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Management of MDR TB

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https://www.readbyqxmd.com/read/29783081/recent-technological-advancements-in-tuberculosis-diagnostics-a-review
#1
REVIEW
Shagun Gupta, Vipan Kakkar
Early diagnosis and on-time effective treatment are indispensable for Tuberculosis (TB) control - a life threatening infectious communicable disease. The conventional techniques for diagnosing TB normally take two to three weeks. This delay in diagnosis and further increase in detection complexity due to the emerging risks of XDR-TB (Extensively drug Resistant-TB) and MDR-TB (Multidrug Resistant-TB) are evoking interest of researchers in the field of developing rapid TB detection techniques such as biosensing and other point-of-care (POC) techniques...
May 11, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29779766/should-all-suspected-tuberculosis-cases-in-high-income-countries-be-tested-with-genexpert
#2
Venanzio Vella, Agnieszka Broda, Francis Drobniewski
In countries with a low incidence of multidrug-resistant tuberculosis (MDR-TB), universal testing with GeneXpert might not be always cost-effective. This study provides hospital managers in low MDR-TB incidence countries with criteria on when decentralised universal GeneXpert testing would make sense. The alternatives taken into consideration include: universal microbiological culture and drug susceptibility testing (DST) only (comparator); as above but with concurrent centralized GeneXpert in a referral laboratory vs a decentralized GeneXpert system in every hospital to test smear-positive cases only; as above but testing all samples with GeneXpert regardless of smear status...
May 2018: Tuberculosis
https://www.readbyqxmd.com/read/29744042/prevalence-and-patterns-of-drug-resistance-among-pulmonary-tuberculosis-patients-in-hangzhou-china
#3
Qingchun Li, Gang Zhao, Limin Wu, Min Lu, Wei Liu, Yifei Wu, Le Wang, Ke Wang, Han-Zhu Qian, Li Xie
Background: To evaluate prevalence and patterns of drug resistance among pulmonary tuberculosis (TB) patients in Hangzhou City, China. Methods: Sputum samples of smear positive TB patients enrolled in 2011 and 2015 were collected and tested for drug susceptibility, and demographic and medical record data were extracted from the electronic database of China Information System for Disease Control and Prevention. Chi-square test was used to compare drug resistance prevalence between new and treated patients and between male and female patients, and Chi-square test for trend was used to compare the prevalence over calendar years 2011 and 2015...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29686169/risk-factors-for-multidrug-resistant-tuberculosis
#4
Cleopas Martin Rumende
In 2015, 10.4 million people developed tuberculosis (TB) and 580,000 amongst them suffered from multidrug-resistant TB (MDR-TB). From those 580,000 cases of MDR-TB, only 125,000 were detected and reported. A total of 111,000 people began to receive MDR-TB treatment in 2014 while 190,000 MDR-TB patients were estimated to have died, largely due to lack of access to effective treatment. The mechanism of drug resistance can be caused by genetic factors, factors related to previous treatment and other factors such as comorbidity with diabetes mellitus...
January 2018: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29677210/provider-reported-barriers-and-solutions-to-improve-testing-among-tuberculosis-patients-eligible-for-drug-susceptibility-test-a-qualitative-study-from-programmatic-setting-in-india
#5
Hemant Deepak Shewade, Arun M Kokane, Akash Ranjan Singh, Malik Parmar, Manoj Verma, Prabha Desikan, Sheeba Naz Khan, Ajay M V Kumar
BACKGROUND: In a study conducted in Bhopal district (a setting with facility for molecular drug susceptibility testing (DST)) located in central India in 2014-15, we found high levels of pre-diagnosis attrition among patients with presumptive multi drug-resistant tuberculosis (MDR-TB)-meaning TB patients who were eligible for DST, were not being tested. OBJECTIVES: In this study, we explored the health care provider perspectives into barriers and suggested solutions for improving DST...
2018: PloS One
https://www.readbyqxmd.com/read/29675789/experimental-platform-utilising-melting-curve-technology-for-detection-of-mutations-in-mycobacterium-tuberculosis-isolates
#6
Agnieszka Broda, Vlad Nikolayevskyy, Nicki Casali, Huma Khan, Richard Bowker, Gemma Blackwell, Bhakti Patel, James Hume, Waqar Hussain, Francis Drobniewski
Tuberculosis (TB) remains one of the most deadly infections with approximately a quarter of cases not being identified and/or treated mainly due to a lack of resources. Rapid detection of TB or drug-resistant TB enables timely adequate treatment and is a cornerstone of effective TB management. We evaluated the analytical performance of a single-tube assay for multidrug-resistant TB (MDR-TB) on an experimental platform utilising RT-PCR and melting curve analysis that could potentially be operated as a point-of-care (PoC) test in resource-constrained settings with a high burden of TB...
April 20, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29642833/-management-and-treatment-difficulties-of-multi-drug-resistant-pulmonary-tuberculosis-in-a-pediatric-case
#7
Selda Hançerli Törün, Emine Manolya Acar, Ayper Somer, Gonca Erköse, Dilek Şatana, Zuhal Bayramoğlu, Emine Çalışkan, Zeki Kılıçaslan
Tuberculosis continues to be a major health problem worldwide. Multidrug resistant tuberculosis (MDR-TB) infection that occurs in childhood is caused by adult MDR-TB agents which are in circulation and resistant to primary drugs. In this case report a 17-month-old child with MDR-TB who was cured after a 24-month therapy regimen was presented. Physical examination of a 17-month-old girl admitted to the hospital with the cause of recurrent pneumonia revealed a rubbery lymphadenopathy less than 2 cm in the right upper cervical region...
January 2018: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29628698/drug-resistant-skeletal-tuberculosis-in-a-tertiary-care-centre-in-south-india
#8
J Arockiaraj, G S Balaji, V M Cherian, Jepegnanam T S, B P Thomas, Joy S Michael, P M Poonnoose
Back ground: Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. Results: A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29611497/validity-of-time-to-sputum-culture-conversion-to-predict-cure-in-patients-with-multidrug-resistant-tuberculosis-a-retrospective-single-center-study
#9
Nafees Ahmad, Arshad Javaid, Afsar Khan Afridi, Anila Basit, Amer Hayat Khan, Izaz Ahmad, Muhammad Atif
To evaluate the predictive value of time to sputum culture conversion (SCC) in predicting cure and factors associated with time to SCC and cure in multidrug-resistant tuberculosis (MDR-TB) patients, a retrospective study was conducted at programmatic management unit of drug resistant tuberculosis (TB), Peshawar. A total of 428 pulmonary MDR-TB patients enrolled at the study site from January 1, 2012 to August 31, 2014 were followed until treatment outcome was recorded. Survival analysis using Cox proportional hazards model and multivariate binary logistic regression were, respectively, used to identify factors associated with time to SCC and cure...
April 2, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29584579/prevalence-of-pyrazinamide-resistance-in-khyber-pakhtunkhwa-pakistan
#10
Muhammad Tahir Khan, Shaukat Iqbal Malik, Sajid Ali, Anwar Sheed Khan, Tariq Nadeem, Muhammad Tariq Zeb, Nayyer Masood, Muhammad Tanvir Afzal
AIMS: Pyrazinamide (PZA) is an important component of first-line tuberculosis (TB) treatment because of its distinctive capability to kill subpopulations of persister Mycobacterium tuberculosis (MTB). The significance of PZA can be understood by its inclusion in the most recent World Health Organization-recommended multidrug-resistant (MDR) TB regimen. Very little information is available about the prevalence of PZA-resistant TB from geographically distinct regions of high burden countries, including Khyber Pakhtunkhwa (KPK), Pakistan, because drug susceptibility testing (DST) of PZA is not regularly performed due to the complexity...
March 27, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/29581937/the-california-multidrug-resistant-tuberculosis-consult-service-a-partnership-of-state-and-local-programs
#11
N S Shah, J Westenhouse, P Lowenthal, G Schecter, L True, S Mase, P M Barry, J Flood
Background: The US Centers for Disease Control and Prevention recommend expert consultation for multi-drug-resistant tuberculosis (MDR-TB) cases. In 2002, the California MDR-TB Service was created to provide expert MDR-TB consultations. We describe the characteristics, treatment outcomes and management of patients referred to the Service. Methods: Surveillance data were used for descriptive analysis of cases, with consultation during July 2002-December 2012. Clinical consultation data and modified World Health Organization indicators were used to assess the care and management of cases, with consultation from January 2009 to December 2012...
March 21, 2018: Public Health Action
https://www.readbyqxmd.com/read/29579424/a-selective-and-sensitive-high-performance-liquid-chromatography-assay-for-the-determination-of-cycloserine-in-human-plasma
#12
A K Hemanth Kumar, Arun Kumar Polisetty, V Sudha, A Vijayakumar, Geetha Ramachandran
BACKGROUND: Cycloserine (CYC) is a second line antitubercular drug that is used for the treatment of multidrug resistant tuberculosis (MDR-TB) along with other antitubercular agents and is often used in developing countries. Monitoring CYC levels in plasma could be useful in the clinical management of patients with MDR-TB. A high performance liquid chromatography method for the determination of CYC in human plasma was developed. METHODS: The method involved extraction of the sample using solid phase extraction cartridges and analysis of the extracted sample using a reverse phase T3 column (150mm) and detection at 240nm with Photo Diode Array (PDA) detector...
April 2018: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/29562986/direct-costs-of-managing-adverse-drug-reactions-during-rifampicin-resistant-tuberculosis-treatment-in-south-africa
#13
K Schnippel, C Firnhaber, R Berhanu, L Page-Shipp, E Sinanovic
OBJECTIVE: To estimate the provider costs of managing adverse drug reactions (ADRs) to standard long-course treatment for multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) according to South African guidelines. METHODS: We parameterised a published Markov health state model for MDR/RR-TB with guidelines-based, bottom-up public-sector provider costing of ADR management. Frequency of ADR occurrence was extracted from the literature. Costs were estimated over 10 years, discounted 3% annually and tested using probabilistic sensitivity analysis...
April 1, 2018: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29509468/clinical-management-of-multidrug-resistant-tuberculosis-in-16-european-countries
#14
Gunar Günther, Frank van Leth, Sofia Alexandru, Neus Altet, Korkut Avsar, Didi Bang, Raisa Barbuta, Graham Bothamley, Ana Ciobanu, Valeriu Crudu, Manfred Danilovits, Martin Dedicoat, Raquel Duarte, Gina Gualano, Heinke Kunst, Wiel de Lange, Vaira Leimane, Anne-Marie McLaughlin, Cecile Magis-Escurra, Inge Muylle, Veronika Polcová, Cristina Popa, Rudolf Rumetshofer, Alena Skrahina, Varvara Solodovnikova, Victor Spinu, Simon Tiberi, Piret Viiklepp, Christoph Lange
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) is a major burden to public health in Europe. Reported treatment success rates are around 50% or less and cure rates are even lower. METHODS: We performed a prospective cohort study, analyzing management and treatment outcomes stratified by incidence of patients with MDR-TB in Europe. Treatment outcomes were compared by WHO and alternative simplified definitions. RESULTS: 380 patients with MDR-TB were recruited and followed-up between 2010 and 2014 in 16 European countries...
March 6, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29486710/molecular-characterization-of-mutations-associated-with-resistance-to-second-line-tuberculosis-drug-among-multidrug-resistant-tuberculosis-patients-from-high-prevalence-tuberculosis-city-in-morocco
#15
Amal Oudghiri, Hind Karimi, Fouad Chetioui, Fathiah Zakham, Jamal Eddine Bourkadi, My Driss Elmessaoudi, Amin Laglaoui, Imane Chaoui, Mohammed El Mzibri
BACKGROUND: The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global TB control. Although multi drug-resistant tuberculosis (MDR- TB) prevalence and associated genetic mutations in Morocco are well documented, scarce information on XDR TB is available. Hence, the evaluation of pre-XDR and XDR prevalence, as well as the mutation status of gyrA, gyrB, rrs, tlyA genes and eis promoter region, associated with resistance to second line drugs, is of great value for better management of M/XDR TB in Morocco...
February 27, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29471907/multidrug-resistant-tuberculosis-in-australia-1998-2012
#16
J R Francis, P Manchikanti, C C Blyth, J Denholm, C Lowbridge, C Coulter, E Donnan, R Stapledon, V L Krause, J Waring
OBJECTIVE: To describe the epidemiology and outcomes of multidrug-resistant tuberculosis (MDR-TB) diagnosed in Australia between 1998 and 2012. DESIGN: A retrospective review was undertaken involving all patients with laboratory-confirmed MDR-TB notified in Australia between 1998 and 2012 inclusive. Demographic, clinical and laboratory features are described. Clinical outcomes were defined according to World Health Organization definitions of treatment success (cure and treatment completion), treatment failure, death, loss to follow-up (including transfer out), or not evaluated at treatment completion...
March 1, 2018: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29470252/multi-and-extensively-drug-resistant-pulmonary-tuberculosis-advances-in-diagnosis-and-management
#17
Emanuele Pontali, Dina Visca, Rosella Centis, Lia D'Ambrosio, Antonio Spanevello, Giovanni Battista Migliori
PURPOSE OF REVIEW: Multidrug-resistant (MDR) tuberculosis (TB) and extensively drug-resistant (XDR)-TB epidemics are key obstacles towards TB control and elimination. RECENT FINDINGS: Diagnosis of MDR/XDR-TB is difficult and requires several weeks. New diagnostic tools are being tested and proposed allowing for shorter time to diagnosis and reduced delays in starting an adequate treatment regimen. MDR/XDR-TB treatment strategies are currently on an evolving stage...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29437632/time-to-multidrug-resistant-tuberculosis-treatment-initiation-in-association-with-treatment-outcomes-in-shanghai-china
#18
Yong Chen, Zhengan Yuan, Xin Shen, Jie Wu, Zheyuan Wu, Biao Xu
In high tuberculosis (TB)-burden countries such as China, the diagnosis of multidrug-resistant tuberculosis (MDR-TB) using conventional drug susceptibility testing (DST) takes months, making treatment delay inevitable. Poor outcomes of MDR-TB might be associated with delayed, even inappropriate, treatment. The purposes of this study were to investigate the time to MDR-TB treatment initiation and to assess the association between early treatment and treatment outcomes. Between April 2011 and December 2014, this population-based retrospective cohort study collected the demographic and clinical characteristics and the drug susceptibility profiles of all registered MDR-TB patients in Shanghai, China...
April 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29406800/rapid-molecular-diagnostics-for-multi-drug-resistant-tuberculosis-in-india
#19
Rajeswari Ramachandran, M Muniyandi
Rapid molecular diagnostic methods help in the detection of TB and Rifampicin resistance. These methods detect TB early, are accurate and play a crucial role in reducing the burden of drug resistant tuberculosis. Areas covered: This review analyses rapid molecular diagnostic tools used in the diagnosis of MDR-TB in India, such as the Line Probe Assay and GeneXpert. We have discussed the burden of MDR-TB and the impact of recent diagnostic tools on case detection and treatment outcomes. This review also discusses the costs involved in establishing these new techniques in India...
March 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29394358/treatment-outcomes-of-multidrug-resistant-tuberculosis-in-taiwan-tackling-loss-to-follow-up
#20
Ming-Chih Yu, Chen-Yuan Chiang, Jen-Jyh Lee, Shun-Tien Chien, Chou-Jui Lin, Shih-Wei Lee, Chih-Bin Lin, Wen-Ta Yang, Ying-Hsun Wu, Yi-Wen Huang
Background: The proportion of treatment success among multidrug-resistant tuberculosis (MDR-TB) patients enrolled between 1992 and 1996 was 51.2%, and that among patients enrolled between 2000 and April 2007 was 61%. To address the challenge of MDR-TB, the Taiwan MDR-TB Consortium (TMTC) was established in May 2007. To assess the performance of the TMTC, we analyzed the data of patients enrolled in its first 5 years. Methods: Comprehensive care was provided at no cost to patients, who were usually hospitalized for one month initially...
January 31, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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