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Management of MDR TB

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https://www.readbyqxmd.com/read/28729186/-tuberculosis-treatment-for-children-an-update
#1
María José Mellado Peña, Begoña Santiago García, Fernando Baquero-Artigao, David Moreno Pérez, Roi Piñeiro Pérez, Ana Méndez Echevarría, José Tomás Ramos Amador, David Gómez-Pastrana Durán, Antoni Noguera Julian
Tuberculosis (TB) is the most important infectious disease all over the world, with a high morbidity and mortality. Pediatric tuberculosis has been a neglected epidemic, due to the difficulties in assessing its global impact, reduced incidence and lower infectivity compared to adults. In 2015, the WHO reported 1 million cases of paediatric TB and 169,000 deaths. In Europe, the emergence of MDR TB is a major concern, representing 16% of the new diagnosis in Eastern Europe. In 2014, it was estimated that about 219,000 children were infected by MDR-TB-strains in Europe, and 2,120 developed the disease...
July 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28717643/chronic-airflow-obstruction-after-successful-treatment-of-multidrug-resistant-tuberculosis
#2
Anthony L Byrne, Ben J Marais, Carole D Mitnick, Frances L Garden, Leonid Lecca, Carmen Contreras, Yaninna Yauri, Fanny Garcia, Guy B Marks
Cross-sectional studies reveal an association between tuberculosis (TB) and chronic airflow obstruction, but cannot adequately address confounding. We hypothesised that treated pulmonary TB is an independent risk factor for chronic airflow obstruction. The Pulmones Post TB cohort study enrolled participants from Lima, Peru, aged 10-70 years with a history of drug-susceptible (DS)- or multidrug-resistant (MDR)-TB who had completed treatment and were clinically cured. Unexposed participants without TB were randomly selected from the same districts...
July 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28712668/treatment-outcomes-of-multidrug-resistant-tuberculosis-patients-in-zhejiang-china-2009-2013
#3
Le Zhang, Qiong Meng, Songhua Chen, Minwu Zhang, Bin Chen, Beibei Wu, Guangsen Yan, Xiaomeng Wang, Zhongwei Jia
OBJECTIVES: To examine treatment outcomes and factors associated with poor outcome of MDR-TB in China. METHODS: Prospective observational cohort study including consecutive patients with MDR-TB between 2009-2013 in six regions of Zhejiang province. Patients were prescribed treatments by infectious disease specialists and treatment outcomes were recorded. Sociodemographic characteristics were obtained through a structured questionnaire. The primary endpoint was poor treatment outcomes, defined as treatment failure based on microbiological persistence, default (lost to follow-up) or death at 24 months...
July 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28700490/side-effects-associated-with-the-treatment-of-multidrug-resistant-tuberculosis-at-a-tuberculosis-referral-hospital-in-south-korea-a-retrospective-study
#4
Tae Won Yang, Hyun Oh Park, Ha Nee Jang, Jun Ho Yang, Sung Hwan Kim, Seong Ho Moon, Joung Hun Byun, Chung Eun Lee, Jong Woo Kim, Dong Hun Kang
Patients with drug-susceptible tuberculosis (TB) show good tolerance of the medications used and have few side effects. However, medications used to treat multidrug-resistant tuberculosis (MDR-TB) have many known side effects. Here, we studied the occurrence of side effects due to treatment of patients with MDR-TB.We conducted a retrospective and consecutive review of the medical records of 256 patients who received treatment for MDR-TB between January 2006 and December 2011.One or more side effects were observed in 95 (37...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28669673/investigation-of-a-pre-xdr-beijing-mycobacterium-tuberculosis-transmission-to-a-healthcare-worker-in-france-2016
#5
Anaïs Appelgren, David Morquin, Sébastien Dufour, Vincent Le Moing, Jacques Reynes, Anne Lotthé, Sylvie Parer, Catherine Corbeau, Alexandra Aubry, Wladimir Sougakoff, Jérôme Solassol, Lucas Bonzon, Yann Dumont, Sylvain Godreuil
We report a case of occupational contamination of a healthcare worker (HCW) by a pre-extensively drug-resistant (pre-XDR) Beijing strain of Mycobacterium tuberculosis in the University Hospital of Montpellier, France. The index case was identified using the genetic fingerprinting of isolates. This report underscores the risk of healthcare-associated contamination by pre-XDR TB in low-incidence countries, the importance of molecular tools for tuberculosis care, and calls for increased vigilance in the management of MDR/XDR TB patients...
June 29, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28633701/management-of-child-mdr-tb-contacts-across-countries-in-the-who-european-region-a-survey-of-current-practice
#6
A Turkova, M Tebruegge, F Brinkmann, M Tsolia, F Mouchet, B Kampmann, J A Seddon
The World Health Organization European Region has one of the highest rates of multidrug-resistant tuberculosis (MDR-TB) in the world, resulting in many vulnerable children being exposed each year. Evidence for preventive therapy following MDR-TB exposure is limited and current guidance is conflicting. An internet-based survey was performed to determine clinical practice in this region. Seventy-two clinicians from 25 countries participated. Practices related to screening and decision-making were highly variable...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28569148/diagnostic-accuracy-and-usefulness-of-the-genotype-mtbdrplus-assay-in-diagnosing-multidrug-resistant-tuberculosis-in-cameroon-a-cross-sectional-study
#7
Ngu Njei Abanda, Josiane Yvonne Djieugoué, Eunjung Lim, Eric Walter Pefura-Yone, Wilfred Fon Mbacham, Guy Vernet, Veronique Mbeng Penlap, Sara Irene Eyangoh, Diane Wallace Taylor, Rose Gana Fomban Leke
BACKGROUND: Drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), is a major public health problem. Effective management of MDR-TB relies on accurate and rapid diagnosis. In this study, we assessed the diagnostic accuracy of the Genotype MTBDRplus assay in diagnosing MDR-TB in Cameroon, and then discuss on its utility within the diagnostic algorithm for MDR-TB. METHODS: In this cross-sectional study, 225 isolates of Mycobacterium tuberculosis cultured from sputum samples collected from new and previously treated pulmonary tuberculosis patients in Cameroon were used to determine the accuracy of the Genotype MTBDRplus assay...
May 31, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28558838/towards-understanding-the-drivers-of-policy-change-a-case-study-of-infection-control-policies-for-multi-drug-resistant-tuberculosis-in-south-africa
#8
Trust Saidi, Faatiema Salie, Tania S Douglas
BACKGROUND: Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon's theoretical framework of policy streams, we explore the temporal ordering of policy framework changes...
May 30, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28545050/prevalence-and-extent-of-heteroresistance-by-next-generation-sequencing-of-multidrug-resistant-tuberculosis
#9
Darwin J Operario, Alexander F Koeppel, Stephen D Turner, Yongde Bao, Suporn Pholwat, Sayera Banu, Suporn Foongladda, Stellah Mpagama, Jean Gratz, Oleg Ogarkov, Svetlana Zhadova, Scott K Heysell, Eric R Houpt
Amplicon-based Next Generation Sequencing (NGS) is an emerging method for Mycobacterium tuberculosis drug susceptibility testing (DST) but has not been well described. We examined 158 clinical multidrug-resistant M. tuberculosis isolates via NGS of 11 resistance-associated gene regions covering 3519 nucleotides. Across these gene regions, complete resistance or heteroresistance (defined as 1%-99% mutation) was present in at least one isolate in 6.3% of loci. The number of isolates with heteroresistance was highest for gyrA codon 94, rpoB codons 526 and 531, and embB codons 306, 372 and 406 (range 11-26% of isolates exhibited heteroresistance)...
2017: PloS One
https://www.readbyqxmd.com/read/28501582/molecular-detection-of-rifampicin-resistance-by-genexpert-%C3%A2-assay-among-treated-and-untreated-pulmonary-tuberculosis-patients-from-khyber-pakhtunkhwa-pakistan
#10
Hazir Rahman, Shakir Ullah Khan, Muhamamd Amjad Khan, Muhammad Qasim, Abdul Jabbar, Sadiq Noor, Zakir Khan, Taj Ali Khan, Mubbashir Hussain, Noor Muhammad, Nawab Ali
OBJECTIVES: Drug-resistant tuberculosis (TB) is an emerging health problem. Rifampicin (RIF) is the major first-line drug against TB. RIF resistance can be used as a marker for the detection of multidrug-resistant TB (MDR-TB). The purpose of this study was to determine the RIF resistance pattern of Mycobacterium tuberculosis complex isolates among treated and untreated patients in Khyber Pakhtunkhwa, Pakistan. METHODS: A total of 349 drug-treated and untreated TB-diagnosed patients were enrolled in this study...
June 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28499828/estimating-the-future-burden-of-multidrug-resistant-and-extensively-drug-resistant-tuberculosis-in-india-the-philippines-russia-and-south-africa-a-mathematical-modelling-study
#11
Aditya Sharma, Andrew Hill, Ekaterina Kurbatova, Martie van der Walt, Charlotte Kvasnovsky, Thelma E Tupasi, Janice C Caoili, Maria Tarcela Gler, Grigory V Volchenkov, Boris Y Kazennyy, Olga V Demikhova, Jaime Bayona, Carmen Contreras, Martin Yagui, Vaira Leimane, Sang Nae Cho, Hee Jin Kim, Kai Kliiman, Somsak Akksilp, Ruwen Jou, Julia Ershova, Tracy Dalton, Peter Cegielski
BACKGROUND: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are emerging worldwide. The Green Light Committee initiative supported programmatic management of drug-resistant tuberculosis in 90 countries. We used estimates from the Preserving Effective TB Treatment Study to predict MDR and XDR tuberculosis trends in four countries with a high burden of MDR tuberculosis: India, the Philippines, Russia, and South Africa. METHODS: We calibrated a compartmental model to data from drug resistance surveys and WHO tuberculosis reports to forecast estimates of incident MDR and XDR tuberculosis and the percentage of incident MDR and XDR tuberculosis caused by acquired drug resistance, assuming no fitness cost of resistance from 2000 to 2040 in India, the Philippines, Russia, and South Africa...
July 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28480653/the-rate-of-drug-resistant-tuberculosis-in-korean-children-and-adolescents-since-2007
#12
Hyun Jung Kim, Hyung Ho Yoon, Byung Wook Eun, Youngmin Ahn, Sungweon Ryoo, Hee Jin Kim
The incidence of drug-resistant tuberculosis (DR-TB) in pediatric populations is a critical indicator of national TB management and treatment strategies. Limited data exist regarding the rate of pediatric DR-TB. In this study, we aimed to analyze the status of DR-TB in Korean children from 2007 to 2013. We analyzed specimens submitted to the Korean Institute of Tuberculosis using Mycobacterium tuberculosis culture and drug susceptibility tests (DSTs) from January 2007 through December 2013. Specimens from patients ≤ 19 years of age were included...
June 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28434936/defining-a-research-agenda-to-address-the-converging-epidemics-of-tuberculosis-and-diabetes-part-1-epidemiology-and-clinical-management
#13
REVIEW
Julia A Critchley, Blanca I Restrepo, Katharina Ronacher, Anil Kapur, Andrew A Bremer, Larry S Schlesinger, Randall Basaraba, Hardy Kornfeld, Reinout van Crevel
There is growing interest in the interaction between type 2 diabetes (DM) and tuberculosis (TB), but many research questions remain unanswered. Epidemiologists, basic scientists and clinical experts recently convened and identified priorities. This is the first of two reviews on this topic, summarising priority areas of research with regard to epidemiology, clinical management and public health. First, from an epidemiological point of view, more study is needed to determine the importance of transient hyperglycemia in TB patients, and on the importance of DM for the global epidemic of multi-drug resistant (MDR)-TB...
April 19, 2017: Chest
https://www.readbyqxmd.com/read/28425873/rapid-detection-of-mycobacterium-tuberculosis-and-rifampicin-resistance-in-extrapulmonary-tuberculosis-and-sputum-smear-negative-pulmonary-suspects-using-xpert-mtb-rif
#14
Irfan Ullah, Arshad Javaid, Haleema Masud, Mazhar Ali, Anila Basit, Waqas Ahmad, Faisal Younis, Rehana Yasmin, Afsar Khan, Abdul Jabbar, Masroor Husain, Zahid Ahmad Butt
BACKGROUND: Tuberculosis (TB) is a serious public health problem in developing countries such as Pakistan. Rapid diagnosis of TB and detection of drug resistance are very important for timely and appropriate management of multidrug-resistant TB (MDR-TB). OBJECTIVE: The purpose of this study was to determine the diagnostic efficacy of the Xpert MTB/RIF assay for rapid diagnosis of TB and detection of rifampicin (RIF) resistance in extrapulmonary and smear-negative pulmonary TB suspects...
April 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28399817/assessments-of-serum-copper-and-zinc-concentration-and-the-cu-zn-ratio-determination-in-patients-with-multidrug-resistant-pulmonary-tuberculosis-mdr-tb-in-c%C3%A3-te-d-ivoire
#15
Gnogbo Alexis Bahi, Lydie Boyvin, Souleymane Méité, Gervais Melaine M'Boh, Kadjowely Yeo, Kouassi Raymond N'Guessan, Alain Dit Philippe Bidié, Allico Joseph Djaman
BACKGROUND: In Côte d'Ivoire, multidrug-resistant tuberculosis (MDR-TB) is a serious public health problem with a prevalence estimated at 2.5% in 2006. Zinc and copper are essential Trace element needed to strengthen the immune system and also useful in the fight against tuberculosis. The Cu / Zn ratio is a good indicator of oxidative stress. The principal aim of this study was to evaluate the serum concentration of some trace element and determine the Cu / Zn ratio in patients with multidrug resistant pulmonary tuberculosis (MDR-TB) before and after second line treatment of TB...
April 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28361737/therapy-of-multidrug-resistant-and-extensively-drug-resistant-tuberculosis
#16
REVIEW
Barbara J Seaworth, David E Griffith
The global epidemic of multidrug-resistant tuberculosis (MDR-TB) caused by Mycobacterium tuberculosis strains resistant to at least isoniazid and rifampin was recently reported as larger than previously estimated, with at least 580,000 new cases reported in 2015. Extensively drug-resistant tuberculosis (XDR-TB), MDR-TB with additional resistance to a second-line fluoroquinolone and injectable, continues to account for nearly 10% of MDR cases globally. Cases in India, China, and the Russian Federation account for >45% of the cases of MDR-TB...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28278406/multidrug-resistant-tuberculosis-in-the-northern-territory-a-10-year-retrospective-case-series
#17
Daniel Judge, Vicki Krause
BACKGROUND AND OBJECTIVE: To describe the clinical characteristics, risk factors, diagnostic modalities, treatments, subsequent outcomes and complications of Multidrug-resistant tuberculosis (MDR-TB) cases residing in the Northern Territory. METHODS: A retrospective case series was conducted of all patients treated for MDR-TB in the Northern Territory between 1 January 2004 and 31 December 2013. This is the first study to analyse data relating to the subset of MDR-TB cases treated in the Northern Territory...
September 30, 2016: Communicable Diseases Intelligence Quarterly Report
https://www.readbyqxmd.com/read/28256380/the-cursed-duet-today-tuberculosis-and-hiv-coinfection
#18
REVIEW
Simon Tiberi, Anna Cristina C Carvalho, Giorgia Sulis, Devan Vaghela, Adrian Rendon, Fernanda C de Q Mello, Ananna Rahman, Nashaba Matin, Ali Zumla, Emanuele Pontali
The tuberculosis (TB) and HIV syndemic continues to rage and are a major public health concern worldwide. This deadly association raises complexity and represent a significant barrier towards TB elimination. TB continues to be the leading cause of death amongst HIV-infected people. This paper reports the challenges that lay ahead and outlines some of the current and future strategies that may be able to address this co-epidemic efficiently. Improved diagnostics, cheaper and more effective drugs, shorter treatment regimens for both drug-sensitive and drug-resistant TB are discussed...
March 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28202091/isolation-unit-for-multidrug-resistant-tuberculosis-patients-in-a-low-endemic-country-a-step-towards-the-world-health-organization-end-tb-strategy
#19
M C Payen, J P VAN Vooren, O Vandenberg, N Clumeck, S DE Wit
Tuberculosis (TB) remains a threat to public health and is the second cause of death due to a single infectious agent after HIV/AIDS. The worldwide distribution of TB is heterogeneous. The incidence is decreasing in most high-income regions, but the situation remains worrying in many parts of the world. The emergence of Mycobacterium tuberculosis strains resistant to key agents used in treatment (rifampin and isoniazid) contributes to TB transmission around the world. To achieve TB elimination, both high and low endemic countries must upscale their efforts to decrease disease transmission and improve cure rates...
May 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28182570/long-term-outcome-and-safety-of-prolonged-bedaquiline-treatment-for-multidrug-resistant-tuberculosis
#20
Lorenzo Guglielmetti, Marie Jaspard, Damien Le Dû, Marie Lachâtre, Dhiba Marigot-Outtandy, Christine Bernard, Nicolas Veziris, Jérôme Robert, Yazdan Yazdanpanah, Eric Caumes, Mathilde Fréchet-Jachym
Bedaquiline, a recently approved drug for the treatment of multidrug-resistant tuberculosis (MDR-TB), is recommended for a duration of 24 weeks. There are scarce data on patients treated with this drug outside clinical trials.All MDR-TB patients who started treatment from January 1, 2011 to December 31, 2013 and received ≥30 days of bedaquiline were included in a multicentre observational cohort.Among 45 MDR-TB patients, 53% harboured isolates resistant to both fluoroquinolones and second-line injectables, and 38% harboured isolates resistant to one of these drug classes...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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