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Management of MDR TB

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/27836793/european-policies-in-the-management-of-tuberculosis-among-migrants
#3
Lia D'Ambrosio, Rosella Centis, Masoud Dara, Ivan Solovic, Giorgia Sulis, Alimuddin Zumla, Giovanni Battista Migliori
Globally 10.4 million new TB incident cases were estimated to have occurred in 2015, of which 3% were reported in the European Region of the World Health Organization. Importantly, about 25% of the global multidrug-resistant TB (MDR-TB) cases are reported in the European Region, representing one of the greatest challenges of TB control particularly in Former Soviet Union Countries. Over a quarter of TB cases in the European Union and European Economic Area (EU/EEA) are reported among foreign-born individuals...
November 8, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27818361/classifying-new-anti-tb-drugs-rationale-and-future-perspectives
#4
Simon Tiberi, Anna Scardigli, Rosella Centis, Lia D'Ambrosio, Marcela Muñoz-Torrico, Miguel Ángel Salazar-Lezama, Antonio Spanevello, Dina Visca, Alimuddin Zumla, Giovanni Battista Migliori, Jose A Caminero Luna
The classification of anti-tuberculosis (TB) drugs is important as it serves the clinician in building an appropriate anti-TB regimen for multidrug (MDR-) and extensively drug resistant (XDR-) TB cases which do not fulfil criteria for the shorter MDR-TB regimen. The World Health Organization (WHO) has recently approved a revision of the classification of new anti-TB drugs based on current evidence on each drug. In the previous WHO guidelines the drug choice was based on their efficacy and toxicity, in a step-down manner from Group 1, including first-line drugs and Group 2-5 including second- line drugs, to Group 5 including drugs with potentially limited efficacy or limited clinical evidence...
November 3, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27806714/the-emerging-threat-of-pre-extensively-drug-resistant-tuberculosis-in-west-africa-preparing-for-large-scale-tuberculosis-research-and-drug-resistance-surveillance
#5
Florian Gehre, Jacob Otu, Lindsay Kendall, Audrey Forson, Awewura Kwara, Samuel Kudzawu, Aderemi O Kehinde, Oludele Adebiyi, Kayode Salako, Ignatius Baldeh, Aisha Jallow, Mamadou Jallow, Anoumou Dagnra, Kodjo Dissé, Essosimna A Kadanga, Emmanuel Oni Idigbe, Catherine Onubogu, Nneka Onyejepu, Aissatou Gaye-Diallo, Awa Ba-Diallo, Paulo Rabna, Morto Mane, Moumine Sanogo, Bassirou Diarra, Zingue Dezemon, Adama Sanou, Madikay Senghore, Brenda A Kwambana-Adams, Edward Demba, Tutty Faal-Jawara, Samrat Kumar, Leopold D Tientcheu, Adama Jallow, Samba Ceesay, Ifedayo Adetifa, Assan Jaye, Mark J Pallen, Umberto D'Alessandro, Beate Kampmann, Richard A Adegbola, Souleymane Mboup, Tumani Corrah, Bouke C de Jong, Martin Antonio
BACKGROUND: Drug-resistant tuberculosis (TB) is a global public health problem. Adequate management requires baseline drug-resistance prevalence data. In West Africa, due to a poor laboratory infrastructure and inadequate capacity, such data are scarce. Therefore, the true extent of drug-resistant TB was hitherto undetermined. In 2008, a new research network, the West African Network of Excellence for Tuberculosis, AIDS and Malaria (WANETAM), was founded, comprising nine study sites from eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo)...
November 3, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27803747/multi-drug-resistant-tuberculous-spondylitis-a-review-of-the-literature
#6
REVIEW
Quratulain Fatima Kizilbash, Barbara Joyce Seaworth
While tuberculous vertebral osteomyelitis is an ancient scourge, multi-drug resistant-tuberculosis (MDR-TB) is a modern major public health concern. The objective of this study was to review and summarize the data available on MDR-TB spondylitis. An extensive search of the PubMed database was conducted for articles in English relevant to MDR-TB spondylitis by December 2015. Tuberculous spondylitis accounts for 0.5-1% of all TB cases, and it is estimated that there are probably 5000 MDR-TB spondylitis cases each year worldwide...
October 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27776589/provider-perspectives-on-drug-resistant-tuberculosis-and-human-immunodeficiency-virus-care-in-south-africa-a-qualitative-case-study
#7
A Daftary, N Padayatchi
OBJECTIVE: To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. DESIGN: Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. RESULTS: Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss...
November 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27770535/conflict-in-eastern-ukraine-strategy-for-tuberculosis
#8
T Kuchuloria, T Akhvlediani, N Akhvlediani
This root cause analysis concerns the conflict in the Eastern Ukraine and its impact on healthcare delivery in the context of treating internally displaced persons (IDPs). Inadequate treatment of tuberculosis (TB) was selected as a major topic for intervention planning in conflict areas in Ukraine. With respect to treating TB among IDPs, rapid diagnosis and adequate nutrition and shelter are important components of care and disease control. The DOT, supported by trained primary healthcare providers equipped with rapid MDR TB diagnostic capacities, need to provide appropriate shelter and nutrition to IDPs...
September 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27756712/clinical-management-of-adults-and-children-with-mdr-and-xdr-tb
#9
REVIEW
Keertan Dheda, Kwok Chiu Chang, Lorenzo Guglielmetti, Jennifer Furin, H Simon Schaaf, Dumitru Chesov, Aliasgar Esmail, Christoph Lange
Globally there is a burgeoning epidemic of drug mono-resistant tuberculosis (TB), multi-drug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB). Almost 20% of all TB strains worldwide are resistant to at least 1 major TB drug including isoniazid. In several parts of the world there is an increasing incidence of MDR-TB, and alarmingly almost a third of MDR-TB cases globally are resistant to either a fluoroquinolone or aminoglycocide. This trend cannot be ignored because DR-TB is associated with greater morbidity compared to drug-sensitive TB, it accounts for almost 25% of global TB mortality, is extremely costly to treat, consuming substantial portions of budgets allocated to national TB programmes in TB endemic countries, and is a major threat to healthcare workers who are already in short supply in resource-poor settings...
October 15, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27756241/drug-susceptibility-profiles-of-pulmonary-mycobacterium-tuberculosis-isolates-from-patients-in-informal-urban-settlements-in-nairobi-kenya
#10
Glennah Kerubo, Evans Amukoye, Stefan Niemann, Samuel Kariuki
BACKGROUND: Anti-tuberculosis drug resistance is an emerging health problem in Kenya and especially in slums. Slum environments create a conducive environment for the spread of tuberculosis (TB) due to high population density and lack of basic amenities such as decent housing, access to clean water, lack of drainage and basic sanitation. Furthermore, ineffective health services in crowded and poorer populations, poor patient compliance, a large pool of untreated cases, delayed diagnosis and inappropriate treatment regimens are likely to favour selection and spread of drug resistant Mycobacterium tuberculosis (Mtb) strains in such settings, however, precise data on this problem are only sparsely available...
October 19, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27730779/abdominal-tuberculosis
#11
Pravin Rathi, Pravir Gambhire
Abdomen is involved in 11% of patients with extra-pulmonary tuberculosis; The most common site of involvement is the ileocaecal region, other locations of involvement, in order of descending frequency, are the ascending colon, jejunum, appendix, duodenum, stomach, oesophagus, sigmoid colon, and rectum. Apart from the basic work up, Investigations like CT scan, EUS, Capsule endoscopy, Balloon enteroscopy, Ascitic fluid ADA, TB-PCR, GeneXpert, Laproscopy are being increasingly used to diagnose tuberculosis.Therapy with standard antituberculous drugs is usually highly effective for intestinal TB...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27725051/comparing-laboratory-costs-of-smear-culture-and-xpert-%C3%A2-mtb-rif-based-tuberculosis-diagnostic-algorithms
#12
P Naidoo, R Dunbar, E du Toit, M van Niekerk, S B Squire, N Beyers, J Madan
SETTING: Cape Town, South Africa, where Xpert(®) MTB/RIF was introduced as a screening test for all presumptive tuberculosis (TB) cases. OBJECTIVE: To compare laboratory costs of smear/culture- and Xpert-based tuberculosis (TB) diagnostic algorithms in routine operational conditions. METHODS: Economic costing was undertaken from a laboratory perspective, using an ingredients-based costing approach. Cost allocation was based on reviews of standard operating procedures and laboratory records, timing of test procedures, measurement of laboratory areas and manager interviews...
October 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27665703/multidrug-resistant-tuberculosis-and-migration-to-europe
#13
Sally Hargreaves, Knut Lönnroth, Laura B Nellums, Ioana D Olaru, Ruvandhi R Nathavitharana, Marie Norredam, Jon S Friedland
Multidrug-resistant tuberculosis (MDR-TB) in low-incidence countries in Europe is more prevalent among migrants than the native population. The impact of the recent increase in migration to EU and EEA countries with a low incidence of TB (fewer than 20 cases per 100,000 [1]) on MDR-TB epidemiology is unclear. This narrative review synthesises evidence on MDR-TB and migration identified through an expert panel and database search. A significant proportion of MDR-TB cases in migrants result from reactivation of latent infection...
September 22, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27553018/tuberculosis-and-its-management-an-overview
#14
Ranju Bansal, Deepika Sharma, Ranjit Singh
Tuberculosis (TB) is a primordial infectious disease that mainly affects the lungs. Mycobacterium tuberculosis (M. tuberculosis) is the etiological agent of TB and currently more than one-third of the world population is suffering from TB. For the treatment of TB, administration of multiple antibiotics such as isoniazid, rifampicin, pyrazinamide and ethambutol is required for long time period to kill the bacteria. Therefore antibiotic resistance is the emerging problem in multiple drug-resistant tuberculosis (MDR-TB) infections...
August 23, 2016: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/27552155/high-treatment-success-rates-among-hiv-infected-multidrug-resistant-tuberculosis-patients-after-expansion-of-antiretroviral-therapy-in-botswana-2006-2013
#15
Sanghyuk S Shin, Chawangwa Modongo, Rosanna Boyd, Cynthia Caiphus, Lesego Kuate, Botshelo Kgwaadira, Nicola M Zetola
BACKGROUND: Few studies have examined multidrug-resistant (MDR) tuberculosis (TB) treatment outcomes among HIV-infected persons after widespread expansion of antiretroviral therapy (ART). We describe MDR-TB treatment outcomes among HIV-infected and HIV-uninfected patients in Botswana after ART expansion. METHODS: We retrospectively reviewed data from patients who started MDR-TB therapy in Botswana during 2006-2013. Multivariable regression models were used to compare treatment outcomes between HIV-infected and HIV-uninfected patients...
January 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27530852/whole-genome-sequencing-of-multidrug-resistant-mycobacterium-tuberculosis-isolates-from-myanmar
#16
Htin Lin Aung, Thanda Tun, Danesh Moradigaravand, Claudio U Köser, Wint Wint Nyunt, Si Thu Aung, Thandar Lwin, Kyi Kyi Thinn, John A Crump, Julian Parkhill, Sharon J Peacock, Gregory M Cook, Philip C Hill
Drug-resistant tuberculosis (TB) is a major health threat in Myanmar. An initial study was conducted to explore the potential utility of whole-genome sequencing (WGS) for the diagnosis and management of drug-resistant TB in Myanmar. Fourteen multidrug-resistant Mycobacterium tuberculosis isolates were sequenced. Known resistance genes for a total of nine antibiotics commonly used in the treatment of drug-susceptible and multidrug-resistant TB (MDR-TB) in Myanmar were interrogated through WGS. All 14 isolates were MDR-TB, consistent with the results of phenotypic drug susceptibility testing (DST), and the Beijing lineage predominated...
September 2016: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27530850/predictors-of-death-among-drug-resistant-tuberculosis-patients-in-kuala-lumpur-malaysia-a-retrospective-cohort-study-from-2009-to-2013
#17
Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin
The emergence of drug-resistant tuberculosis (TB) is a major public health threat. However, little is known about the predictors of death in drug-resistant TB in Malaysia. This study aimed to determine the predictors of death in drug-resistant TB patients, including multidrug-resistant TB (MDR-TB), in Kuala Lumpur, Malaysia. This study adopted a retrospective cohort study design and involved laboratory-confirmed drug-resistant TB patients (n=426) from January 2009 to June 2013. A Cox regression model and Kaplan-Meier curves were used to model the outcome measure...
September 2016: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27524534/prevalence-and-drug-resistance-pattern-of-mdr-tb-in-retreatment-cases-of-punjab-pakistan
#18
Abdul Majeed Akhtar, Muhammad Awais Arif, Shamsa Kanwal, Sadia Majeed
OBJECTIVE: To determine the prevalence and resistance pattern of multidrug-resistant tuberculosis. METHODS: This cross-sectional study was carried out from January 2010 to June 2014 in nine tertiary care hospitals implementing programmatic management of drug-resistant tuberculosis in Punjab, and comprised retreatment tuberculosis cases. Data was collected from the Electronic Nominal Review System. SPSS 17 was used for data analysis. RESULTS: Of the 1,250 cases, 861(69%) were of multidrug-resistant tuberculosis confirmed through drug sensitivity testing...
August 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27519406/rifampicin-resistance-mutations-in-the-81%C3%A2-bp-rrdr-of-rpob-gene-in-mycobacterium-tuberculosis-clinical-isolates-using-xpert-mtb-rif-in-khyber-pakhtunkhwa-pakistan-a-retrospective-study
#19
Irfan Ullah, Aamer Ali Shah, Anila Basit, Mazhar Ali, Afsar Khan, Ubaid Ullah, Muhammad Ihtesham, Sumaira Mehreen, Anita Mughal, Arshad Javaid
BACKGROUND: Multi-drug resistant tuberculosis (MDR-TB) is a major public health problem especially in developing countries. World Health Organization (WHO) recommends use of Xpert MTB/RIF assay to simultaneously detecting Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance. The primary objective of this study was to determine the frequency of MDR-TB in patients suspected to have drug resistance in Khyber Pakhtunkhwa. The frequency of probes for various rpoB gene mutations using Xpert MTB/RIF assay within 81 bp RRDR (Rifampicin Resistance Determining Region) was the secondary objective...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27510247/multidrug-resistant-tuberculosis-patients-lost-to-follow-up-self-reported-readiness-to-restart-treatment
#20
J M Mangan, T E Tupasi, A M C G Garfin, V Lofranco, R Orillaza-Chi, R Basilio, L C Naval, G I Balane, E S Joson, D Burt, W-J Lew, M Mantala, S Pancho, J N Sarol, A Golubkov, E V Kurbatova
SETTING: Multidrug-resistant tuberculosis (MDR-TB) patients lost to follow-up (LTFU) from Programmatic Management of Drug-resistant Tuberculosis facilities in the Philippines. OBJECTIVES: To gain insight into patients' readiness to return to treatment. METHODS: MDR-TB patients who initiated treatment and were categorized as LTFU were identified using TB registers, contacted, and asked to consent to an interview and medical record review. At the conclusion of the interview, patients' readiness to restart treatment was assessed and examined in relation to demographic, clinical, and interview data...
September 2016: International Journal of Tuberculosis and Lung Disease
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