resistant-pulmonary-tuberculosis
#9
B Velayutham, D Nair, T Kannan, C Padmapriyadarsini, K S Sachdeva, J Bency, J S Klinton, S Haldar, A Khanna, S Jayasankar, S Swaminathan
INTRODUCTION: Sputum culture conversion in pulmonary multidrug-resistant tuberculosis (MDR-TB) is important to make treatment-related decisions and prevent transmission of disease. OBJECTIVE: To identify factors associated with sputum culture conversion, and to determine time to culture conversion and the impact of culture conversion on successful treatment outcomes in MDR-/rifampicin (RMP) resistant TB. METHOD: Retrospective analysis of data from treatment cards and registers of MDR-/RMP-resistant patients initiated on treatment under India's Revised National TB Control Programme in Delhi, West Bengal and Kerala from January 2009 to December 2011...
December 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27738284/impact-of-rapid-molecular-diagnostic-tests-on-time-to-treatment-initiation-and-outcomes-in-patients-with-multidrug-resistant-tuberculosis-tamil-nadu-india
#10
Dina Nair, Pooranaganga D Navneethapandian, Jaya Prasad Tripathy, Anthony D Harries, Joel S Klinton, Basilea Watson, Gomathi N Sivaramakrishnan, Devarajulu S Reddy, Lakshmi Murali, Mohan Natrajan, Soumya Swaminathan
BACKGROUND: India is replacing culture and drug sensitivity testing (CDST) with rapid molecular tests for diagnosing MDR-TB. We assessed the impact of rapid tests on time to initiation of treatment and outcomes in patients with MDR-TB compared with CDST. METHODS: A retrospective cohort study involving MDR-TB patients from six districts in Tamil Nadu state, who underwent CDST (2010-2011) and rapid tests (2012-2013). RESULTS: There were 135 patients in the CDST group and 389 in the rapid diagnostic test group...
September 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27727274/tradeoffs-in-introduction-policies-for-the-anti-tuberculosis-drug-bedaquiline-a-model-based-analysis
#11
Amber Kunkel, Frank G Cobelens, Ted Cohen
BACKGROUND: New drugs for the treatment of tuberculosis (TB) are becoming available for the first time in over 40 y. Optimal strategies for introducing these drugs have not yet been established. The objective of this study was to compare different strategies for introducing the new TB drug bedaquiline based on patients' resistance patterns. METHODS AND FINDINGS: We created a Markov decision model to follow a hypothetical cohort of multidrug-resistant (MDR) TB patients under different bedaquiline use strategies...
October 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27633308/screening-outcomes-of-household-contacts-of-multidrug-resistant-tuberculosis-patients-in-peshawar-pakistan
#12
Arshad Javaid, Mazhar Ali Khan, Mir Azam Khan, Sumaira Mehreen, Anila Basit, Raza Ali Khan, Muhammad Ihtesham, Irfan Ullah, Afsar Khan, Ubaid Ullah
OBJECTIVE: To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. METHODS: Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB. RESULTS: Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases...
September 2016: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/27509173/implementation-and-operational-research-clinical-impact-of-the-xpert-mtb-rif-assay-in-patients-with-multidrug-resistant-tuberculosis
#13
Nesri Padayatchi, Naressa Naidu, Nonhlanhla Yende-Zuma, Max Roe OʼDonnell, Kogieleum Naidoo, Stanton Augustine, Alimuddin Zumla, Marian Loveday
BACKGROUND: The Xpert MTB/RIF assay has been widely implemented in South Africa for rapid tuberculosis (TB) screening. However, its usefulness in management and improving treatment outcomes in patients with multidrug-resistant TB (MDR-TB) remains undefined. The aim of this study was to evaluate the clinical impact of introduction of the Xpert MTB/RIF assay in patients with MDR-TB. METHODS: We enrolled 921 patients with MDR-TB, who presented to a specialist drug-resistant TB facility in KwaZulu-Natal, South Africa, pre- and post-rollout and implementation of the Xpert MTB/RIF assay...
September 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27223622/programmatic-management-of-drug-resistant-tuberculosis-an-updated-research-agenda
#14
Carole D Mitnick, Carly A Rodriguez, Marita L Hatton, Grania Brigden, Frank Cobelens, Martin P Grobusch, Robert Horsburgh, Christoph Lange, Christian Lienhardt, Eyal Oren, Laura J Podewils, Barbara Seaworth, Susan van den Hof, Charles L Daley, Agnes C Gebhard, Fraser Wares
INTRODUCTION: There are numerous challenges in delivering appropriate treatment for multidrug-resistant tuberculosis (MDR-TB) and the evidence base to guide those practices remains limited. We present the third updated Research Agenda for the programmatic management of drug-resistant TB (PMDT), assembled through a literature review and survey. METHODS: Publications citing the 2008 research agenda and normative documents were reviewed for evidence gaps. Gaps were formulated into questions and grouped as in the 2008 research agenda: Laboratory Support, Treatment Strategy, Programmatically Relevant Research, Epidemiology, and Management of Contacts...
2016: PloS One
https://www.readbyqxmd.com/read/27142682/the-effect-of-early-versus-late-treatment-initiation-after-diagnosis-on-the-outcomes-of-patients-treated-for-multidrug-resistant-tuberculosis-a-systematic-review
#15
Rebecca C Harris, Louis Grandjean, Laura J Martin, Alexander J P Miller, Joseph-Egre N Nkang, Victoria Allen, Mishal S Khan, Katherine Fielding, David A J Moore
BACKGROUND: Globally it is estimated that 480 000 people developed multidrug-resistant tuberculosis (MDR-TB) in 2014 and 190 000 people died from the disease. Successful treatment outcomes are achieved in only 50 % of patients with MDR-TB, compared to 86 % for drug susceptible disease. It is widely held that delay in time to initiation of treatment for MDR-TB is an important predictor of treatment outcome. The objective of this review was to assess the existing evidence on the outcomes of multidrug- and extensively drug-resistant tuberculosis patients treated early (≤4 weeks) versus late (>4 weeks) after diagnosis of drug resistance...
May 4, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27055269/the-impact-of-a-line-probe-assay-based-diagnostic-algorithm-on-time-to-treatment-initiation-and-treatment-outcomes-for-multidrug-resistant-tb-patients-in-arkhangelsk-region-russia
#16
MULTICENTER STUDY
Platon Eliseev, Grigory Balantcev, Elena Nikishova, Anastasia Gaida, Elena Bogdanova, Donald Enarson, Tara Ornstein, Anne Detjen, Russell Dacombe, Elena Gospodarevskaya, Patrick P J Phillips, Gillian Mann, Stephen Bertel Squire, Andrei Mariandyshev
BACKGROUND: In the Arkhangelsk region of Northern Russia, multidrug-resistant (MDR) tuberculosis (TB) rates in new cases are amongst the highest in the world. In 2014, MDR-TB rates reached 31.7% among new cases and 56.9% among retreatment cases. The development of new diagnostic tools allows for faster detection of both TB and MDR-TB and should lead to reduced transmission by earlier initiation of anti-TB therapy. STUDY AIM: The PROVE-IT (Policy Relevant Outcomes from Validating Evidence on Impact) Russia study aimed to assess the impact of the implementation of line probe assay (LPA) as part of an LPA-based diagnostic algorithm for patients with presumptive MDR-TB focusing on time to treatment initiation with time from first-care seeking visit to the initiation of MDR-TB treatment rather than diagnostic accuracy as the primary outcome, and to assess treatment outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27044259/dilemma-of-managing-asymptomatic-children-referred-with-culture-confirmed-drug-resistant-tuberculosis
#17
Marian Loveday, Babu Sunkari, Ben J Marais, Iqbal Master, James C M Brust
BACKGROUND: The diagnosis of drug-resistant tuberculosis (DR-TB) in children is challenging and treatment is associated with many adverse effects. OBJECTIVE: We aimed to assess if careful observation, without initiation of second-line treatment, is safe in asymptomatic children referred with 'culture-confirmed' DR-TB. SETTING: KwaZulu-Natal, South Africa-an area with high burdens of HIV, TB and DR-TB. DESIGN, INTERVENTION AND MAIN OUTCOME MEASURES: We performed an outcome review of children with 'culture-confirmed' DR-TB who were not initiated on second-line TB treatment, as they were asymptomatic with normal chest radiographs on examination at our specialist referral hospital...
July 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27000461/linezolid-as-a-potentially-effective-drug-for-the-treatment-of-multidrug-resistant-tuberculosis-in-japan
#18
Lina Yi, Takashi Yoshiyama, Masao Okumura, Kozo Morimoto, Yuka Sasaki, Yuji Shiraishi, Hideo Ogata, Satoshi Mitarai
Linezolid (LZD) is classified as a WHO group 5 drug used in the treatment of tuberculosis (TB). Although its efficacy and long-term safety have not yet been established, it is being increasingly used in the treatment of multidrug resistant tuberculosis (MDR-TB) and extensive multidrug-resistant tuberculosis (XDR-TB). The current study is a single-center retrospective clinical analysis of hospitalized M/XDR-TB patients in Fukujuji Hospital involving 26 patients (18 males and 8 females) consecutively treated with combinations of anti-TB drugs including LZD from 2009 to 2015...
March 18, 2016: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/26967493/the-role-of-adherence-and-retreatment-in-de-novo-emergence-of-mdr-tb
#19
Dominique Cadosch, Pia Abel Zur Wiesch, Roger Kouyos, Sebastian Bonhoeffer
Treatment failure after therapy of pulmonary tuberculosis (TB) infections is an important challenge, especially when it coincides with de novo emergence of multi-drug-resistant TB (MDR-TB). We seek to explore possible causes why MDR-TB has been found to occur much more often in patients with a history of previous treatment. We develop a mathematical model of the replication of Mycobacterium tuberculosis within a patient reflecting the compartments of macrophages, granulomas, and open cavities as well as parameterizing the effects of drugs on the pathogen dynamics in these compartments...
March 2016: PLoS Computational Biology
https://www.readbyqxmd.com/read/26846562/later-emergence-of-acquired-drug-resistance-and-its-effect-on-treatment-outcome-in-patients-treated-with-standard-short-course-chemotherapy-for-tuberculosis
#20
Jingtao Gao, Yan Ma, Jian Du, Guofeng Zhu, Shouyong Tan, Yanyong Fu, Liping Ma, Lianying Zhang, Feiying Liu, Daiyu Hu, Yanling Zhang, Xiangqun Li, Liang Li, Qi Li
BACKGROUNDS: The failure of current Standard Short-Course Chemotherapy (SCC) in new and previously treated cases with tuberculosis (TB) was mainly due to drug resistance development. But little is known on the characteristics of acquired drug resistant TB during SCC and its correlation with SCC failure. The objective of the study is to explore the traits of acquired drug resistant TB emergence and evaluate their impacts on treatment outcomes. METHODS: A prospective observational study was performed on newly admitted smear positive pulmonary TB (PTB) cases without drug resistance pretreatment treated with SCC under China's National TB Control Program (NTP) condition from 2008 to 2010...
February 4, 2016: BMC Pulmonary Medicine
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