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Management of MDR TB

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https://www.readbyqxmd.com/read/29351672/high-treatment-success-rate-among-multidrug-resistant-tuberculosis-patients-in-myanmar-2012-2014-a-retrospective-cohort-study
#1
Myat K Thu, Ajay M V Kumar, Kyaw T Soe, Saw Saw, Saw Thein, Zaw Mynit, Htet M W Maung, Si T Aung
Background: Since 2011, Myanmar has adopted domiciliary care for multidrug-resistant tuberculosis (MDR-TB) patients and implemented several patient-support measures such as community-based directly observed treatment, nutritional support and financial incentives for patients and providers. We assessed treatment outcomes among MDR-TB patients registered for treatment in the Yangon and Mandalay Regions of Myanmar during 2012-2014 and factors associated with unfavourable treatment outcomes...
January 17, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29336677/molecular-screening-versus-phenotypic-susceptibility-testing-of-multidrug-resistant-mycobacterium-tuberculosis-isolates-for-streptomycin-and-ethambutol
#2
Noura M Al-Mutairi, Suhail Ahmad, Eiman Mokaddas
Proper management of multidrug-resistant tuberculosis (MDR-TB) requires accurate drug susceptibility testing (DST) of Mycobacterium tuberculosis isolates to other (ethambutol [EMB], pyrazinamide, and streptomycin [SM]) first-line drugs. This study compared the performance of Mycobacterium Growth Indicator Tube (MGIT) 960 system for DST of MDR-TB isolates with polymerase chain reaction (PCR) sequencing of embB, rpsL, and rrs genes for detecting resistance to EMB and SM. MDR-TB strains (n = 60) and 25 pansusceptible M...
January 16, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/29319042/multidrug-resistant-tuberculosis-rifampicin-resistant-tuberculosis-principles-of-management
#3
Rajendra Prasad, Nikhil Gupta, Amitabh Banka
Multidrug-resistant tuberculosis (MDR-TB)/rifampicin-resistant TB (RR-TB) is human-made problem and emerging due to poor management of TB and is a threat to control of TB. Early suspicion and diagnosis are important. Culture and drug susceptibility testing are gold standards, but newer molecular methods help in rapid diagnosis. Once diagnosed, prompt treatment should be started, preferably under direct observation. Treatment can be standardized or individualized. Conventional regimen takes up to 24 months but recently shorter regimen of up to 12 months was introduced in specific subset of MDR-TB/RR-TB patients...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29319026/sequelae-of-pulmonary-multidrug-resistant-tuberculosis-at-the-completion-of-treatment
#4
Rupak Singla, Manashree Mallick, Parul Mrigpuri, Neeta Singla, Amitesh Gupta
BACKGROUND: Treatment of multidrug-resistant (MDR-TB) mainly focuses on bacteriological cure. However, only limited studies have evaluated the sequelae left after the completion of treatment among MDR-TB patients. OBJECTIVE: To assess the persistent symptoms, radiological sequelae, pulmonary function impairment and quality of life at the completion of treatment among MDR-TB patients. METHODS: Forty six MDR-TB patients were enrolled, who completed two years of treatment under programmatic management of Drug Resistant tuberculosis at a tertiary referral institute in Delhi, India...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29302148/association-of-risk-factors-and-drug-resistance-pattern-in-tuberculosis-patients-in-north-india
#5
Pallavi Sinha, G N Srivastava, Anamika Gupta, Shampa Anupurba
Context: India is one of the high tuberculosis (TB) burden countries in the world. Improper implementation in the guidelines for the management of TB and high rate of defaults on the part of the patients are most important risk factors for the development of multi-drug resistant TB. Aims: This study examines the drug resistance profile and the effect of demographic, clinical and behavioral risk factors on the prevalence of TB and multidrug resistance (MDR) in north India...
October 2017: Journal of Global Infectious Diseases
https://www.readbyqxmd.com/read/29280409/challenges-of-using-new-and-repurposed-drugs-for-the-treatment-of-multidrug-resistant-tuberculosis-in-children
#6
H Simon Schaaf, Anthony J Garcia-Prats, Lindsay McKenna, James A Seddon
New and repurposed antituberculosis drugs are urgently needed to more safely and effectively treat multidrug-resistant (MDR) tuberculosis (TB) in children. Multiple challenges limit timely access to new MDR-TB treatments in children. Areas covered: Diagnosis of MDR-TB in children remains a barrier, with few children with MDR-TB diagnosed and treated. Other barriers to timely access to new and repurposed drugs are discussed, and include delayed initiation of paediatric trials, limited funding for paediatric drug development, fragmented regulatory systems and operational challenges...
December 27, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29238270/treatment-of-latent-tuberculosis-infection
#7
REVIEW
Patrick Tang, James Johnston
The treatment of latent tuberculosis infection (LTBI) is an essential component of tuberculosis (TB) elimination in regions that have a low incidence of TB. However, the decision to treat individuals with LTBI must consider the limitations of current diagnostic tests for LTBI, the risk of developing active TB disease, the potential adverse effects from chemoprophylactic therapy, and the importance of treatment adherence. When an individual has been diagnosed with LTBI and active TB has been ruled out, this is followed by an evaluation of the risks and benefits of LTBI treatment within the context of the regional epidemiology of TB and public health priorities...
2017: Current Treatment Options in Infectious Diseases
https://www.readbyqxmd.com/read/29229274/team-approach-to-manage-difficult-to-treat-tb-cases-experiences-in-europe-and-beyond
#8
L D'Ambrosio, G Bothamley, J A Caminero Luna, R Duarte, L Guglielmetti, M Muñoz Torrico, M C Payen, N Saavedra Herrera, M A Salazar Lezama, A Skrahina, M Tadolini, S Tiberi, N Veziris, G B Migliori
As recommended by the World Health Organization (WHO), optimal management of MDR-TB cases can be ensured by a multi-speciality consultation body known as 'TB Consilium'. This body usually includes different medical specialities, competences and perspectives (e.g., clinical expertise both for adults and children; surgical, radiological and public health expertise; psychological background and nursing experience, among others), thus lowering the risk of making mistakes - or managing the patients inappropriately, in order to improve their clinical outcomes...
December 8, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29219878/community-based-management-of-multiple-drug-resistant-tuberculosis-in-a-tertiary-hospital-in-tanzania-a-best-practice-implementation-project
#9
Isaya Jelly, Micah D J Peters
BACKGROUND: The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. AIM: The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29130630/a-structure-based-strategy-toward-the-development-of-novel-candidates-for-antimycobacterial-activity-synthesis-biological-evaluation-and-docking-study
#10
Linhu Li, Yuanyuan Jin, Bin Wang, Zhaoyong Yang, Mingliang Liu, Huiyuan Guo, Jun Zhang, Yu Lu
Bacterial resistance to most of the available antibiotics has stimulated the discovery of novel efficacious antibacterial agents. Bedaquiline is first of its type that has been specifically introduced for the management of MDR-TB in combination with other drugs. In the current study, a series of isoniazid/ethambutol/pyrazinamide -quinoline conjugates based on the structures of Bedaquiline were designed and synthesized. Biological activity tests revealed that some of isoniazid/ethambutol-quinoline conjugates have useful antibiotic activity against MTB H37Rv (MIC: 2...
November 11, 2017: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/29116637/epidemiology-of-drug-resistant-tuberculosis
#11
Anna S Dean, Helen Cox, Matteo Zignol
As we move into the era of the Sustainable Development Goals (SDGs), the World Health Organization (WHO) has developed the End TB strategy 2016-2035 with a goal to end the global epidemic of tuberculosis (TB) by 2035. Achieving the targets laid out in the Strategy will require strengthening of the whole TB diagnosis and treatment cascade, including improved case detection, the establishment of universal drug susceptibility testing and rapid treatment initiation. An estimated 3.9% of new TB cases and 21% of previously treated cases had rifampicin-resistant (RR) or multidrug-resistant (MDR) TB in 2015...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29098997/adverse-drug-reactions-and-treatment-outcome-analysis-of-dots-plus-therapy-of-mdr-tb-patients-at-district-tuberculosis-centre-a-four-year-retrospective-study
#12
Arif I Dela, Nitish Kumar D Tank, Anil P Singh, Kiran G Piparva
BACKGROUND: Treatment of multidrug-resistant tuberculosis (MDR-TB) requires the use of expensive and toxic second-line anti-tubercular drugs which are given for a longer duration. Adverse drug reactions (ADRs) of second-line antitubercular drugs affect compliance and thereby treatment outcome. We set out to analyze ADRs and treatment outcome of MDR-TB patients receiving directly observed treatments plus therapy. MATERIALS AND METHODS: A retrospective study of registered MDR-TB cases at district tuberculosis center during 2010-2014 was performed...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29094039/host-directed-therapeutic-strategies-for-tuberculosis
#13
REVIEW
Afsal Kolloli, Selvakumar Subbian
Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a leading cause of morbidity and mortality in humans worldwide. Currently, the standard treatment for TB involves multiple antibiotics administered for at least 6 months. Although multiple antibiotics therapy is necessary to prevent the development of drug resistance, the prolonged duration of treatment, combined with toxicity of drugs, contributes to patient non-compliance that can leads to the development of drug-resistant Mtb (MDR and XDR) strains...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29061336/management-of-mdr-tb-in-hiv-co-infected-patients-in-eastern-europe-results-from-the-tb-hiv-study
#14
A M W Efsen, A Schultze, R F Miller, A Panteleev, A Skrahin, D N Podlekareva, J M Miro, E Girardi, H Furrer, M H Losso, J Toibaro, J A Caylà, A Mocroft, J D Lundgren, F A Post, O Kirk
OBJECTIVES: Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. METHODS: In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). RESULTS: A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB...
October 20, 2017: Journal of Infection
https://www.readbyqxmd.com/read/29050672/genetic-diversity-of-multidrug-resistant-mycobacterium-tuberculosis-strains-isolated-from-tuberculosis-patients-in-iran-using-miru-vntr-technique
#15
Azar Dokht Khosravi, Abdolrazagh Hashemi Shahraki, Soolmaz Khandan Dezfuli, Mohammad Hashemzadeh, Hamed Goodarzi, Parviz Mohajeri
Tuberculosis (TB) is considered as one of the most important infectious diseases in the world, and recent rise and spread of multidrug-resistant (MDR) Mycobacterium tuberculosis (MTB) strains, have made the matter worsened. Due to the importance of TB prevalence in Iran, this study was designed to investigate the genetic diversity among MDR strains of MTB by MIRU-VNTR typing scheme. A total of 88 drug resistant M. tuberculosis isolates belong to pulmonary TB cases were collected from several TB reference centers of Iran...
November 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29033301/characterization-of-gyra-and-gyrb-mutations-associated-with-fluoroquinolone-resistance-in-mycobacterium-tuberculosis-isolates-from-morocco
#16
Imane Chaoui, Amal Oudghiri, Mohammed El Mzibri
BACKGROUND: Fluoroquinolones (FQs) are the cornerstone for treatment of drug-resistant TB, there are the most effective second-line anti-mycobacterial drugs and are recommended for the treatment of MDR-TB. However, it's widely accepted that FQs resistance is high among MDR-TB. Thus, characterization of mutations conferring resistance to FQs will be of a great interest for an effective and efficient management of TB resistance in Morocco. METHODS: A laboratory collection of 30 MTB isolates already characterized as phenotypically and genotypically MDR and 20 pan-susceptible isolates randomly selected were enrolled in this retrospective study...
October 12, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29027495/monitoring-and-managing-antibiotic-resistance-in-refugee-children
#17
Helena C Maltezou, Dana Elhadad, Daniel Glikman
The past decade the Middle East and Southeastern Europe have witnessed an enormous movement of refugees due to the Syrian war and conflicts in Asia and Africa. Although carriage of and infections with multi-drug resistant (MDR) pathogens in refugees have been reported, pediatric data are scarce. Areas covered: MDR bacterial carriage and infections, and MDR-tuberculosis (TB) in refugee children from 2010. Expert commentary: High MDR carriage rates in refugee children are attributed to high pre-civil war MDR rates, war-damaged infrastructure and healthcare systems, and poor hygiene conditions...
November 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28962599/predictors-of-unsuccessful-interim-treatment-outcomes-of-multidrug-resistant-tuberculosis-patients
#18
Muhammad Atif, Arslan Bashir, Nafees Ahmad, Razia Kaneez Fatima, Sehar Saba, Shane Scahill
BACKGROUND: Interim treatment outcomes at 6-months for multidrug-resistant tuberculosis (MDR-TB) treatment are among the most basic performance monitoring and key evaluation indicators in the Stop and End TB strategy of the World Health Organization (WHO). Therefore, this study was conducted to evaluate the interim treatment outcomes of MDR-TB patients in Pakistan. METHODS: This study was conducted at the Programmatic Management Unit for Drug-resistance TB (PMDT) site of the National Tuberculosis Program (NTP), Pakistan...
September 29, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28946683/usability-of-a-medication-event-reminder-monitor-system-merm-by-providers-and-patients-to-improve-adherence-in-the-management-of-tuberculosis
#19
Xiaoqi Liu, Terrence Blaschke, Bruce Thomas, Sabina De Geest, Shiwen Jiang, Yongxin Gao, Xinxu Li, Elizabeth Whalley Buono, Stacy Buchanan, Zhiying Zhang, Shitong Huan
Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories...
September 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28941848/drug-development-against-tuberculosis-past-present-and-future
#20
REVIEW
Mahesh S Vasava, Manoj N Bhoi, Sanjay K Rathwa, Mayuri A Borad, Sneha G Nair, Hitesh D Patel
Infection of Mycobacterium tuberculosis (MTB) was observed as early as 5000 years ago with evidence, which is a primeval enemy of the humanoid race. MTB is the pathogen which is responsible for causing the infectious disease tuberculosis; it remains a major cause of morbidity and mortality in poor low-income countries as well as in developing countries because of non-availability of reliable laboratory facilities. The current treatment for drug-resistant tuberculosis (TB) is lengthy, complex, and connected with severe harmful side effects and poor outcomes...
October 2017: Indian Journal of Tuberculosis
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