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Management of MDR TB

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https://www.readbyqxmd.com/read/28905529/who-treatment-guidelines-for-drug-resistant-tuberculosis-2016-update-applicability-in-south-korea
#1
REVIEW
Doosoo Jeon
Despite progress made in tuberculosis control worldwide, the disease burden and treatment outcome of multidrug-resistant tuberculosis (MDR-TB) patients have remained virtually unchanged. In 2016, the World Health Organization released new guidelines for the management of MDR-TB. The guidelines are intended to improve detection rate and treatment outcome for MDR-TB through novel, rapid molecular testing and shorter treatment regimens. Key changes include the introduction of a new, shorter MDR-TB treatment regimen, a new classification of medicines and updated recommendations for the conventional MDR-TB regimen...
September 1, 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28903800/predicting-treatment-failure-death-and-drug-resistance-using-a-computed-risk-score-among-newly-diagnosed-tb-patients-in-tamaulipas-mexico
#2
B E Abdelbary, M Garcia-Viveros, H Ramirez-Oropesa, M H Rahbar, B I Restrepo
The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use...
September 14, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28817723/sequence-analysis-of-the-rifampicin-resistance-determining-region-rrdr-of-rpob-gene-in-multidrug-resistance-confirmed-and-newly-diagnosed-tuberculosis-patients-of-punjab-pakistan
#3
Salma Hameed, Kartyk Moganeradj, Nasir Mahmood, Timothy D McHugh, Muhammad Nawaz Chaudhry, Catherine Arnold
Molecular screening of new patients suspected for TB could help in the effective control of TB in Pakistan as it is a high TB burden country. It will be informative to understand the prevalence of multi drug resistance for a better drug regimen management in this geographical area. The Rifampicin resistance determining region (RRDR) sequencing was used to identify mutations associated with drug resistance in DNA extracts from 130 known multidrug resistant (MDR) cultured strains and compared with mutations observed in DNA extracts directly from 86 sputum samples from consecutive newly diagnosed cases in Lahore, Pakistan...
2017: PloS One
https://www.readbyqxmd.com/read/28814276/treatment-outcomes-of-patients-with-multidrug-resistant-and-extensively-drug-resistant-tuberculosis-in-hunan-province-china
#4
Kefyalew Addis Alene, Hengzhong Yi, Kerri Viney, Emma S McBryde, Kunyun Yang, Liqiong Bai, Darren J Gray, Archie C A Clements, Zuhui Xu
BACKGROUND: The worldwide emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has posed additional challenges for global tuberculosis (TB) control efforts, as limited treatment options are available and treatment outcomes are often sub-optimal. This study determined treatment outcomes among a cohort of MDR-TB and XDR-TB patients in Hunan Province, China, and identified factors associated with poor treatment outcomes. METHODS: We conducted a retrospective study using data obtained from medical records of TB patients in Hunan Chest Hospital, and from the internet-based TB management information system managed by the Tuberculosis Control Institute of Hunan Province, for the period 2011 to 2014...
August 16, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28756826/frequency-of-multi-drug-resistance-and-mutations-in-mycobacterium-tuberculosis-isolates-from-punjab-state-of-india
#5
Ritu Singhal, Jyoti Arora, Grish C Sah, Manpreet Bhalla, Rohit Sarin, Vithal Prasad Myneedu
Data regarding prevalence of multi-drug resistant tuberculosis (MDR-TB) and associated common mutations is scarce from Punjab region. The study was designed to determine rate of MDR-TB among presumptive MDR-TB from Punjab and mutation patterns using GenoType MTBDRplus assay. Total of 812 consecutive sputum samples were received from January 2012 to July 2013, from 14 districts of Punjab at the National Reference Laboratory at New Delhi for diagnosis of MDR-TB as hand holding activity. Presumptive MDR-TB patients were identified on basis of criterion B defined by the programme...
September 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/28749390/extensively-drug-resistant-tuberculosis-in-india-current-evidence-on-diagnosis-management
#6
REVIEW
Rajendra Prasad, Abhijeet Singh, Viswesvaran Balasubramanian, Nikhil Gupta
Emergence of extensively drug-resistant tuberculosis (XDR-TB) has significantly threatened to jeopardize global efforts to control TB, especially in HIV endemic regions. XDR-TB is mainly an iatrogenically created issue, and understanding the epidemiological and risk factors associated with it is of paramount importance in curbing this menace. Emergence of this deadly phenomenon can be prevented by prompt diagnosis and effective treatment with second-line drugs in rifampicin-resistant TB (RR-TB) as well as multidrug-resistant TB (MDR-TB) patients...
March 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28744149/determinants-of-multidrug-resistant-tuberculosis-in-addis-ababa-ethiopia
#7
Demelash Assefa, Berhanu Seyoum, Lemessa Oljira
Multidrug-resistant tuberculosis (MDR-TB) has been jeopardizing the global effort to prevent and control tuberculosis (TB). However, data on MDR-TB in Ethiopia in general, and in our study area in particular, are very scarce. The aim of this study was to identify determinants of MDR-TB in a cohort of patients managed in two referral hospitals of Addis Ababa, Ethiopia, between April 1, 2013 and June 30, 2013. A health facility-based case-control study was conducted. A total of 710 TB patients (229 confirmed MDR-TB and 481 drug susceptible TB patients) were enrolled in this study...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28743645/extensively-drug-resistant-tuberculosis-in-morocco
#8
Wifak Ennassiri, Sanae Jaouhari, Wafa Cherki, Reda Charof, Abdelkarim Filali-Maltouf, Ouafae Lahlou
OBJECTIVES: Extensively drug-resistant tuberculosis (XDR-TB) has recently been identified as a major global health threat. The aim of the study was to evaluate the XDR-TB presence within TB isolates in Morocco, and its association with the demographic, clinical and epidemiological features. METHODS: A total of 524 patients from the National Tuberculosis Reference Laboratory, representative of all the geographic regions, were subject to first-line drug susceptibility testing (DST)...
July 22, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28743312/emergence-of-fluoroquinolone-resistance-among-drug-resistant-tuberculosis-patients-at-a-tertiary-care-facility-in-karachi-pakistan
#9
Syed Mohammad Asad Zaidi, Abdul Haseeb, Shifa Salman Habib, Amyn Malik, Saira Khowaja, Nausheen SaifUllah, Nadeem Rizvi
BACKGROUND: Pakistan is classified as one of the high multi-drug resistant tuberculosis (MDR-TB) burden countries. A poorly regulated private sector, over-prescription of antibiotics and self-medication has led to augmented rates of drug-resistance in the country. Pakistan's first national anti-tuberculosis drug resistance survey identified high prevalence of fluoroquinolone resistance among MDR-TB patients. Further institutional evidence of fluoroquinolone drug-resistance can support re-evaluation of treatment regimens as well as invigorate efforts to control antibiotic resistance in the country...
July 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28729186/-tuberculosis-treatment-for-children-an-update
#10
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
#11
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
#12
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
#13
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-pre-xdr-beijing-mycobacterium-tuberculosis-transmission-to-a-healthcare-worker-in-france-2016
#14
A Appelgren, D Morquin, S Dufour, V Le Moing, J Reynes, A Lotthé, S Parer, C Corbeau, A Aubry, W Sougakoff, J Solassol, L Bonzon, Y Dumont, S Godreuil
A case of occupational contamination of a healthcare worker by a pre-extensively drug-resistant (pre-XDR) Beijing strain of Mycobacterium tuberculosis at the University Hospital of Montpellier, France is reported. The index case was identified using genetic fingerprinting of isolates. This report underscores the risk of healthcare-associated contamination by pre-XDR tuberculosis (TB) in low-incidence countries and the importance of molecular tools for TB care. It also calls for increased vigilance in the management of multi-drug-resistant/XDR TB patients...
June 30, 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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