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Management of MDR TB

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https://www.readbyqxmd.com/read/28278406/multidrug-resistant-tuberculosis-in-the-northern-territory-a-10-year-retrospective-case-series
#1
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
#2
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...
February 27, 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
#3
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...
February 16, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28182570/long-term-outcome-and-safety-of-prolonged-bedaquiline-treatment-for-multidrug-resistant-tuberculosis
#4
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...
December 22, 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28157461/multidrug-resistant-tuberculosis-patients-views-of-interventions-to-reduce-treatment-loss-to-follow-up
#5
T Tupasi, A M C G Garfin, J M Mangan, R Orillaza-Chi, L C Naval, G I Balane, R Basilio, A Golubkov, E S Joson, W-J Lew, V Lofranco, M Mantala, S Pancho, J N Sarol, A Blumberg, D Burt, E V Kurbatova
SETTING: Patients who initiated treatment for multidrug-resistant tuberculosis (MDR-TB) at 15 Programmatic Management of Drug-resistant Tuberculosis (PMDT) health facilities in the Philippines between July and December 2012. OBJECTIVES: To describe patients' views of current interventions, and suggest changes likely to reduce MDR-TB loss to follow-up. METHODS: In-depth interviews were conducted between April and July 2014 with MDR-TB patients who were undergoing treatment, had finished treatment at the time of the interview (controls), or had been lost to follow-up (LTFU)...
January 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28110049/performance-of-microscopic-observation-drug-susceptibility-for-the-rapid-diagnosis-of-tuberculosis-and-detection-of-drug-resistance-in-bamako-mali
#6
M Sanogo, B Kone, B Diarra, M Maiga, B Baya, A M Somboro, Y S Sarro, A C G Togo, B P P Dembele, D Goita, A Kone, O M'Baye, N Coulibaly, S Diabate, B Traore, M H Diallo, Y I Coulibaly, P Saleeb, M Belson, S Orsega, S Siddiqui, M A Polis, S Dao, R L Murphy, S Diallo
OBJECTIVES: In Mali early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) are still challenging due to the cost, time and/or complexity associated with regular tests. Microscopic Observation Drug Susceptibility (MODS) is a low-cost assay validated by WHO in 2010. It is a liquid-culture-based assay to detect the 'cording' characteristic of Mycobacterium tuberculosis complex and to assess susceptibility to both isoniazid and rifampicin defining multidrug-resistant tuberculosis (MDR-TB)...
January 18, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28068907/hospitalized-care-for-mdr-tb-in-port-harcourt-nigeria-a-qualitative-study
#7
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/28057041/rifampicin-resistance-pattern-of-mycobacterium-tuberculosis-and-associated-factors-among-presumptive-tuberculosis-patients-referred-to-debre-markos-referral-hospital-ethiopia-a-cross-sectional-study
#8
Wondemagegn Mulu, Bayeh Abera, Mulat Yimer, Tadesse Hailu, Haimanot Ayele, Dereje Abate
BACKGROUND: Prevailing data on rifampicin-resistant M. tuberculosis is essential for early management of MDR-TB. Therefore, this study was conducted to determine the prevalence of rifampicin-resistant Mycobacterium tuberculosis and associated factors among presumptive TB cases in Debre Markos Referral Hospital, Ethiopia. METHODS: A cross-sectional study was conducted from September 2014 to March 2015. Detection of M. tuberculosis and resistance to rifampicin was performed using Gene Xpert MTB/RIF assay...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28043788/comparison-of-bacteriological-conversion-and-treatment-outcomes-among-mdr-tb-patients-with-and-without-diabetes-in-mexico-preliminary-data
#9
M Muñoz-Torrico, J Caminero Luna, G B Migliori, L D'Ambrosio, J L Carrillo-Alduenda, H Villareal-Velarde, A Torres-Cruz, H Flores-Ergara, D Martínez-Mendoza, C García-Sancho, R Centis, M Á Salazar-Lezama, R Pérez-Padilla
Diabetes mellitus (DM) is a well-known risk factor for tuberculosis (TB). However, it is not known to what extent DM affects the outcome in patients with multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) treated with second-line anti-TB drugs. The objective of this study was to compare the microbiological evolution (sputum smear and culture conversion) and final outcomes of MDR/XDR-TB patients with and without DM, managed at the national TB reference centre in Mexico City. RESULTS: Ninety patients were enrolled between 2010 and 2015: 73 with MDR-TB (81...
December 30, 2016: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28043606/ethambutol-resistance-testing-by-mutation-detection-using-mtbdrsl
#10
H Margaryan, S Rüsch-Gerdes, A Hayrapetyan, A Mirzoyan
AIMS AND OBJECTIVES: Despite the successes in managing drug-susceptible TB, drug-resistant (DR) tuberculosis is a major challenge to the effectiveness of National Tuberculosis Program in Armenia, placing the country in the list of 18 high-burden countries for MDR-TB in the WHO European Region. Estimated burden of MDR-TB in 2012 was 9.4 (7-12) and 43 (38-49) among retreatment TB cases. A total of 92 laboratory confirmed cases had been reported to the WHO (57 new and 35 previously treated) out of 511 cases tested for MDR-TB...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28043599/genetic-diversity-transmission-dynamics-and-drug-resistance-of-mycobacterium-tuberculosis-in-luanda-angola
#11
João Perdigão, Sofia Clemente, Jorge Ramos, Pedro Masakidi, Diana Machado, Carla Silva, Isabel Couto, Miguel Viveiros, Nuno Taveira, Isabel Portugal
OBJECTIVE/BACKGROUND: Despite the important role that the African region plays in a global tuberculosis (TB) epidemiological context, many countries in the region still lack data on the prevalence of specific Mycobacterium tuberculosis strains and drug resistance. This is the case for Angola, which presently lacks any data concerning drug-resistance rates and prevalence of specific M. tuberculosis genotypes and respective population structure. In this study, we made the first characterization of the genetic diversity and drug resistance of M...
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
#12
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/28043502/genotypic-analysis-of-multidrug-resistant-tuberculosis-isolates-from-extra-pulmonary-tuberculosis-cases-in-tertiary-care-centers-in-northern-india
#13
Anand K Maurya, Vijaya L Nag, Surya Kant, Ramawadh S Kushwaha, Tapan N Dhole
OBJECTIVE/BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The diagnosis of MDR-TB is of paramount importance in establishing appropriate clinical management and infection control measures. Rapid detection of MDR-TB allows the establishment of an effective treatment regimen, minimizes the risk of further resistance, and limits the spread of drug-resistant strains. The aim of this study is to determine the genotypic characterization of MDR-TB isolates from extra pulmonary tuberculosis (EPTB) cases in tertiary care centers in Northern India...
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
#14
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
#15
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/27979786/exploring-tuberculosis-by-molecular-tests-on-dna-isolated-from-smear-microscopy-slides
#16
REVIEW
Niaina Rakotosamimanana, Marie Sylvianne Rabodoarivelo, Juan Carlos Palomino, Anandi Martin, Voahangy Rasolofo Razanamparany
Tuberculosis (TB) is an infectious disease of global public health importance caused by Mycobacterium tuberculosis complex. The disease has worsened with the emergence of multidrug-resistant (MDR)-TB strains. The timely diagnosis and treatment of TB remains a key public health priority, and laboratories have a critical role in the rapid and accurate detection of TB and drug resistance. Molecular assays based on nucleic acid amplification techniques have been developed for the rapid, sensitive, and specific diagnosis of TB, with the ability to determine the drug sensitivity status...
December 12, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27974543/evaluation-of-the-genotype-mtbdrsl-version-2-0-assay-for-second-line-drug-resistance-detection-of-mycobacterium-tuberculosis-isolates-in-south-africa
#17
Y Gardee, A W Dreyer, H J Koornhof, S V Omar, P da Silva, Z Bhyat, N A Ismail
Early detection of resistance to second-line antituberculosis drugs is important for the management of multidrug-resistant tuberculosis (MDR-TB). The GenoType MTBDRsl version 2.0 (VER 2.0) line probe assay has been redesigned for molecular detection of resistance-conferring mutations of fluoroquinolones (FLQ) (gyrA and gyrB genes) and second-line injectable drugs (SLID) (rrs and eis genes). The study evaluated the diagnostic performance of the GenoType MTBDRsl VER 2.0 assay for the detection of second-line drug resistance compared with phenotypic drug susceptibility testing (DST), using the Bactec MGIT 960 system on Mycobacterium tuberculosis complex isolates from South Africa...
March 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/27927822/clinical-implications-of-the-global-multidrug-resistant-tuberculosis-epidemic
#18
Kartik Kumar, Ibrahim Abubakar
Multidrug-resistant tuberculosis (MDR TB) is a significant threat to global health estimated to account for nearly half a million new cases and over 200,000 deaths in 2013. The number of MDR TB cases in the UK has risen over the last 15 years, with ever more complex clinical cases and associated challenging public health and societal implications. In this review, we provide an overview of the epidemiology of MDR TB globally and in the UK, outline the clinical management of MDR TB and summarise recent advances in diagnostics and prospects for new treatment...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27865234/rapid-detection-of-extensively-drug-resistant-xdr-tb-strains-from-multidrug-resistant-tuberculosis-mdr-tb-cases-isolated-from-smear-negative-pulmonary-samples-in-an-intermediate-reference-laboratory-in-india
#19
Himanshu Vashistha, M Hanif, Sanjeev Saini, Ashwani Khanna, Srashty Sharma, Zeeshan Sidiq, Vasim Ahmed, Manoj Dubey, K K Chopra, Divya Shrivastava
BACKGROUND: Direct sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). The objectives of the study were first, to determine the recovery of Mycobacterium tuberculosis in smear-negative sputum samples through liquid culture (using MGIT 960) and solid culture (using LJ slant) and second, to screen multidrug-resistant isolates through line probe assay and further third, to identify XDR isolates through MGIT second-line DST from these positive MDR cultures in Delhi region...
July 2016: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/27846235/population-based-drug-resistance-surveillance-of-multidrug-resistant-tuberculosis-in-taiwan-2007-2014
#20
Pei-Hua Chuang, Mei-Hua Wu, Shin-Yuan Fan, Keng-Yu Lin, Ruwen Jou
OBJECTIVE: To determine the extent of drug resistance in multidrug-resistant tuberculosis (MDR-TB) cases, we conducted a retrospective, population-based analysis using drug susceptibility testing (DST) results of MDR Mycobacterium tuberculosis complex isolates obtained from 2007-2014 in Taiwan. METHODS: M. tuberculosis isolates collected from 1,331 MDR-TB cases were included in this survey. Treatment histories, age, sex, chest radiograph and bacteriological results of patients were analyzed...
2016: PloS One
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