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Alex Guri, Michal Kori, Pearl Herskovitz, Oren Zimhony
A 15-year-old girl presented with erythema nodosum and mild abdominal complaints. Her intestinal granulomatous disease was erroneously diagnosed as Crohn's disease despite the fact that the possibility of tuberculosis was considered. The final diagnosis of tuberculosis was made only when an anti-tumour necrosis factor therapy resulted in further deterioration. The patient was treated with isoniazid, rifampin, pyrazinamide and ethambutol, with slow and steady clinical improvement until complete recovery was achieved...
April 19, 2018: BMJ Case Reports
J Kuhlin, C Smith, A Khaemraev, Z Tigay, N Parpieva, M Tillyashaykhov, J Achar, J Hajek, J Greig, P du Cros, D Moore
SETTING: The World Health Organization (WHO) recommends the inclusion of pyrazinamide (PZA) in treatment regimens for multidrug-resistant tuberculosis (MDR-TB) unless resistance has been confirmed. OBJECTIVE: To investigate the association between PZA susceptibility and MDR-TB treatment outcome among patients treated with a PZA-containing regimen and whether the duration of the intensive phase of the PZA-containing regimen affected treatment outcome. DESIGN: We conducted a retrospective cohort study including all eligible MDR-TB patients starting treatment in 2003-2013 in the TB programme in Karakalpakstan, Uzbekistan...
May 1, 2018: International Journal of Tuberculosis and Lung Disease
A Wakamiya, O Seguchi, A Shionoiri, Y Kumai, K Kuroda, S Nakajima, M Yanase, S Matsuda, K Wada, Y Matsumoto, S Fukushima, T Fujita, J Kobayashi, N Fukushima
INTRODUCTION: Tuberculous paradoxical reactions (PRs) are excessive immune reactions occurring after antituberculosis (TB) treatment and are commonly observed in immunocompromised hosts such as patients infected with the human immunodeficiency virus. CASE REPORT: We recently encountered a 63-year-old male heart transplant recipient who developed tuberculous PR after treatment for miliary TB. The patient had been receiving immunosuppressive therapy with cyclosporine and mycophenolate mofetil for over 15 years...
April 2018: Transplantation Proceedings
Manijeh Kahbazi, Hossein Sarmadian, Azam Ahmadi, Farshideh Didgar, Maryam Sadrnia, Toktam Poolad, Mohammad Arjomandzadegan
In clinical isolates of Mycobacterium tuberculosis (MTB), resistance to pyrazinamide occurs by mutations in any positions of the pncA gene (NC_000962.3) especially in nucleotides 359 and 374. In this study we examined the pncA gene sequence in clinical isolates of MTB. Genomic DNA of 33 clinical isolates of MTB was extracted by the Chelex100 method. The polymerase chain reactions (PCR) were performed using specific primers for amplification of 744 bp amplicon comprising the coding sequences (CDS) of the pncA gene...
April 16, 2018: Scientia Pharmaceutica
Takayuki Hori, Motoshi Ouchi, Naoyuki Otani, Masakatsu Nohara, Asuka Morita, Yusuke Otsuka, Promsuk Jutabha, Ikuko Shibasaki, Yasushi Matsushita, Tomoe Fujita, Hirotsugu Fukuda, Naohiko Anzai
The purpose of this study was to create novel urate under-excretion animal models using pyrazinamide and to evaluate whether dihydropyridine calcium channel blockers (CCBs) have uricosuric effects in vivo. Adult male ICR mice were treated with pyrazinamide, vehicle (dimethyl sulfoxide: DMSO), or tap water. Thirty minutes later, pyrazinamide-treated mice were given benzbromarone, losartan, nilvadipine, nitrendipine, nifedipine or azelnidipine. Six hours after the second administration, urine (by urinary bladder puncture) and plasma were collected to measure uric acid and creatinine levels, and fractional excretion of uric acid (FEUA) and creatinine clearance (Ccr) were calculated and evaluated...
March 8, 2018: Journal of Pharmacological Sciences
Selda Hançerli Törün, Emine Manolya Acar, Ayper Somer, Gonca Erköse, Dilek Şatana, Zuhal Bayramoğlu, Emine Çalışkan, Zeki Kılıçaslan
Tuberculosis continues to be a major health problem worldwide. Multidrug resistant tuberculosis (MDR-TB) infection that occurs in childhood is caused by adult MDR-TB agents which are in circulation and resistant to primary drugs. In this case report a 17-month-old child with MDR-TB who was cured after a 24-month therapy regimen was presented. Physical examination of a 17-month-old girl admitted to the hospital with the cause of recurrent pneumonia revealed a rubbery lymphadenopathy less than 2 cm in the right upper cervical region...
January 2018: Mikrobiyoloji Bülteni
Basanth Babu Eedara, Bhamini Rangnekar, Shubhra Sinha, Colin Doyle, Alex Cavallaro, Shyamal C Das
This study aimed to develop a high payload dry powder inhalation formulation containing a combination of the first line anti-TB drug, pyrazinamide, and the second line drug, moxifloxacin HCl. Individual powders of pyrazinamide (PSD ) and moxifloxacin (MSD ) and combination powders of the two drugs without (PM) and with 10% L-leucine (PML) and 10% DPPC (PMLD) were produced by spray drying. PSD contained >10 μm crystalline particles and showed poor aerosolization behaviour with a fine particle fraction (FPF) of 18...
April 3, 2018: European Journal of Pharmaceutical Sciences
Mansoor Ahmed, Mohsin Ali, Seyed Abdulmajid Ayatollahi, Marjan Esfahanizadeh, Farzad Kobarfard, Ameer Hasan, Khalid Mohammed Khan, Syed Moazzam Haider
During the past few decades the emergence of inorganic medicinal chemistry has been developed novel therapeutic agents. Researcher's perseverance in this branch of chemistry has led them to explore further valuable chemical spaces by synthesizing metal complexes already known pharmacological agents for their potential use. However, it is in its early stage, this methodology has demonstrated metal complexes with better bioactivities than the parent ligand molecules. In this study, transition metal complexes of pyrazinamide (PZ), isoniazid (INH), fluconazole (FCZ), metformin (dimethylbiguanide, DMBG) and losartan potassium (LS-K) were selected to evaluate for their possible anti-platelets aggregation in the light of reports on divalent and trivalent cations like calcium, copper, manganese, magnesium, and cadmium may influence the process of thrombocytic activity and aggregation...
March 2018: Pakistan Journal of Pharmaceutical Sciences
Rangappa S Keri, Sudam S Pandule, Srinivasa Budagumpi, Bhari M Nagaraja
Tuberculosis (TB) is a highly dreaded, infectious, chronic, airborne disease affecting more than two million people all around the world, with more than eight million cases every calendar year. TB is the second leading infectious cause of death after HIV/AIDS. Over the past few decades, numerous efforts have been undertaken to develop new anti-TB agents. The current frontline therapy for TB consists of administering three or more different drugs (usually isoniazid, rifampin, pyrazinamide, and ethambutol) over an extended period of time...
April 3, 2018: Archiv der Pharmazie
Joonhong Park, So Youn Shin, Kyungjong Kim, Kuhn Park, Soyoung Shin, Chunhwa Ihm
BACKGROUND: We examined the feasibility of a full-length gene analysis for the drug resistance-related genes inhA, katG, rpoB, pncA, rpsL, embB, eis, and gyrA using ion semiconductor next-generation sequencing (NGS) and compared the results with those obtained from conventional phenotypic drug susceptibility testing (DST) in multidrug-resistant Mycobacterium tuberculosis (MDR-TB) isolates. METHODS: We extracted genomic DNA from 30 pure MDR-TB isolates with antibiotic susceptibility profiles confirmed by phenotypic DST for isoniazid (INH), rifampin (RIF), ethambutol (EMB), pyrazinamide (PZA), amikacin (AMK), kanamycin (KM), streptomycin (SM), and fluoroquinolones (FQs) including ofloxacin, moxifloxacin, and levofloxacin...
July 2018: Annals of Laboratory Medicine
Juan Bautista Gutiérrez-Aroca, Pilar Ruiz, Manuel Vaquero, Manuel Causse, Manuel Casal
Multidrug-resistant tuberculosis (MDR-TB) is a cause of increasing concern. This study investigated first-line anti-TB drug resistance in Mycobacterium tuberculosis strains submitted to the Tuberculosis Reference Center in Córdoba (Spain) between 2001 and 2015. A total of 1,207 cultures were tested against first-line drugs using the BACTEC MGIT 960 system. Resistance to first-line drugs was detected in 207 strains (17.2%), the greatest resistance being found in INH (5.3%) followed by streptomycin (3%), pyrazinamide (2...
April 2, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Federica Fregonese, Shama D Ahuja, Onno W Akkerman, Denise Arakaki-Sanchez, Irene Ayakaka, Parvaneh Baghaei, Didi Bang, Mayara Bastos, Andrea Benedetti, Maryline Bonnet, Adithya Cattamanchi, Peter Cegielski, Jung-Yien Chien, Helen Cox, Martin Dedicoat, Connie Erkens, Patricio Escalante, Dennis Falzon, Anthony J Garcia-Prats, Medea Gegia, Stephen H Gillespie, Judith R Glynn, Stefan Goldberg, David Griffith, Karen R Jacobson, James C Johnston, Edward C Jones-López, Awal Khan, Won-Jung Koh, Afranio Kritski, Zhi Yi Lan, Jae Ho Lee, Pei Zhi Li, Ethel L Maciel, Rafael Mello Galliez, Corinne S C Merle, Melinda Munang, Gopalan Narendran, Viet Nhung Nguyen, Andrew Nunn, Akihiro Ohkado, Jong Sun Park, Patrick P J Phillips, Chinnaiyan Ponnuraja, Randall Reves, Kamila Romanowski, Kwonjune Seung, H Simon Schaaf, Alena Skrahina, Dick van Soolingen, Payam Tabarsi, Anete Trajman, Lisa Trieu, Velayutham V Banurekha, Piret Viiklepp, Jann-Yuan Wang, Takashi Yoshiyama, Dick Menzies
BACKGROUND: Isoniazid-resistant, rifampicin-susceptible (INH-R) tuberculosis is the most common form of drug resistance, and is associated with failure, relapse, and acquired rifampicin resistance if treated with first-line anti-tuberculosis drugs. The aim of the study was to compare success, mortality, and acquired rifampicin resistance in patients with INH-R pulmonary tuberculosis given different durations of rifampicin, ethambutol, and pyrazinamide (REZ); a fluoroquinolone plus 6 months or more of REZ; and streptomycin plus a core regimen of REZ...
April 2018: Lancet Respiratory Medicine
Muhammad Tahir Khan, Shaukat Iqbal Malik, Sajid Ali, Anwar Sheed Khan, Tariq Nadeem, Muhammad Tariq Zeb, Nayyer Masood, Muhammad Tanvir Afzal
AIMS: Pyrazinamide (PZA) is an important component of first-line tuberculosis (TB) treatment because of its distinctive capability to kill subpopulations of persister Mycobacterium tuberculosis (MTB). The significance of PZA can be understood by its inclusion in the most recent World Health Organization-recommended multidrug-resistant (MDR) TB regimen. Very little information is available about the prevalence of PZA-resistant TB from geographically distinct regions of high burden countries, including Khyber Pakhtunkhwa (KPK), Pakistan, because drug susceptibility testing (DST) of PZA is not regularly performed due to the complexity...
March 27, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Anil K Jain, Karan Raj Jaggi, Himanshu Bhayana, Rumpa Saha
Drug-resistant spinal tuberculosis (TB) is an emerging health problem in both developing and developed countries. In this review article, we aim to define management protocols for suspicion, diagnosis, and treatment of such patients. Spinal TB is a deep-seated paucibacillary lesion, and the demonstration of acid-fast bacilli on Ziehl-Neelsen staining is possible only in 10%-30% of cases. Drug resistance is suspected in patients showing the failure of clinicoradiological improvement or appearance of a fresh lesion of osteoarticular TB while on anti tubercular therapy (ATT) for a minimum period of 5 months...
March 2018: Indian Journal of Orthopaedics
Matteo Zignol, Andrea Maurizio Cabibbe, Anna S Dean, Philippe Glaziou, Natavan Alikhanova, Cecilia Ama, Sönke Andres, Anna Barbova, Angeli Borbe-Reyes, Daniel P Chin, Daniela Maria Cirillo, Charlotte Colvin, Andrei Dadu, Andries Dreyer, Michèle Driesen, Christopher Gilpin, Rumina Hasan, Zahra Hasan, Sven Hoffner, Alamdar Hussain, Nazir Ismail, S M Mostofa Kamal, Faisal Masood Khanzada, Michael Kimerling, Thomas Andreas Kohl, Mikael Mansjö, Paolo Miotto, Ya Diul Mukadi, Lindiwe Mvusi, Stefan Niemann, Shaheed V Omar, Leen Rigouts, Marco Schito, Ivita Sela, Mehriban Seyfaddinova, Girts Skenders, Alena Skrahina, Sabira Tahseen, William A Wells, Alexander Zhurilo, Karin Weyer, Katherine Floyd, Mario C Raviglione
BACKGROUND: In many countries, regular monitoring of the emergence of resistance to anti-tuberculosis drugs is hampered by the limitations of phenotypic testing for drug susceptibility. We therefore evaluated the use of genetic sequencing for surveillance of drug resistance in tuberculosis. METHODS: Population-level surveys were done in hospitals and clinics in seven countries (Azerbaijan, Bangladesh, Belarus, Pakistan, Philippines, South Africa, and Ukraine) to evaluate the use of genetic sequencing to estimate the resistance of Mycobacterium tuberculosis isolates to rifampicin, isoniazid, ofloxacin, moxifloxacin, pyrazinamide, kanamycin, amikacin, and capreomycin...
March 21, 2018: Lancet Infectious Diseases
A S Sandhya, Brijesh Prajapat
Thrombocytopenia is one of the most common hematological manifestations seen in HIV patients with approximately 40% of the patients developing thrombocytopenia during their course of illness. Opportunistic infection like tuberculosis is a rare but curative cause of thrombocytopenia in these patients. Clinically, it is a challenge to determine the exact cause and decide the treatment of thrombocytopenia in these patients as both infections can lead to significant thrombocytopenia by varied mechanisms. The treatment options are limited by drug antitubercular treatment highly active antiretroviral therapy (ATT and HAART)-induced thrombocytopenia...
October 2017: Journal of Family Medicine and Primary Care
Benson R Kidenya, Stephen E Mshana, Daniel W Fitzgerald, Oksana Ocheretina
BACKGROUND: Drug resistant Tuberculosis (TB) is considered a global public health threat. Whole-genome sequencing (WGS) is a new technology for tuberculosis (TB) diagnostics and is capable of providing rapid drug resistance profiles and genotypes for epidemiologic surveillance. Therefore, we used WGS to determine genotypic drug resistance profiles and genetic diversity of drug resistant Mycobacterium tuberculosis isolates from Mwanza, North-western Tanzania. METHODS: A cross-sectional study was conducted at the Bugando Medical Center (BMC) from September 2014 to June 2015...
March 2018: Tuberculosis
Shouhong Gao, Zhipeng Wang, Xinfang Xie, Chunhua You, Yang Yang, Yanhai Xi, Wansheng Chen
First-line anti-tuberculosis drugs are playing vital roles for curbing rapid spread of tuberculosis. Multidrug therapies are commonly applied in clinical to achieve better treatment outcomes. However, drug resistance and adverse reactions come along with this therapies and therapeutic drug monitoring is a feasible way to precaution them. For this reasons, a simple and sensitive method based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) and single protein precipitation was developed and validated for simultaneously quantifying of pyrazinamide, isoniazid, ethambutol, streptomycin and rifampicin in human plasma...
March 2018: Tuberculosis
Vahid Lohrasbi, Malihe Talebi, Abed Zahedi Bialvaei, Lanfranco Fattorini, Michel Drancourt, Mohsen Heidary, Davood Darban-Sarokhalil
Despite the low expensive and effective four-drug treatment regimen (isoniazid, rifampicin, pyrazinamide and ethambutol) was introduced 40 years ago, TB continues to cause considerable morbidity and mortality worldwide. In 2015, the WHO estimated a total of 10.4 million new tuberculosis (TB) cases worldwide. Currently, the increased number of multidrug-resistant (MDR-TB), extensively-drug resistant (XDR-TB) and in some recent reports, totally drug-resistant TB (TDR-TB) cases raises concerns about this disease...
March 2018: Tuberculosis
Precious Bwalya, Tomoyuki Yamaguchi, Georgina Mulundu, Chie Nakajima, Grace Mbulo, Eddie Samuneti Solo, Yukari Fukushima, Kunda Kasakwa, Yasuhiko Suzuki
Pyrazinamide forms a core part of treatment for all types of tuberculosis (TB) in Zambia. Due to challenges associated with pyrazinamide testing, little information is available to indicate the frequency of resistance to this drug in Zambia. To determine the frequency of pyrazinamide (PZA) resistance and its correlation with mutation in pncA in Mycobacterium tuberculosis isolated from patients in Lusaka, Zambia, BACTEC MGIT M960 was used for phenotypic PZA susceptibility testing while sequencing was used to determine resistance-conferring mutations in the pncA...
March 2018: Tuberculosis
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