EDITOR-Lawn and Wilkinson report on the global emergence of extensively drug resistant tuberculosis.1 An outbreak of extensively drug resistant tuberculosis has been ongoing for a decade in Norway.2 In 1994 treatment was started in a patient with pulmonary tuberculosis who was lost to follow-up. One year later, the same patient was admitted to hospital with smear positive, pulmonary, extensively drug resistant tuberculosis.2 In the following 10 years, 23 other patients were diagnosed with a strain of Mycobacterium tuberculosis that carried the same IS6110 RFLP and spoligotyping DNA patterns. Of these, 15 had extensively drug resistant tuberculosis (table). Among 3131 patients diagnosed with tuberculosis in Nor-way during these 12 years M tuberculosis was isolated from 2284. Multidrug resistant tuberculosis was identified in 37 of them. The 15 cases of extensively drug resistant tuberculosis in the current outbreak are 0.66% of all culture positive cases and 40% of the multidrug resistant cases ...
TY - JOUR. T1 - High treatment failure and default rates for patients with multidrug-resistant tuberculosis in KwaZulu-Natal, South Africa, 2000-2003. AU - Brust, James C.M.. AU - Gandhi, N. R.. AU - Carrara, H.. AU - Osburn, G.. AU - Padayatchi, N.. PY - 2010/4/1. Y1 - 2010/4/1. N2 - SETTING: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant public health threat in South Africa. OBJECTIVE: To describe treatment outcomes and determine risk factors associated with unfavorable outcomes among MDR-TB patients admitted to the provincial TB referral hospital in KwaZulu-Natal Province, South Africa. DESIGN: Retrospective observational study of MDR-TB patients admitted from 2000 to 2003. RESULTS: Of 1209 MDR-TB patients with documented treatment outcomes, 491 (41%) were cured, 35 (3%) completed treatment, 208 (17%) failed treatment, 223 (18%) died and 252 (21%) defaulted. Of the total number of patients with known human immunodeficiency virus (HIV) status, 52% were HIV-infected. ...
Background: Tuberculosis is a major cause of infectious disease mortality all over the world. Multidrug resistant tuberculosis (MDR-TB) is a major problem in the management of tuberculosis. With recent advances in understanding the immunopathogenesis of tuberculosis, the use of various cytokine therapies has been suggested. The objective of this study was to evaluate the efficacy of parenteral INF- for treating MDR-TB patients. Materials and Methods: To conduct the study, 12 MDR- TB patients hospitalised in the clinical mycobacteriology ward of Massih Daneshvari hospital were selected randomly between October 2000 and March 2001. All had chest involvement in radiography, so they were smear and culture positive on two occasions. All had at least resistance to isoniazid and rifampin in antibiogram. They were divided in two groups. One group received INF- ; (3,000,000U, three times a week, subcutaneously) in addition to anti-TB drugs, and the other group received only anti -TB medications as control group.
abstract = Background: Default from multidrug-resistant tuberculosis (MDR-TB) treatment remains a major barrier to cure and epidemic control. We sought to identify patient risk factors for default from MDR-TB treatment and high-risk time periods for default in relation to hospitalization and transition to outpatient care. Methods: We retrospectively analyzed a cohort of 225 patients who initiated MDR-TB treatment between 2007 through 2010 at a rural TB hospital in the Western Cape Province, South Africa. Results: Fifty percent of patients were cured or completed treatment, 27{\%} defaulted, 14{\%} died, 4{\%} failed treatment, and 5{\%} transferred out. Recent alcohol use was common (63{\%} of patients). In multivariable proportional hazards regression, older age (hazard ratio [HR]= 0.97 [95{\%} confidence interval 0.94-0.99] per year of greater age), formal housing (HR=0.38 [0.19-0.78]), and steady employment (HR=0.41 [0.19-0.90]) were associated with decreased risk of default, while recent ...
Background: Multidrug resistant tuberculosis (MDR TB) is an emerging challenge for TB control programs globally. According to the National DRS result in 2005, ...
There are three special situations in drug resistant tuberculosis that merit a more detail description: HIV co-infection, pregnancy and drug resistant TB in children. HIV co-infection: The risk of reactivation of latent tuberculosis infection is 50-100 times higher for subject living with HIV and up to 170 times higher for those with AIDS. Every patient diagnosed with TB must be tested for HIV infection and vice versa. The WHO recommends that ARV treatment in patients recently diagnosed as co-infected with HIV and tuberculosis should start within 8 weeks from the start on antituberculosis drugs. </p><p> Pregnancy: The best way to deal with MDR-TB during pregnancy is to prevent it. All females of child-bearing age being treated for MDR-TB should be encouraged to adopt an effective contraceptive method or even a combination of them. Most of the drugs used to treat MDR-TB are classified as unsafe during pregnancy or their safety is unknown. </p><p> Pediatric tuberculosis: ...
Researchers find the preventive treatment beneficial in protecting the children, who are in close contact with multidrug resistant tuberculosis affected patients, from acquiring the disease.
Although new molecular diagnostic tests such as GenoType MTBDRplus and Xpert® MTB/RIF have reduced multidrug-resistant tuberculosis (MDR-TB) treatment initiation times, patients experiences of diagnosis and treatment initiation are not known. This study aimed to explore and compare MDR-TB patients experiences of their diagnostic and treatment initiation pathway in GenoType MTBDRplus and Xpert® MTB/RIF-based diagnostic algorithms. The study was undertaken in Cape Town, South Africa where primary health-care services provided free TB diagnosis and treatment. A smear, culture and GenoType MTBDRplus diagnostic algorithm was used in 2010, with Xpert® MTB/RIF phased in from 2011-2013. Participants diagnosed in each algorithm at four facilities were purposively sampled, stratifying by age, gender and MDR-TB risk profiles. We conducted in-depth qualitative interviews using a semi-structured interview guide. Through constant comparative analysis we induced common and divergent themes related to symptom
We wish to clarify a point made in our report on multidrug-resistant tuberculosis in the United States. By noting that clusters of multidrug-resistant tuberculosis cases had been reported from 12 U.S. hospitals [1], we did not mean that nosocomial transmission had been verified in each. Hospital clusters may result from outbreaks caused by transmission inside or outside the hospital. Transmission in the hospital may be implicated by epidemiologic associations between exposure in the hospital and the subsequent development of disease or by the demonstration of molecular genetic similarity between patient isolates [1 ...
Although our baseline analysis assumed that DOTS-plus can be implemented effectively, the proportion of patients completing even standard treatment regimens is low in areas where multidrug resistant tuberculosis has become a major problem.21 In areas where direct smear microscopy and giving two to four relatively non-toxic drugs for six months is impossible, routinely performing mycobacterial cultures and first and second line susceptibility testing as well as administering four to seven toxic drugs for 18-24 months is unlikely to be possible.. A tuberculosis control programme should have implemented effective DOTS before implementing DOTS-plus.28 A poorly run control programme can generate multidrug resistant tuberculosis, but effective DOTS can decrease the rates of multidrug resistant tuberculosis.29 More widespread implementation of effective DOTS would therefore decrease the number of cases for which DOTS-plus would be necessary.30 Currently, 77% of tuberculosis cases worldwide are not ...
Strong strategies, including proven service delivery models, are needed to address the growing global threat of multidrug-resistant tuberculosis (MDR-TB) in low- and middle-income settings. The objective of this study was to assess the feasibility and effectiveness of the nationally approved ambulatory service delivery model for MDR-TB treatment in two regions of Ethiopia. We used routinely reported data to describe the process and outcomes of implementing an ambulatory model for MDR-TB services in a resource-limited setting. We compared percentage improvements in the number of MDR-TB diagnostic and treatment facilities, number of MDR-TB sputum samples processed per year, and MDR-TB cases ever enrolled in care between baseline and 2015. We also calculated interim and final treatment outcomes for patients who had completed at least 12 and 24 months of follow-up, respectively. Between 2012 and 2015, the number of MDR-TB treatment-initiating centers increased from 1 to 23. The number of sputum ...
Tuberculosis (TB) control is a primary global health priority but the goal to eliminate TB is being threatened by the increase in incidence of multidrug-resistant tuberculosis (MDR-TB). With this series of seven MDR-TB cases in migrant patients with identical Mycobacterium tuberculosis strains we aim to illustrate the challenges encountered during therapy and follow-up: language barriers, access to care for migrant patients, depression due to isolation, adverse reactions to the treatment, management of pediatric TB, further contact tracing. We also discuss best practices for the management of complex MDR-TB cases in settings with low overall TB incidence focusing on modern diagnostic assays and an individualized and an interdisciplinary therapeutic approach. We describe a case series of seven consecutively diagnosed MDR-TB patients, six of them treated at our tertiary care hospital between May 2018 and March 2020. Epidemiologic data was gained by semi-structured patient interviews and reconstruction of
The Philippines has the highest documented prevalence of tuberculosis (TB) in the Southeast Asian region. In the 1997 nationwide TB survey, the prevalence of multidrug-resistant tuberculosis (MDR-TB, meaning having TB bacilli resistant to at least isoniazid and rifampicin) was 4.3%; 1.5% in untreated patients and 14.3% in those who had had previous treatment. Extrapolated to the estimated number of bacillary cases, the estimated number of MDR-TB would be 26,082 nationwide and 2,085 in the urban poor settlements. This poses a public health emergency of global magnitude due to the prospect of potential transnational transmission.
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Drug-resistant tuberculosis (TB) has become one of the major obstacles currently encountered in the control of this disease worldwide.1 The widespread and sometimes inappropriate use of rifampicin in the last 40 years has generated a growing number of cases of rifampicin-resistant TB (RR-TB). Rifampicin resistance is the most decisive factor in the prognosis of TB patients.2 If this drug cannot be used, treatment must continue for at least 21-24 months, and combinations of less effective, more toxic drugs3 are required, leading to cure rates of only 50%.1 Moreover, more than 90% of RR-TB cases are also carriers of isoniazid (H)-resistant strains3; these patients make up the so-called multidrug-resistant TB (MDR-TB) group.. The problem is further compounded by the appearance and spread of cases of extensively drug-resistant TB (XDR-TB), which is MDR-TB that is also resistant to the fluoroquinolones (FQ: levofloxacin and/or moxifloxacin) and second-line injectable drugs (SLID: amikacin and/or ...
There are approximately 13000 cases of multi drug resistant Tuberculosis (MDRTB) diagnosed in Pakistan each year. Treatment of MDR-TB requires 18-24 months of medication, support and supervision at a significant cost. The study will assess 2 types of service delivery models for their effectiveness and cost-effectiveness in low resource settings in Pakistan. These care models are: ...
Multidrug-resistant tuberculosis (MDR TB) in Africa may be more prevalent than previously appreciated. Factors leading to development of drug resistance need to be understood to develop appropriate control strategies for national programs. We gathered estimates of MDR TB rates for 39 of 46 countries in Africa. The relationship between MDR TB rates and independent factors was analyzed by using correlation and linear regression models. Our findings indicate that drug resistance surveys in Africa are critically needed. MDR TB rates must be assessed in countries without these surveys. In countries that have conducted a drug resistance survey, a new survey will determine evolution of drug resistance rates. We found no correlation between high MDR rates and TB incidence, HIV/TB co-infection rates, or year of introduction of rifampin. Results show that the retreatment failure rate was the most predictive indicator for MDR TB. Current category II drug regimens may increase MDR TB.
Multidrug- and higher degrees of drug resistant Mycobacterium tuberculosis have become a global public health issue of high priority. According to the World Health Organization (WHO) 2008 estimates, there were 440.000 cases and 150.000 deaths of multidrug-resistant tuberculosis (MDR-TB) globally and only about 1% of these cases were on treatment regimens based on WHO recommended standards [1]. In 2010, extensively drug-resistant (XDR)-TB was reported in 58 countries throughout all regions of the world. Due to the emergence of MDR-TB, the WHO developed a directly observed therapy short-course (DOTS) Plus strategy in 2000 [2]. This strategy aims at ensuring correct identification and proper management of MDR-TB patients. DOTS-Plus treatment of MDR-TB cases has been proven to be highly cost effective in certain areas [3, 4].. Treatment delays have been attributed to various factors, such as living far from the health care facility, feeling a high degree of stigma, seeking initial care at a ...
Introduction In high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population. We studied primary MDR in patients considered to be at low risk of MDR-TB in Lima, Peru. Methods We enrolled new sputum smear-positive TB patients who did not report any MDR-TB risk factor: known exposure to a TB patient whose treatment failed or who died or who was known to have MDR-TB; immunosuppressive co-morbidities, ex prison inmates; prison and health care workers; and alcohol or drug abuse. A structured questionnaire was applied to all enrolled participants to confirm the absence of these factors and thus minimize underreporting. Sputum from all participants was cultured on Löwenstein-Jensen media and DST for first line drugs was performed using the 7H10 agar method. Results Of 875 participants with complete data,
Discussion In early 2012 the Chhattisgarh state government included packages under RSBY (Rastriya Swasthya Bima Yojana) and MSBY (Mukhyamantri Swasthya Bima Yojana) in various national health programmes, where hospitalisation is necessary. Leveraging this opportunity, the state TB Control Programme in Chhattisgarh facilitated Revised National Tuberculosis Programme (RNTCP) partnership with RSBY and MSBY through creation of innovative MDR-TB packages under the Universal Health Insurance Scheme (UHIS), integrating it in a list of other disease packages by December 2012.. Our study provides evidence of cost savings for MDR-TB patients requiring hospitalisation for ambulatory care patients in comparison with facility-based treatment with similar outcomes. These cost savings may improve equity, however covering of indirect costs such as travel as part of the current government initiative for covering MDR-TB costs under the state health insurance schemes could mitigate the costs impact on low-income ...
Multidrug-resistant tuberculosis (MDR-TB) outcomes are adversely impacted by delay in diagnosis and treatment. Mixed qualitative and quantitative approaches were utilized to identify healthcare system related barriers to implementation of molecular diagnostics for MDR-TB. Randomly sampled districts from the 5 highest TB burden regions were enrolled during the 4th quarter of 2016. District TB & Leprosy Coordinators (DTLCs), and District AIDS Coordinators (DACs) were interviewed, along with staff from all laboratories within the selected districts where molecular diagnostics tests for MDR-TB were performed. Furthermore, the 2015 registers were audited for all drug-susceptible but retreatment TB cases and TB collaborative practices in HIV clinics, as these patients were in principal targeted for drug susceptibility testing by rapid molecular diagnostics. Twenty-eight TB districts from the 5 regions had 399 patients reviewed for retreatment with a drug-susceptible regimen. Only 160 (40%) had specimens
TY - JOUR. T1 - Shorter regimens for multidrug-resistant tuberculosis should also be applicable in Europe. AU - Heldal, Einar. AU - Van Deun, Armand. AU - Chiang, Chen-Yuan. AU - Rieder, Hans L. PY - 2017/6. Y1 - 2017/6. KW - Antitubercular Agents. KW - Europe. KW - Humans. KW - Mycobacterium tuberculosis. KW - Tuberculosis, Multidrug-Resistant. U2 - 10.1183/13993003.00228-2017. DO - 10.1183/13993003.00228-2017. M3 - Article. C2 - 28572127. VL - 49. JO - European Respiratory Journal. JF - European Respiratory Journal. SN - 0903-1936. IS - 6. ER - ...
Multidrug-resistant TB (MDR-TB) is a major threat to global health security. In 2017, only 50% of patients with MDR-TB who received WHO-recommended treatment were cured. Most MDR-TB patients who recover continue to suffer from functional disability due to long-term lung damage. Whilst new MDR-TB treatment regimens are becoming available, conventional drug therapies need to be complemented with host-directed therapies (HDTs) to reduce tissue damage and improve functional treatment outcomes. This viewpoint highlights recent data on biomarkers, immune cells, circulating effector molecules and genetics which could be utilised for developing personalised HDTs. Novel technologies currently used for cancer therapy which could facilitate in-depth understanding of host genetics and the microbiome in patients with MDR-TB are discussed. Against this background, personalised cell-based HDTs for adjunct MDR-TB treatment to improve clinical outcomes are proposed as a possibility for complementing standard ...
Tuberculosis is usually treated with first-line anti-tuberculous drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide.. Multi-drug resistant tuberculosis (MDR) is disease due to strains resistant to both isoniazid and rifampicin. Treatment of such strains requires use of second-line drugs which include fluoroquinolones, aminoglycosides, capreomycin (injectable drugs), para-aminosalicylate, cycloserine, and ethionamide.. Recently, however, strains resistant to fluoroquinolones have been noticed worldwide. When MDR TB strains become resistant to fluoroquinolones, treatment becomes difficult since other drugs used have limited efficacy. Treatment options become even more limited when in addition to fluoroquinolones, strains are resistant to any one of the injectable drugs. Such strains are labeled extensively drug resistant (XDR).. Patients with XDR TB require longer duration of treatment (at least 18 months) with drugs regimens that incorporate both old and new agents. Newer drugs ...
Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to follow-up (non-initiation of treatment by programme within 6 months of diagnosis) and time from diagnosis to treatment initiation in Bhopal district, central India (2014). Pre-treatment loss to follow-up was 13% (0.95 CI: 7%, 23%), not significantly different from the national estimates (18%) and median time to initiate treatment was seven days, lower than that reported elsewhere in the country. Bhopal was performing well with reference to time to treatment initiation in programmatic settings.
Revised national tuberculosis control programme in India has limited co-hort-wise information about what happens to patients diagnosed with multidrug resistant TB (MDR-TB). We determined the pre-treatment loss to follow-up (non-initiation of treatment by programme within 6 months of diagnosis) and time from diagnosis to treatment initiation in Bhopal district, central India (2014). Pre-treatment loss to follow-up was 13% (0.95 CI: 7%, 23%), not significantly different from the national estimates (18%) and median time to initiate treatment was seven days, lower than that reported elsewhere in the country. Bhopal was performing well with reference to time to treatment initiation in programmatic settings.
TY - JOUR. T1 - Rationale for high-dose isoniazid in the treatment of multidrug-resistant tuberculosis. AU - Rieder, Hans L.. AU - Van Deun, Armand. N1 - PPU. PY - 2017. Y1 - 2017. KW - MYCOBACTERIUM-TUBERCULOSIS. U2 - 10.5588/ijtld.16.0619. DO - 10.5588/ijtld.16.0619. M3 - Letter. VL - 21. SP - 123. EP - 124. JO - International Journal of Tuberculosis and Lung Disease. JF - International Journal of Tuberculosis and Lung Disease. SN - 1027-3719. IS - 1. ER - ...
TY - JOUR. T1 - Multidrug-resistant tuberculosis treatment failure detection depends on monitoring interval and microbiological method. AU - Collaborative Grp Anal Bacteriolog. AU - Mitnick, Carole D.. AU - White, Richard A.. AU - Lu, Chunling. AU - Rodriguez, Carly A.. AU - Bayona, Jaime. AU - Becerra, Mercedes C.. AU - Burgos, Marcos. AU - Centis, Rosella. AU - Cohen, Theodore. AU - Cox, Helen. AU - DAmbrosio, Lia. AU - Danilovitz, Manfred. AU - Falzon, Dennis. AU - Gelmanova, Irina Y.. AU - Gler, Maria T.. AU - Grinsdale, Jennifer A.. AU - Holtz, Timothy H.. AU - Keshavjee, Salmaan. AU - Leimane, Vaira. AU - Menzies, Dick. AU - Migliori, Giovanni Battista. AU - Milstein, Meredith B.. AU - Mishustin, Sergey P.. AU - Pagano, Marcello. AU - Quelapio, Maria I.. AU - Shean, Karen. AU - Shin, Sonya S.. AU - Tolman, Arielle W.. AU - van der Walt, Martha L.. AU - Van Deun, Armand. AU - Viiklepp, Piret. N1 - PPU. PY - 2016. Y1 - 2016. N2 - Debate persists about monitoring method (culture or smear) ...
The Harvard Medical School Center for Global Health Delivery-Dubai celebrated its inaugural symposium on Sunday, October 25, 2015 at the Mohammed Bin Rashid Academic Medical Center in Dubai Healthcare City. At the launch, the Center distributed a policy brief, Post-Exposure Management of Multidrug-Resistant Tuberculosis Contacts: Evidence-Based Recommendations, which was written by Sentinel Project members.. The principles and recommendations outlined in this policy brief were developed by a global panel of 51 tuberculosis practitioners from 33 cities in 19 countries who gathered at the Harvard Medical School Center for Global Health Delivery-Dubai on April 12 and 13, 2015. This global consultation provided a forum for TB practitioners to synthesize evidence and produce practical guidance for the management of children and adults who are household contacts of patients with DR-TB. Following the meetings and a review of published and unpublished evidence, the panel arrived at a set of seven ...
Attend the Drug Resistant Tuberculosis Clinicians Short Course on the 10th of July 2019 to add additional points to your (CPD) Continuing Professional Development po
Kiev, Ukraine (PRWEB) January 26, 2009 -- Ekomed LLC publishes study of immunoadjuvant therapy with Dzherelo (Immunoxel) in patients with drug-resistant TB.
The largest recent outbreak of multidrug-resistant tuberculosis (MDR-TB) in the United States is currently unfolding in the Minnesota Hmong community. Many Hmong elders were resettled in the Twin Cities years ago after living in a Thai refugee camp where TB ...
Extremely drug resistant TB, or XDR-TB, is a serious problem in India, according to a study presented at the American Thoracic Society 2007 International Conference, on Monday, May 21.
This natural history study seeks to determine some of the mycobacterial and host factors involved in the failure of antituberculous chemotherapy, disease recurrence, and the development of multidrug resistance by M. tuberculosis. Despite optimal treatment with directly-observed short-course therapy (DOTS), about 5-10% of compliant patients with cured tuberculosis relapse, usually within a year after completion of therapy. In Korea, where DOTS is not practiced, the relapse rate has been reported to be 15 to 20 %. In individual patients, failure to eradicate disease contributes directly to the development of drug-resistance and to low overall cure rates. While factors such as patient drug compliance and HIV status have been extensively studied in relation to rates of relapse; host genetic factors and the specific relevance of the infecting mycobacterial strain have not yet been investigated in detail. Identification of patient characteristics and specific strains of M. tuberculosis that are ...
Sirturo (bedaquiline) is used to treat multi-drug resistant pulmonary tuberculosis. Includes Sirturo side effects, interactions and indications.
Background There are significant delays in initiation of multidrug-resistant tuberculosis (MDR -TB) treatment. The Xpert MTB/RIF test has been shown to reduce the time to diagnosis and treatment of...
This case report describes an HIV-positive patient with recurrent tuberculosis in Uganda. After several failed courses of treatment, the patient was diagnosed with multi-drug resistant tuberculosis (MDR-TB). As adequate in-patient facilities were unavailable, we advised the patient to remain at home, and he received treatment at home via his family and a community nurse. The patient had a successful clearance of tuberculosis. This strategy of home-based care represents an important opportunity for treatment of patients in East Africa, where human resource constraints and inadequate hospital facilities exist for complex patients at high risk of infection to others.
The WHO warned on Friday that the new drug resistant TB could create an apocalyptic scenario if it not contained. It has already affected more than 30,000 people.
The STREAM study is an international, multi-centre, parallel-group, open-label, randomised, controlled trial in patients with multi-drug resistant tuberculosis (MDR-TB) including patients with rifampicin-resistant and isoniazid-sensitive TB.. Background and Rationale:. In 2011, World Health Organisation (WHO) guidelines for the treatment for MDR-TB recommended an intensive phase of treatment based on at least four drugs known to be effective and given for a minimum of 20 months; this is referred to as the WHO 2011 long regimen. Outcomes with this approach are generally poor. In the most recent WHO TB surveillance report only 50% of MDR-TB patients were successfully treated and a recent meta-analysis reported on average 62% successful outcome and a mortality of 11%.. In 2010, Van Deun et al (2010) reported excellent long-term outcomes in a cohort of over 200 patients in Bangladesh with MDR-TB who were treated with a regimen given for only nine to 11 months. Such a regimen, if successful, would ...
A major obstacle in the successful control of tuberculosis (TB) is multidrug-resistant TB (MDR-TB), defined as mycobacterium strains resistant to
Multidrug-resistant tuberculosis (MDR-TB) is an increasing global problem. Meta-analysis by Orenstein et al. about treatment outcome of MDR TB worldwide was: 62% successful, 11% death and 12% defaulted. Report by Chiang et al. about treatment without DOTS-Plus showed an outcome for 299 MDR-TB patients in Taiwan as follows: 51.2% treatment success, 9.4% died, and 29.1% defaulted.. Our aim was to assess treatment outcome of MDR-TB patients after introduction of DOTS-Plus strategy in Eastern Taiwan, following WHO guidelines.. We reviewed all patients who began treatment with DOTS-Plus for MDR-TB in Eastern Taiwan, between May 1st, 2007 and November 30th, 2012.. Out of a total of 135 bacteriologically confirmed MDR-TB cases, 13 were still in treatment. Among 122 patients with final outcomes, 54 (44.26%) were new cases, 47 (38.52%) have been previously treated with first line anti-TB drugs, 21 (17.21%) with secondary second line drugs. The mean age was 49.7 years (range 12 to 93) and 94 (77.05%) ...
Drug-resistant tuberculosis strains is jeopardising TB control worldwide. Over 450.000 new cases of multi drug resistant TB (MDR-TB)...
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The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format. By default, clicking on the export buttons will result in a download of the allowed maximum amount of items. To select a subset of the search results, click Selective Export button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export. After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format. ...
A 35-year-old female prisoner presented to the infirmary with a complaint of fever and 22-pound weight loss. She denied cough, nausea, emesis, headache, ...
Background:Poverty and overcrowding in urban slums creates hot spots for initial drug resistant tuberculosis. One such area is the M (east) ward in Mumbai, India.. Aim:. 1. To identify factors for drug resistant TB in urban slums. 2. Study resistance patterns to anti-TB drugs. Method: Retrospective analysis of records at a tertiary care hospital in Navi Mumbai was done. Patients from M (east) ward in Mumbai were included. Multidrug resistant (MDR) and extensively drug resistant (XDR) TB were diagnosed by analysis of sputum/relevant samples by Line probe assay, liquid culture and sensitivity.. Results:. 38 patients (23 men,15 women), had drug resistant TB. 33(84%) had MDR, 5(16%) XDR TB. No HIV/diabetes.. Initial drug resistance - MDR-5/33 (15%). XDR-1/5(20%).. Contact history- 6/38 (15%) cases.. Causes identified in each group- ...
This year alone, approximately half a million people will develop drug-resistant TB. Multidrug-resistant TB (MDR-TB) is caused by TB bacteria that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. Less than 20 percent of people with MDR-TB receive treatment; of that small fraction, about half are cured. To place the drug resistant TB situation in perspective, patients with Ebola, for whom there is no available drug therapy, have the same chances of survival that patients with drug-resistant TB patients have, accessing todays available medicines. MDR-TB is also the most contagious of all the pathogens noted on the WHOs list, spreading readily from person to person, and is especially dangerous to children, people with HIV, and other vulnerable populations ...
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Looking for online definition of Multidrug-resistant tuberculosis in the Medical Dictionary? Multidrug-resistant tuberculosis explanation free. What is Multidrug-resistant tuberculosis? Meaning of Multidrug-resistant tuberculosis medical term. What does Multidrug-resistant tuberculosis mean?
Molecular detection of multidrug-resistant tuberculosis among smear-positive pulmonary tuberculosis patients in Jigjiga town, Ethiopia Mussie Brhane,1 Ameha Kebede,2 Yohannes Petros 2 1Department of Tuberculosis Culture and DST Laboratory, Harar Health Research and Regional Laboratory, Harar, Ethiopia; 2Department of Biology, College of Computational and Natural Sciences, Haramaya University, Haramaya, Ethiopia Background: Molecular methods that target drug resistance mutations are suitable approaches for rapid drug susceptibility testing to detect multidrug-resistant tuberculosis (MDR-TB). The aim of the study was to determine MDR-TB cases and to analyze the frequency of gene mutations associated with rifampicin (RIF) and/or isoniazid (INH) resistance of Mycobacterium tuberculosis among smear-positive pulmonary tuberculosis patients. Methods: Institution-based cross-sectional study design was employed. Sputum specimens were collected, and using a pretested questionnaire, data for associated risk
Background. A drug resistance survey is an essential public health management tool for evaluating and improving the performance of National Tuberculosis control programmes. The current manuscript describes the implementation of the first national drug resistance survey in Tanzania. Methods. Description of the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and Standard Operating Procedures. Results. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation. Factors contributing negatively to the implementation were a long delay between training and actual survey activities, limited monitoring of activities, and an unclear design of the data capture forms leading to difficulties in form-filling. Conclusion. ...
Our objectives was to measure the serum zinc level in multidrug-resistant tuberculosis (MDRTB) patients and explore its association with different predictors of MDRTB in comparison with drug-sensitive tuberculosis (DSTB). We recruited 107 MDRTB and 87 DSTB patients from the National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka, in our study. We have used laboratory data on drug resistance patterns of these patients through the line probe assay. About 5 ml overnight fasting blood was collected from each patient to measure serum zinc level through the graphite furnace atomic absorption spectrophotometry method. Multivariate logistic regression in forward LR method was employed to measure the associated factors of MDRTB. Of them, serum zinc level was found significantly lower in MDRTB patients than DSTB (mean value, 65.1 µg/dl vs. 72.8 µg/dl, p-value|0.001). Younger age (Odds ratio [OR], 0.974; 95% confidence interval [CI], 0.951 - 0.997), female gender (OR, 3.480; 95% CI, 1.519-7.972
BACKGROUND: Peru holds the fourth highest burden of tuberculosis in the Americas. Despite an apparently well-functioning DOTS control program, the prevalence of multidrug resistant tuberculosis (MDR-TB) continues to increase. To worsen this situation, cases of extensively drug resistance tuberculosis (XDR-TB) have been detected. Little information exists about the genetic diversity of drug-susceptible vs. MDR-TB and XDR-TB. METHODS: Cryopreserved samples of XDR strains from 2007 to 2009 (second semester), were identified and collected. Starting from 227 frozen samples, a total of 142 XDR-TB strains of Mycobacterium tuberculosis complex (MTBC; 1 isolate per patient) were retained for this study. Each strain DNA was analyzed by spoligotyping and the 15-loci Mycobacterial Interspersed Repetitive Unit (MIRU-15). RESULTS: Among the 142 isolates analyzed, only 2 samples (1.41%) could not be matched to any lineage. The most prevalent sublineage was Haarlem (43.66%), followed by T (27.46%), LAM (16.2%),
Pyrazinamide (PZA) is an important first-line drug in multidrug-resistant tuberculosis (MDRTB) treatment. However, the unreliable results obtained from traditional susceptibility testing limits its usefulness in clinical settings. The detection of pncA gene mutations is a potential surrogate of PZA susceptibility testing, especially in MDRTB isolates. The impact of genotypes of M. tuberculosis in pncA gene mutations also remains to be clarified. MDRTB isolates were collected from six hospitals in Taiwan from January 2007 to December 2009. pncA gene sequencing, pyrazinamidase activity testing, and spoligotyping were performed on all of the isolates. PZA susceptibility was determined by the BACTEC MGIT 960 PZA method. The sensitivity and specificity of pncA gene analysis were estimated based on the results of PZA susceptibility testing. A total of 66 MDRTB isolates, including 37 Beijing and 29 non-Beijing strains, were included for analysis. Among these isolates, 36 (54.5%) were PZA-resistant and 30 (45.5
Multidrug-resistant tuberculosis (MDR-TB) is difficult to treat and there exists a significant lack of information about this infectious disease. The World Health Organization (WHO) developed the Stop TB Strategy and guidelines on how to prevent, control and treat MDR-TB by using available data worldwide.. Guidelines, however, are theoretical knowledge that are not always easy to put into practice. The WMA therefore volunteered to produce a learning programme for the MDR-TB Guidelines. The course was updated together with the new WHO MDR-TB strategy in 2010.. This MDR-TB online course exists as a free self-learning online tool in English and Mandarin Chinese allowing physicians worldwide to learn and test their knowledge about MDR-TB. It is accredited by the South African Medical Association and the Norwegian Medical Association and will therefore be recognised throughout Europe.. A tablet application of the MDR TB course was developed to scale-up the education and skills of health care workers ...
Abstract. To find out the reason why some people get infected directly with multidrug-resistant tuberculosis (MDR-TB), whereas some get infected with drug-susceptible tuberculosis (DS-TB), a 1:1:1 matched-pairs case-control study was conducted to identify predictors associated with primary MDR-TB and primary DS-TB against the control in Jiangsu Province, China. All three groups were geographically matched (by neighborhood) and matched on sex and age (±5 years). In total, 110 participants were enrolled in each of three matched groups. Conditional logistic regression analysis showed that predictors independently associated with primary MDR-TB were illiteracy or primary school education, annual per capita income ≤ US$2,000, per capita living space < 40 m2, and interval ≥ 7 days of eating fruits; predictors with primary DS-TB were body mass index ≤ 20 and feeling higher life pressure. This indicates that there are different predictors impacting the transmission range of primary MDR-TB and primary
Nanomedicine as a Newly Emerging Approach Against Multidrug-Resistant Tuberculosis (MDR-TB): 10.4018/978-1-5225-0610-2.ch003: Emergence of MDR-TB is highly associated with morbidity and mortality and it needs high concerns about the possibility of a future TB epidemic as limited
The American Thoracic Society, Centers for Disease Control and Prevention, European Respiratory Society and IDSA have published an official clinical guideline on the treatment of drug-resistant tuberculosis in the Nov. 15 American Journal of Respiratory and Critical Care Medicine.. The guideline makes new recommendations for the choice and number of drugs, as well as the duration of treatment for drug-resistant tuberculosis. These recommendations prioritize the use of medications that can be administered orally. The guideline makes clear that treatment should be tailored based on drug-susceptibility testing, and that individuals should not receive medicines to which the Mycobacterium tuberculosis strain is resistant.. The guideline recommends treatment with a later-generation fluoroquinolone of all infected contacts of multidrug-resistant tuberculosis patients, rather than watchful observation, and it provides evidence-based guidance for the treatment of pregnant women with MDR-TB for the first ...
Institute of Human Virology, Nigeria has appealed to federal, state and local governments to provide more treatment centres for the management of drug resistant tuberculosis.. Dr Vivian Ibeziako, the Programme Manager, Drug Resistant Tuberculosis of the Institute, said on Friday in Lagos, that there currently 22 tuberculosis treatment centres in Nigeria.. Ibeziako made the call at the on-going review meeting organised by the institute and National Tuberculosis and Leprosy Control Programme which begun on Thursday.. According to her, the 22 tuberculosis treatment centres in the country are funded with global funds.. Global funds provide most of the drugs which made them to introduce shorter regimen, because it is better than the longer regimen, she said.. Promoting more centres that can manage drug resistant tuberculosis is necessary in all health centres.. More communities need treatment centres to tackle the missing cases of tuberculosis among the people.. We have a lot of missing cases in ...
Research in the June issue of The Journal of Nuclear Medicine, however, shows that the use of 18F-FDG positron emission tomography (PET) scans can help to determine earlier if treatment for tuberculosis is working or if the disease is MDR.. Tuberculosis and HIV have been linked since the AIDS epidemic began. Approximately 33.2 million people across the world are living with HIV, and an estimated one-third of them are co-infected with tuberculosis. In 2008, the number of MDR tuberculosis cases reached between 390,000-510,000, or 3.6 percent of all incident tuberculosis cases. MDR tuberculosis is very difficult to treat and is often fatal.. Early detection of drug resistance of tuberculosis allows the initiation of an appropriate treatment, which may significantly affect patient survival. Currently, more than two-thirds of patients with MDR tuberculosis die, said Mike Sathekge, MD, PhD, lead author of the study Use of 18F-FDG PET to Predict Response to First-Line Tuberculostatics in ...
In a nationwide survey in 2011, multidrug-resistant tuberculosis (MDR TB) was found in 5.2% and 40.8% of patients with new and previously treated TB, respectively. These levels of drug resistance are among the highest ever documented in Africa and the Middle East. This finding presents a serious challenge for TB control in Somalia.
Although progress has been made to reduce global incidence of drug-susceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. However, countries are responding far too slowly. Of the estimated 440 000 cases of MDR tuberculosis that occurred in 2008, only 7% were identified and reported to WHO. Of these cases, only a fifth were treated according to WHO standards. Although treatment of MDR and XDR tuberculosis is possible with currently available diagnostic techniques and drugs, the treatment course is substantially more costly and laborious than for drug-susceptible tuberculosis, with higher rates of treatment failure and mortality. Nonetheless, a few countries provide examples of how existing technologies can be used to reverse the epidemic of MDR tuberculosis within a decade. Major improvements in laboratory capacity, infection control, performance of tuberculosis control ...
Kwonjune Seung and Stephen Linton from the non-governmental organization EugeneBell discuss the worryingly high levels of multidrug-resistant tuberculosis they have observed in North Koreas tuberculosis sanatoria. Please see later in the article for the Editors Summary
TY - JOUR. T1 - Rifabutin. T2 - Is it useful in the treatment of multidrug-resistant tuberculosis?. AU - Tiberi, S.. AU - DAmbrosio, L.. AU - Centis, R.. AU - Migliori, G. B.. PY - 2017/12/1. Y1 - 2017/12/1. UR - http://www.scopus.com/inward/record.url?scp=85034789501&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=85034789501&partnerID=8YFLogxK. U2 - 10.1016/j.ijid.2017.10.019. DO - 10.1016/j.ijid.2017.10.019. M3 - Editorial. AN - SCOPUS:85034789501. VL - 65. SP - 133. EP - 134. JO - International Journal of Infectious Diseases. JF - International Journal of Infectious Diseases. SN - 1201-9712. ER - ...
TY - JOUR. T1 - Newer drugs and targets in tuberculosis. AU - Subramanian, Harish Thanu. AU - Meena Kumari, K.. AU - Amberkar Mohan Babu, V.. PY - 2016/1/1. Y1 - 2016/1/1. N2 - In the year 2013, nine million people suffered from tuberculosis. Around 1.5 million people (men, woman and children) died due to tuberculosis. About 1.1 million people with HIV developed tuberculosis. The major drawbacks of tuberculosis treatment in a patient are multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB). Recently newer drugs and targets have been the key focus of research in finding the permanent cure for tuberculosis. The FDA has recently approved a new tuberculosis drug bedaquiline. The drugs under trials are delamanid, pretomanid, sutezolid and SQ109. Drugs in preclinical development showing promising results are benzothiazinone, spectinamide, capuramycin, TBI-166 (Riminophenazines antibiotic). The various lead compounds which showed promising activity against ...
In 2011, Georgia, in the Caucasus, reported that 11% of new and 32% of previously treated tuberculosis (TB) cases nationally had multidrug-resistant TB (MDR-TB). To help understand the mechanisms driving these high risks of drug-resistance and plan for targeted interventions, we identified geographical variability in the MDR-TB burden in Georgia and patient-level MDR-TB risk factors. We used routinely collected surveillance data on notified TB cases to estimate the MDR-TB incidence/100,000 people and the percentage of TB cases with MDR-TB for each of 65 districts and regression modelling to identify patient-level MDR-TB risk factors. 1,795 MDR-TB cases were reported (January 2009?June 2011); the nationwide notified MDR-TB incidence was 16.2/100,000 but far higher (837/100,000) in the penitentiary system. We found substantial geographical heterogeneity between districts in the average annual MDR-TB incidence/100,000 (range: 0.0?5.0 among new and 0.0?18.9 among previously treated TB cases) and the ...
Mycobacterium tuberculosis drug resistance (DR) challenges effective tuberculosis disease control. Current molecular tests examine limited numbers of mutations, and although whole genome sequencing approaches could fully characterise DR, data complexity has restricted their clinical application. A library (1,325 mutations) predictive of DR for 15 anti-tuberculosis drugs was compiled and validated for 11 of them using genomic-phenotypic data from 792 strains. A rapid online TB-Profiler tool was developed to report DR and strain-type profiles directly from raw sequences. Using our DR mutation library, in silico diagnostic accuracy was superior to some commercial diagnostics and alternative databases. The library will facilitate sequence-based drug-susceptibility testing.
TY - JOUR. T1 - Transmission of MDR and XDR tuberculosis in Shanghai, China. AU - Zhao, Ming. AU - Li, Xia. AU - Xu, Peng. AU - Shen, Xin. AU - Gui, Xiaohong. AU - Wang, Lili. AU - DeRiemer, Kathryn. AU - Mei, Jian. AU - Gao, Qian. PY - 2009. Y1 - 2009. N2 - Background: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are global health problems. We sought to determine the characteristics, prevalence, and relative frequency of transmission of MDR and XDR TB in Shanghai, one of the largest cities in Asia. Methods: TB is diagnosed in district TB hospitals in Shanghai, China. Drug susceptibility testing for first-line drugs was performed for all culture positive TB cases, and tests for second-line drugs were performed for MDR cases. VNTR-7 and VNTR- 16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient. Results: There were 4,379 culture positive TB cases diagnosed with drug susceptibility test results ...
But TB is making a comeback globally today - particularly among the homeless, those in prison, and those rendered susceptible because of HIV infection. TB remains one of the major diseases afflicting children throughout the world. Although the exact number of annual cases of childhood tuberculosis is unknown, the World Health Organization (WHO) has estimated approximately 1 million new cases and 400,000 deaths per year in children due to tuberculosis. Many of these cases go undiagnosed and untreated and many of these children could be salvaged if there were improvements in diagnosis and treatment available for ...
The majority of persons with the illness (90% to 95%) have latent TB infection (LTBI) and do not exhibit any symptoms. The bacteria can remain inactive for many years and the chance of developing active TB diminishes over time.. Persons with active TB have symptoms which include excessive coughing (sometimes with blood), chest pain, general weakness, lack of appetite, weight loss, swollen lymph glands, fever, chills, and night sweats. It can be misdiagnosed for bronchitis or pneumonia. If untreated, active TB can fatal.. Tuberculosis treatment involves taking antibiotics for a minimum of 6 months. Drug-resistant TB is a major concern as an increasing number of people are no longer able to be treated with previously effective drugs. Due to misuse of antibiotic therapies, patients can develop multi-drug resistant Tuberculosis (MDR TB). When a second line of antibiotics fail to cure the multi-drug resistant infection, it is known as extensively drug-resistant Tuberculosis (XDR TB).. ...
The majority of persons with the illness (90% to 95%) have latent TB infection (LTBI) and do not exhibit any symptoms. The bacteria can remain inactive for many years and the chance of developing active TB diminishes over time.. Persons with active TB have symptoms which include excessive coughing (sometimes with blood), chest pain, general weakness, lack of appetite, weight loss, swollen lymph glands, fever, chills, and night sweats. It can be misdiagnosed for bronchitis or pneumonia. If untreated, active TB can fatal.. Tuberculosis treatment involves taking antibiotics for a minimum of 6 months. Drug-resistant TB is a major concern as an increasing number of people are no longer able to be treated with previously effective drugs. Due to misuse of antibiotic therapies, patients can develop multi-drug resistant Tuberculosis (MDR TB). When a second line of antibiotics fail to cure the multi-drug resistant infection, it is known as extensively drug-resistant Tuberculosis (XDR TB).. ...
Endalkachew Fekadu, a multi-drug resistant TB survivor. Multi-drug resistant, or MDR-TB, is on the rise in the developing world. In 2014, WHO estimated that between 32 000 to 49 000 MDR-TB patients live in the African Region. In Ethiopia, about 40 health centres do have the capacity to diagnose and treat MDR-TB.. Diagnosis didnt lead to immediate treatment. The MDR-TB treatment I desperately needed was only available outside Ethiopia, and it was too expensive. My family and friends made contributions but it wasnt enough.. Everybody was waiting for my death, until a guardian angel appeared. Mr. Mike Hinckfoot from Compassion International offered to bring the drugs from the USA. They were difficult to import and werent even registered with drug administration and control authority. But after many ups and downs I got the medicine, tells Endalkachew.. But with thanks to God I finished the medication on 6 June 2007. I was certified cured and I am perfectly OK now! I feel like Ive been given a ...
Scanning electron micrograph (SEM) of Mycobacterium tuberculosis, MDR-TB and XDR-TB strain, rod bacterium (prokaryote). Mycobacterium tuberculosis is the primary causative agent of human tuberculosis (TB). Contaminated respiratory secretions transmit the infection between humans. In the past few years drug resistant strains, MDR-TB and XDR-TB strains have emerged, especially in developing countries. MDR-TB (Multidrug Resistant TB) strains are resistant to at least the two first-line TB drugs, isoniazid and rifampicin. XDR-TB, or Extensive Drug Resistant TB (also known as Extreme Drug Resistance) is a strain that is also resistant to three or more of the six classes of second-line drugs. Drug-resistant TB is a public health issue in many developing countries, as treatment is longer and requires more expensive drugs. Magnification: x3,400 when shortest axis printed at 25 millimetres. - Stock Image C037/0132
The Cambodian MDR-TB programme achieved 77% treatment success (cure or completion) using a standardised treatment regimen between September 2006 and June 2015. Treatment success was achieved equally in patients with MDR-TB treated in hospitalised and community arms. Notably, this level of treatment success observed in the community arm is equivalent or superior to outcomes achieved in other resource-limited settings with prolonged initial inpatient hospitalisation,18 and equivalent or superior to other community-based MDR-TB treatment programmes.19. The CHC/NTP collaborative Cambodian MDR-TB programme represents the first large-scale MDR-TB treatment programme in Asia with a significant home-based component. The outcomes from the Cambodian MDR-TB programme demonstrate that a programme designed with the following fundamental components can achieve high rates of cure and completion in a resource-limited setting: (1) the option for primarily ambulatory, community-based care from the initiation of ...
Olive leaf extract, which has been shown in clinical research to be effective against HIV, should be investigated for the treatment of Extremely Drug Resistant tuberculosis (XDR-TB).. Olive leaf extract (OLE) is a powerful anti-viral, anti-bacterial, anti-fungal and anti-inflammatory agent which has been shown to be effective in the treatment of many conditions where antibiotics and other conventional medications have been found to be ineffective.. Like artemisinin, which is used for the treatment of malaria, olive leaf extract traditionally received little attention in medical circles, despite a wealth of anecdotal evidence indicating its efficacy for the treatment of anything from a multitude of conditions.. Olive leaf extract (OLE) is a powerful anti-viral, anti-bacterial, anti-fungal and anti-inflammatory agent which has been shown to be effective in the treatment of many conditions where antibiotics and other conventional medications have been found to be ineffective.. Like artemisinin, ...
A new report, Tuberculosis surveillance in Europe 2009, a joint publication from ECDC and the WHO Regional Office for Europe to mark World Tuberculosis Day 2011, provides evidence for concern about the spread of multi-drug resistant tuberculosis (MDR TB) and the persistence of TB among children.
Tuberculosis drug shows promise against latent bacteria WASHINGTON, Sept. 12 (Xinhua) -- A new study has shown that an investigational drug R207910, currently in clinical trials against multi-drug resistant tuberculosis strains, is quite effective at killing latent bacteria, a report said on Friday. This revelation suggests that R207910 may lead to improved and shortened treatments for this globally prevalent disease, researchers from Johnson & Johnson reported in the Sept. 12 issue of Journal of Biological Chemistry. Despite numerous treatment advances, tuberculosis (TB) remains a serious disease -- fueled by co-infection of HIV patients, the rise of drug-resistant strains, and the ability of Mycobacterium tuberculosis to become dormant and linger in the lungs. People can be infected, asymptotically, with latent TB and is at risk of developing active TB disease during their life time. The research team tested R207910 on dormant M. tuberculosis in three different laboratory models of latency. ...
DNA fingerprinting is an important tool for tracking the spread and studying the global diversity of M. tuberculosis. With the increasing recognition of the importance of the Beijing genotype family in the worldwide TB epidemic (2, 10), the availability of a suitable typing method for this family, which can be used for large-scale typing, became a matter of utmost importance in the global control of TB. Due to its high resolution, simplicity, sensitivity, high reproducibility, and easy interlaboratory comparison (15, 18, 25), the 12-locus MIRU typing method has been found to be highly suitable for global epidemiological surveillance of TB. MIRU typing was even found to produce more distinct patterns than IS6110 RFLP and spoligotyping (1, 4). In 2002, following the adoption of an agreed International Standard Protocol, a consensus was reached in the European Union Concerted Action meeting, New Genetic Markers and Techniques for the Epidemiology and Control of Tuberculosis (Cascais, Portugal, ...
Background: Since in low incidence TB countries population migration and complex treatment of drug-resistant tuberculosis (DR-TB) patients are major issues, we aimed to analyse patient risk factors associated with the incidence of poor outcome of TB treatment among DR-TB patients in the Netherlands.. Methods: This retrospective cohort study included adult patients with confirmed DR-TB treated from 2005 to 2015. We obtained data from a nationwide exhaustive registry of tuberculosis patients in the Netherlands. Predictors for unsuccessful TB treatment (defaulted and failed treatment) and TB-associated mortality were analysed using multivariate logistic regression.. Results: Among 10,303 registered TB patients, 545 patients with DR-TB were analysed. Six types of DR-TB were identified from the included patients, i.e. isoniazid mono- or poly-resistance (68%); rifampicin mono- or poly-resistance (3.1%); pyrazinamide mono-resistance (8.3%); ethambutol mono-resistance (0.1%); multidrug-resistance ...
Multidrug-resistant tuberculosis (TB) threatens TB control worldwide. The microscopic observation drug susceptibility (MODS) assay is a low-cost, high-performance TB diagnostic tool for rapid liquid culture and direct isoniazid and rifampicin drug susceptibility testing (DST). The objective of this study was to explore the potential for extending the MODS assay to rapid second-line DST and to identify critical concentrations of candidate drugs for prospective testing. Sputum samples from 94 TB culture-positive patients receiving second-line TB agents were cultured following standardised MODS protocols, with a range of titrations of antimicrobial drugs added. Critical concentrations were determined using a modified Kaplan-Meier survival curve analysis. Candidate critical concentrations were determined for capreomycin (10 mu g.mL(-1)), ciprofloxacin (1.25 mu g.mL(-1)), cycloserine (40 mu g.mL(-1)), ethambutol (10 mu g.mL(-1)), ethionamide (5 mu g.mL(-1)), kanamycin (5 mu g.mL(-1)) ...
Ghanaian experts are concerned about the rising number of tuberculosis. The Ghana Health Service said 14,632 people were diagnosed with TB and put on treatment.. Health experts in Ghana are urging the government to tackle rising cases of multidrug resistance tuberculosis (MDR-TB) in the country. We need multiple TB drugs, said Paula Fujiwara, the scientific director of the International Union Against Tuberculosis and Lung Disease. When you treat tuberculosis, you need many drugs.. Fujiwara said Ghana is recording an increase in the number of patients who developed multidrug resistance TB. The worst thing you can do in treating TB is to give one drug. Because you give one drug it kills some of the germs but other germs are living. So you need to have another drug that attacks it from another angle. But we are running out of drugs, said Fujiwara.. MDR-TB is a form of TB infection caused by bacteria that are resistant to treatment. The resistance is fueled by many factors including the poor ...
TY - JOUR. T1 - Multidrug-resistant and extensively drug-resistant tuberculosis. AU - Chiang, Chen Yuan. AU - Yew, W. W.. PY - 2009/3. Y1 - 2009/3. KW - Extensively drug-resistant. KW - Multidrug-resistant. KW - Tuberculosis. UR - http://www.scopus.com/inward/record.url?scp=62349133683&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=62349133683&partnerID=8YFLogxK. M3 - Article. C2 - 19275788. AN - SCOPUS:62349133683. VL - 13. SP - 304. EP - 311. JO - International Journal of Tuberculosis and Lung Disease. JF - International Journal of Tuberculosis and Lung Disease. SN - 1027-3719. IS - 3. ER - ...
The rise of drug-resistant strains is a major challenge to containing the tuberculosis (TB) pandemic. Yet, little is known about the extent of resistance in early years of chemotherapy and when transmission of resistant strains on a larger scale became a major public health issue. Here we reconstruc …
RESULTS: Fifty-five cases of culture-confirmed MDR-TB, including two cases of extensively drug-resistant TB, were diagnosed. All cases were reviewed by an expert management panel. Fifty cases (91%) were foreign-born, and 50 cases (91%) had fully supervised treatment. Of the 55 cases, 46 (84%) successfully completed treatment, 3 (5%) died of TB and 3 (5%) required surgery. No MDR-TB cases were reported among contacts ...
RESULTS: In the Western Cape and Eastern Cape Provinces, the percentage of isolates exhibiting inhA promoter mutations increased significantly from respectively 48.4% and 62.4% in multidrug-resistant tuberculosis (MDR-TB) isolates to 85.5% and 91.9% in XDR isolates. Data from the Western Cape revealed that significantly more XDR-TB isolates showed mutations in the inhA promoter than in katG (85.5% vs. 60.9%, P < 0.01), while the respective proportions were equal for INH-resistant non-MDR-TB isolates (∼30 ...
The summary report on multidrug-resistant tuberculosis (MDR-TB) services was released during the ongoing Lung Week (12-17 November) and the 43rd Union World Conference on Lung Health in Kuala Lumpur, Malaysia. Citizen News Service - CNS, a partner of the Stop TB Partnership, along with other partners such as National Partnership for TB Care and Control in India, Rural Youth Advocate for Health and Development in Nigeria, National Council of People Living with HIV in India (NCPI+), International Treatment Preparedness Coalition (ITPC) India, Global Health Advocates (GHA), Sneha Foundation Varanasi, Asha Parivar, Vote For Health campaign, National Alliance of Peoples Movements (NAPM) and the Global Stop-TB eForum had hosted the online consultation and key informant interviews on issues related to multidrug-resistant tuberculosis (MDR-TB ...
A recent study, now published in the highly regarded scientific journal Nature Genetics, considerably expands the present body of knowledge concerning the genetic determinants of drug resistance in M. tuberculosis. In this study, new genetic mutations associated with important second-line drugs for multidrug resistant tuberculosis treatment regimens such as cycloserine, ethionamide and para-amino salicylic acid are described. Also, the study identifies novel interactions between drug resistance associated genes that may contribute to increased resistance levels and, also highlights the role of efflux pumps (membrane proteins specialized in molecular transport) in the development of drug resistance across this bacterial species.. Beyond the more comprehensive and deeper knowledge on M. tuberculosis resistance mechanisms conveyed by this new data, it will enable the inclusion of specific markers for drug resistance in new rapid molecular diagnosis tests, envisioning an increase in sensitivity and ...
The main treatment for drug-resistant tuberculosis (TB) could increase the appearance of resistant bacteria if used inappropriately, say researchers who have identified the genetic cause of this ironic twist.
Tuberculosis is the second leading cause of infectious deaths globally. Many effective conventional antimycobacterial drugs have been available, however, emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) has overshadowed the effectiveness of the current first and second line drugs. Further, currently available agents are complicated by serious side effects, drug interactions and long-term administration. This has prompted urgent research efforts in the discovery and development of new anti-tuberculosis agent(s). Several families of compounds are currently being explored for the treatment of tuberculosis. This review article presents an account of the existing chemotherapeutics and highlights the therapeutic potential of emerging molecules that are at different stages of development for the management of tuberculosis disease.
Romania has the highest number of resistant TB patients in Europe. A story about people and statistics. Iulian Dobre died of multi-drug resistant tuberculosis. He was 42 years old and was one of the few patients who openly spoke about this disease, which is considered shameful in Romania. In theory the disease is treatable. In […]. ...
Researchers say there is an urgent need for rapid diagnostics to prevent the geographical spread of multi-drug resistant tuberculosis (TB) in Papua New Guinea (PNG).. A joint University of Queensland and Queensland Health-led team has completed the first genetic analysis of TB strains circulating on PNGs Daru Island, a major hotspot for TB outbreaks on Australias doorstep.. UQ Institute for Molecular Bioscience (IMB) Associate Professor Lachlan Coin said by retrospectively constructing a molecular clock, researchers found one strain had developed mutations against 12 drugs by 2009, rendering all first- and second-line treatments ineffective.. Standard treatments would not help people with this extensively drug-resistant strain, and those patients would remain infectious until an effective treatment was given, Dr Coin said.. Other strains have acquired resistance to a varying number of the drugs contained in standard treatments.. PNG health services urgently need the tools to rapidly ...
Wednesday, March 25, 2015. Johns Hopkins-affiliated health IT startup emocha is marking World TB Day with the launch of a new system in South Africa.. The system uses three apps to take patients with multi-drug resistant tuberculosis (MDR-TB) - a more deadly form of TB - through the process of getting care. There are three separate apps that are designed to link patients with the disease to treatment at specialized clinics.. The emocha system is specifically designed to address a major gap in the healthcare system: about half of the 16,000 people diagnosed with MDR-TB dont return for treatment after being diagnosed at a primary care clinic.. emocha developed the apps as part of an initiative called the MDR-TB Partnership. Made up of the Johns Hopkins University School of Nursing, the National Department of Health of South Africa and the National Health Lab Service, the partnership aims to devise new approaches to treating TB. The startup, which uses mobile health technology licensed from JHU, ...