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Caminero, Jose, and Charles Daley. "Management of Multidrug-Resistant Tuberculosis." Seminars in Respiratory and Critical Care Medicine 39, no. 03 (June 2018): 310–24. http://dx.doi.org/10.1055/s-0038-1661383.
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AbstractDrug-resistant strains of Mycobacterium tuberculosis pose a major threat to global tuberculosis control. Despite the availability of curative antituberculosis therapy for nearly half a century, inappropriate and inadequate treatment of tuberculosis, as well as unchecked transmission of M. tuberculosis, has resulted in alarming levels of drug-resistant tuberculosis. The World Health Organization (WHO) estimates that there were 600,000 cases of multidrug-resistant tuberculosis (MDR-TB)/rifampin-resistant (RR) tuberculosis in 2016, defined as strains that are resistant to at least isoniazid and rifampicin. Globally, WHO estimates that 4.1% of new tuberculosis cases and 19% of retreatment cases have MDR-TB. By the end of 2016, 123 countries had reported at least one case of extensively drug-resistant strains, which are MDR-TB strains that have acquired additional resistance to fluoroquinolones and at least one second-line injectable. It is estimated that only 22% of all MDR-TB cases are currently receiving therapy. This article reviews the management of MDR/RR-TB and updates recommendations regarding the use of shorter course regimens and new drugs.
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Mashidayanti, Aulia, Nurlely Nurlely, and Nani Kartinah. "Faktor Risiko Yang Berpengaruh Pada Kejadian Tuberkulosis dengan Multidrug-Resistant Tuberculosis (MDR-TB) di RSUD Ulin Banjarmasin." Jurnal Pharmascience 7, no. 2 (October 31, 2020): 139. http://dx.doi.org/10.20527/jps.v7i2.7928.
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MDR-TB (Multidrug-Resistant Tuberculosis) adalah salah satu jenis TB yang resisten dengan OAT (Obat Anti Tuberculosis) dengan resisten terhadap 2 obat anti tuberculosis yang paling ampuh yaitu rifampisin dan isoniazid. Obat rifampisin dan isoniazid sudah tidak efektif dalam membunuh kuman mycobacterium tuberkulosis dikarenakan kuman yang sudah resisten terhadap obat tersebut. MDR-TB merupakan suatu permasalahan yang menjadi hambatan utama dunia dalam pemberantasan TB. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor risiko apa saja yang dapat berpengaruh pada kejadian tuberkulosis dengan multidrug-resistant tuberculosis (MDR-TB) di RSUD Ulin Banjarmasin dengan variabel yang ditinjau adalah pengetahuan, motivasi dan keteraturan minum obat. Metode penelitian dengaan rancangan Cross Sectional dengan metode pengambilan dengan kuesioner. Populasi dalam penelitian ini adalah seluruh pasien dengan diagnosis tuberkulosis multidrug resistant tuberculosis (MDR-TB) dan pasien TB Non MDR yang digunakan sebagai pembanding yang dipilih secara acak. Hasil pada penelitian ini menunjukkan bahwa faktor risiko yang terbukti berpengaruh pada kejadian TB-MDR adalah keteraturan minum obat (p-value< 0,05). Oleh karena itu, untuk mengurangi potensi bertambahnya penderita TB-MDR, maka perlu diperhatikan lagi keteraturan minum obat penderita, memastikan agar penderita benar-benar rutin dan teratur dalam minum obat. MDR-TB (Multidrug-Resistant Tuberculosis) is one of tuberculosis characterized by resistant to anti-TB drug (Anti Tuberculosis Drug). An MDR-TB event is a resistance event to 2 of the most effective anti-TB drugs which are rifampicin and isoniazid. Rifampicin and isoniazid are no longer effective in killing Mycobacterium tuberculosis bacteria due to its resistant to the drug. The purpose of this study is to identify any risk factors that can affect the incidence of tuberculosis with multidrug-resistant tuberculosis (MDR-TB) in RSUD Ulin Banjarmasin. The variables in this study were knowledge, motivation and regularity of taking drugs. The research method was a cross sectional design using questionnaire to the patients. The population in this study was all patients with a diagnosis of multidrug resistant tuberculosis (MDR-TB) and non-MDR TB patients who used as a comparison which were selected randomly. The results of this study indicate that the risk factor that has been shown to influence the incidence of MDR-TB was the regularity of taking medication (p-value <0.05). Therefore, to reduce the potential of MDR-TB sufferers to increase, it is necessary to pay attention to taking drug regularity of patient, ensuring that the patient is really routine and taking medication regularly.Keywords: RSUD Ulin Banjarmasin, MDR-TB (Multidrug-Resistant Tuberculosis), Tuberculosis
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Paudel, Sita. "Risk Factors of Multidrug-Resistant Tuberculosis." International Journal of Applied Sciences and Biotechnology 5, no. 4 (December 24, 2017): 548–54. http://dx.doi.org/10.3126/ijasbt.v5i4.18771.
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Multidrug-resistant tuberculosis has been increased worldwide which is a severe problem. A case-control study was carried out among 50 MDR-TB cases and 63 drug susceptible controls to identify risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Lumbini Zone. Irregularity in taking medicine (OR=2.36), large family size (OR=2.40), farming as occupation (OR=2.83), history of TB and bovine at home (OR=6.5) were statistically associated with MDR-TB. Most of the MDR-TB cases were males (82%) and individual with the age group 21-30 years (40%) were highly infected with MDR-TBInt. J. Appl. Sci. Biotechnol. Vol 5(4): 548-554
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Yulianti, Yulianti, and Sally Mahdiani. "Gangguan pendengaran penderita Tuberkulosis Multidrug Resistant." Oto Rhino Laryngologica Indonesiana 45, no. 2 (December 31, 2015): 83. http://dx.doi.org/10.32637/orli.v45i2.112.
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Latar belakang: Tuberkulosis Multidrug Resistant (TB MDR) merupakan penyakit tuberkulosis (TB) yang resisten terhadap isoniazid dan rifampisin, dengan atau tanpa resisten terhadap obat anti- TB lain. Terapi aminoglikosida pada TB MDR berisiko untuk terjadinya gangguan fungsi telinga dan sistem keseimbangan tubuh, yang dapat bersifat irreversible atau permanen. Kerusakan pada koklea dapat menimbulkan penurunan pendengaran permanen. Tujuan: Mengetahui gangguan pendengaran penderita TB MDR di poliklinik TB MDR Ilmu Penyakit Dalam RS Hasan Sadikin Bandung. Metode: Penelitian deskriptif secara retrospektif pada pasien TB MDR yang berobat jalan di poliklinik TB MDR Ilmu Penyakit Dalam Rumah Sakit Hasan Sadikin Bandung periode 1 Januari - 31 Desember 2013. Hasil: Didapatkan gangguan pendengaran sebanyak 20,8% dari pasien TB MDR selama mendapat terapi TB MDR dengan keluhan tinitus dan gangguan pendengaran dengan onset timbulnya keluhan di bulan ke-3 (53,3%), kemudian bulan ke-6 (40%), dan bulan ke-10 (6,7%) setelah mulai pemberian terapi TB MDR. Pada pemeriksaan audiometri nada murni ditemukan penurunan pendengaran sensorineural yang bervariasi dari derajat ringan sampai berat. Kesimpulan: Pengobatan TB MDR dapat menyebabkan penurunan pendengaran sensorineural.Kata Kunci : Tuberkulosis Multidrug Resistant, audiometri nada murni, gangguan pendengaran sensorineural ABSTRACT Background: Multidrug Resistant Tuberculosis (MDR TB) is a tuberculosis (TB) which resistant to isoniazid and rifampin, with or without resistancy to other anti-TB drugs. Aminoglycoside therapy in MDR TB patients takes risks to malfunctioning of the ear and balance system. The hearing loss and balance system impairment that appeared are irreversible/permanent. Cochlear damage can cause permanent hearing loss. Purpose: To describe hearing loss in patients with MDR TB at MDR TB clinic of internal medicine in Hasan Sadikin hospital. Methods: A retrospective descriptive study on MDR TB patients in MDR TB outpatient clinic of Internal Medicine in Hasan Sadikin hospital in the period of January 1st to December 31th, 2013. Results: There were 20,8% of MDR TB patients who received treatment for MDR TB with tinnitus and hearing loss with onset of presentation at the 3rd month (53,3%), at the 6th month (40%), and at the 10th month (6,7%) of MDR TB therapy. Pure tone audiometry examination found sensorineural hearing loss with various degrees from mild to severe. Conclusion: Treatment of MDR TB could cause sensorineural hearing loss.Keywords: Tuberculosis Multidrug Resistant, pure tone audiometric, sensorineural hearing loss
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Khurram, Muhammad, Hamama Tul Bushra Khaar, and Muhammad Fahim. "Multidrug-resistant tuberculosis in Rawalpindi, Pakistan." Journal of Infection in Developing Countries 6, no. 01 (September 26, 2011): 29–32. http://dx.doi.org/10.3855/jidc.1738.
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Introduction: Multidrug-resistant (MDR) tuberculosis (TB) strains are resistant to isoniazid and rifampicin. Clinical characteristics, drug susceptibility patterns, and outcomes of MDR-TB patients treated at Holy Family Hospital, Rawalpindi, Pakistan, were studied from January 2007 to April 2010. Methodology: Thirty diagnosed patients (60% male and 40% female) of MDR pulmonary TB were included. Each patient was treated according to WHO guidelines and followed for two years. Clinical characteristics (age, gender, literate or illiterate educational status, employment status, and income), drug susceptibility testing (DST) reports, and outcome (cured, treatment failure, default, and died) of each patient was noted.Results: Mean patient age was 36.2 ± 15.4 years. In total, 60% patients were illiterate, 60% employed, 60% had income < Rs 5000 (42 Euro per month), 73.3% lived in an overcrowded residence, 60% were smokers, and 83.3% had taken anti-tuberculosis therapy previously. DST of MDR-TB strains for ethambutol, pyrazinamide, and streptomycin showed high resistance ( > 60%). Except for ofloxacin and ciprofloxacin, < 20% resistance was noted in second-line anti-tuberculosis agents. Overall, 10% of patients were cured, 40% died, 20% had treatment failure, and 30% patients defaulted.Conclusion: Pulmonary MDR-TB in Rawalpindi, Pakistan, is common in young males, poverty related circumstances, and has poor outcome. DST shows high resistance to first- line anti-tuberculosis agents and quinolones
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Huang, Huai, Yu-Shuai Han, Jing Chen, Li-Ying Shi, Li-Liang Wei, Ting-Ting Jiang, Wen-Jing Yi, Yi Yu, Zhi-Bin Li, and Ji-Cheng Li. "The novel potential biomarkers for multidrug-resistance tuberculosis using UPLC-Q-TOF-MS." Experimental Biology and Medicine 245, no. 6 (February 11, 2020): 501–11. http://dx.doi.org/10.1177/1535370220903464.
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The lack of rapid and efficient diagnostics impedes largely the epidemic control of multidrug-resistant tuberculosis, and might misguide the therapeutic strategies as well. This study aimed to identify novel multidrug-resistant tuberculosis biomarkers to improve the early intervention, symptomatic treatment and control of the prevalence of multidrug-resistant tuberculosis. The serum small molecule metabolites in healthy controls, patients with drug-susceptible tuberculosis, and patients with multidrug-resistant tuberculosis were screened using ultra-high-performance liquid chromatography combined with quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF-MS). The differentially abundant metabolites were filtered out through multidimensional statistical analysis and bioinformatics analysis. Compared with drug-susceptible tuberculosis patients and healthy controls, the levels of 13 metabolites in multidrug-resistant tuberculosis patients altered. Among them, the most significant changes were found in N1-Methyl-2-pyridone-5-carboxamide (N1M2P5C), 1-Myristoyl-sn-glycerol-3-phosphocholine (MG3P), Caprylic acid (CA), and D-Xylulose (DX). And a multidrug-resistant tuberculosis/drug-susceptible tuberculosis differential diagnostic model was built based on these four metabolites, achieved the accuracy, sensitivity, and specificity of 0.928, 86.7%, and 86.7%, respectively. The enrichment analysis of metabolic pathways showed that the phospholipid remodeling of cell membranes was active in multidrug-resistant tuberculosis patients. In addition, in patients with tuberculosis, the metabolites of dipalmitoyl phosphatidylcholine (DPPC), a major component of pulmonary surfactant, were down-regulated. N1M2P5C, MG3P, CA, and DX may have the potential to serve as novel multidrug-resistant tuberculosis biomarkers. This research provides a preliminary experimental basis to further investigate potential multidrug-resistant tuberculosis biomarkers. Impact statement The MDR-TB incidence remains high, making the effective control of TB epidemic yet challenging. Rapid and accurate diagnosis is vitally important for improving the therapeutic efficacy and controlling the prevalence of drug resistance TB. Metabolomics has dramatic potential to distinguish MDR-TB and DS-TB. N1M2P5C, MG3P, CA, and DX that we identified in this study might have potential as novel MDR-TB biomarkers. The phospholipid remodeling of cell membranes was highly active in MDR-TB. The DPPC metabolites in TB were significantly down-regulated. This work aimed to investigate potential MDR-TB biomarkers to enhance the clinical diagnostic efficacy. The metabolic pathway distinctly altered in MDR-TB might provide novel targets to develop new anti-TB drugs.
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Gobaud, A. N., C. A. Haley, J. W. Wilson, R. Bhavaraju, A. Lardizabal, B. J. Seaworth, and N. D. Goswami. "Multidrug-resistant tuberculosis care in the United States." International Journal of Tuberculosis and Lung Disease 24, no. 4 (April 1, 2020): 409–13. http://dx.doi.org/10.5588/ijtld.19.0515.
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BACKGROUND: To examine the utilization of the Tuberculosis (TB) Centers of Excellence (COE) medical consultation service and evaluate how these services were being employed for patients in relation to multidrug-resistant TB (MDR-TB).METHODS: Medical consults are documented in a secure database. The database was queried for MDR-TB consultations over the period 1 January 2013–31 December 2017. All were analyzed to assess provider type, center, setting, year of call, and type of patient (pediatric vs. adult). A subgroup was randomly selected for thematic analysis.RESULTS: The centers received 1560 MDR-TB consultation requests over this period. Providers requesting consults were primarily physicians (55%). The majority of requests were from public health departments (64%) and for adult patients (80%). Four major topic areas emerged: 1) initial management of MDR-TB, 2) MDR-TB longitudinal treatment and complications, 3) management of persons exposed to MDR-TB, and 4) MDR-TB treatment completion.CONCLUSIONS: Analysis of these consultations provides insight into the type of expert advice about MDR-TB that was provided. These findings highlight topics where increased medical training and education may help to improve MDR-TB-related practices.
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Butov, D., C. Lange, J. Heyckendorf, I. Kalmykova, T. Butova, N. Borovok, M. Novokhatskaya, and D. Chesov. "Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine." International Journal of Tuberculosis and Lung Disease 24, no. 5 (May 1, 2020): 485–91. http://dx.doi.org/10.5588/ijtld.19.0508.
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OBJECTIVE: To document the level of drug resistance in MDR-TB patients and to characterize management capacities for their medical care and MDR-TB treatment outcomes in the Kharkiv region of Ukraine. This area has one of the highest frequencies of MDR-TB worldwide.METHODS: A retrospective observational cohort study was performed on registry data from the regional anti-TB dispensary in Kharkiv. All microbiologically confirmed MDR-TB patients registered in 2014 were included. Diagnostic, treatment and post-treatment follow-up data were analysed.RESULTS: Of 169 patients with MDR-TB, 55.0% had pre-extensively drug-resistant (pre-XDR) or XDR resistant patterns. Rapid molecular diagnosis by GeneXpert and liquid M. tuberculosis cultures were only available for 66.9% and 56.8% of patients, respectively. Phenotypic drug-susceptibility testing (DST) for high priority TB drugs (bedaquiline, linezolid, clofazimine) were not available. DST for later generation fluroquinolones was available only in 53.2% of patients. 50.9% of patients had less than 4 drugs in the treatment regimen proven to be effective by DST. More than 23.1% of patients with MDR-TB failed their treatment and only 45.0% achieved a cure.CONCLUSION: The high prevalence of MDR-TB and poor MDR-TB treatment outcomes in the Kharkiv region, is associated with substantial shortages in rapid molecular and phenotypic DST, a lack of high priority MDR-TB drugs, poor treatment monitoring and follow-up capacities.
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Samper, S., M. J. Iglesias, and O. Tello. "The Spanish multidrug resistant tuberculosis network." Eurosurveillance 5, no. 4 (April 1, 2000): 43–45. http://dx.doi.org/10.2807/esm.05.04.00037-en.
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The network to monitor the spread of multidrug resistance tuberculosis (MDR-TB) in Spain based on genomic typing and set up in January 1998 benefits from the participation of about 90% of the laboratories of the national health system. Of the 94 MDR-TB pa
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Datta, Bikram Singh, Ghulam Hassan, Syed Manzoor Kadri, Waseem Qureshi, Mustadiq Ahmad Kamili, Hardeep Singh, Ahmad Manzoor, Mushtaq Ahmad Wani, Shamas u. Din, and Natasha Thakur. "Multidrug-Resistant and Extensively Drug Resistant Tuberculosis in Kashmir, India." Journal of Infection in Developing Countries 4, no. 01 (November 21, 2009): 019–23. http://dx.doi.org/10.3855/jidc.669.
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Background: To study the profile of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in tertiary care hospital setting, representing almost the whole affected population in Kashmir valley of India. Methodology: A total of 910 cases of pulmonary tuberculosis were enrolled over four years. Among these, cases of MDR-TB and XDR-TB were meticulously studied for drug susceptibility, treatment, adverse effects profile and overall survival. Results: Fifty-two (5.7%) cases of MDR-TB were identified, among which eight (15.3%) were diagnosed as XDR-TB on the basis of drug susceptibility testing, using the prescribed definition. The cases were sensitive to 2, 3, 4, 5 and more than 5 drugs in almost equal proportions. Thirty-seven (71.1%) cases were successfully cured; eleven (21.1%) patients died; and only four (7.6%) cases defaulted, indicating overall satisfactory adherence to treatment. Conclusion: For effective treatment of MDR-TB and XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens, and financial assistance in resource-limited settings through effective political intervention are necessary for better patient adherence and overall cure.
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Azwar, Gusti Andhika, Dewi Indah Noviana, and FX Hendriyono. "KARAKTERISTIK PENDERITA TUBERKULOSIS PARU DENGAN MULTIDRUG-RESISTANT TUBERCULOSIS (MDR-TB) DI RSUD ULIN BANJARMASIN." Berkala Kedokteran 13, no. 1 (May 12, 2017): 23. http://dx.doi.org/10.20527/jbk.v13i1.3436.
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Abstract: Tuberculosis is the main health problem in the world and getting worse with Multidrug-Resistant Tuberculosis (MDR-TB) cases. Many research about MDR-TB patients is conducted to describe MDR-TB patients characteristics. This research aims to describe the characteristics of pulmonary tuberculosis MDR-TB at RSUD Ulin Banjarmasin on December 2015-May 2016. This was a descriptive research with crossectional approaches. Data were collected from clinical pathology laboratory and patients medical record. The Result indicate that as many as 19 pulmonary TB patients with MDR-TB at RSUD Ulin Banjarmasin on December 2015-May 2016 with characteristics were dominated by men 84,2% (16 subjects); age 45-54 years 35,8% (7 subjects); junior and senior high school both 21,1% (4 subjects); private employees 31,6% (6 subjects); came with TB relapses 68,4% (13 subjects); and the acid-fast bacilli examination showed negative and positive both 21,1% (4 subjects). In conclusion, the characteristics of pulmonary tuberculosis patients with Multidrug-Resistant Tuberculosis (MDR-TB) at RSUD Ulin Banjarmasin on December 2015-May 2016 are dominated by men, age 45-54 years old, junior and senior high school, private employees, from Banjarmasin, come with TB relapses and the acid-fast bacilli examination showed negative and positive. Keywords: multidrug-resistant tuberculosis (MDR-TB), Tuberculosis patient’s characteristics, RSUD Ulin Banjarmasin Abstrak: Tuberkulosis merupakan masalah kesehatan utama di dunia dan bertambah berat dengan munculnya kasus multidrug-resistant tuberculosis (MDR-TB). Berbagai penelitian dilakukan untuk mengetahui karakteristik penderita MDR-TB. Oleh karena itu, penelitian ini bertujuan untuk mengetahui karakteristik penderita tuberkulosis paru dengan MDR-TB di RSUD Ulin Banjarmasin periode Desember 2015-Mei 2016. Penelitian ini adalah penelitian deskriptif dengan rancangan cross-sectional. Data diambil dari Laboratorium Patologi Klinik dan rekam medis penderita. Hasil penelitian menunjukkan 19 penderita tuberkulosis paru dengan MDR-TB di RSUD Ulin Banjarmasin periode Desember 2015-Mei 2016 didominasi oleh laki-laki 84,2% (16 orang); usia 45-34 35,8% (7 orang); pendidikan SMP dan SMA masing-masing 21,1% (4 orang); pekerja swasta 31,6% (6 orang); berasal dari Banjarmasin 57,9% (11 orang); datang dengan keadaaan TB kasus relaps kategori 1 dan kategori 2 68,4% (13 orang); dan dengan hasil pemeriksaan sputum BTA positif dan negatif masing-masing 21,1% (4 orang). Kesimpulan penelitian ini adalah karakteristik penderita tuberkulosis paru dengan multidrug-resistant Tuberculosis (MDR-TB) di RSUD Ulin Banjarmasin periode Desember 2015-Mei 2016 didominasi oleh laki-laki, usia 45-54 tahun, pendidikan SMP dan SMA, pekerja swasta, berasal dari Banjarmasin, datang dengan keadaan kasus TB relaps dan hasil sputum BTA negatif dan positif. Kata-kata kunci: Multidrug-resistant tuberculosis (MDR-TB), karakteristik penderita Tuberkulosis Paru
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Espinosa-Pereiro, Juan, Adrian Sánchez-Montalvá, Maria Luisa Aznar, and Maria Espiau. "MDR Tuberculosis Treatment." Medicina 58, no. 2 (January 26, 2022): 188. http://dx.doi.org/10.3390/medicina58020188.
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Multidrug-resistant (MDR) tuberculosis (TB), resistant to isoniazid and rifampicin, continues to be one of the most important threats to controlling the TB epidemic. Over the last few years, there have been promising pharmacological advances in the paradigm of MDR TB treatment: new and repurposed drugs have shown excellent bactericidal and sterilizing activity against Mycobacterium tuberculosis and several all-oral short regimens to treat MDR TB have shown promising results. The purpose of this comprehensive review is to summarize the most important drugs currently used to treat MDR TB, the recommended regimens to treat MDR TB, and we also summarize new insights into the treatment of patients with MDR TB.
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Ali, Monadil H., Alian A. Alrasheedy, Mohamed Azmi Hassali, Dan Kibuule, and Brian Godman. "Predictors of Multidrug-Resistant Tuberculosis (MDR-TB) in Sudan." Antibiotics 8, no. 3 (July 9, 2019): 90. http://dx.doi.org/10.3390/antibiotics8030090.
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Multidrug-resistant tuberculosis (MDR-TB) is a global public health threat and burden on the health system. This is especially the case in high tuberculosis (TB) prevalence countries, such as Sudan. Consequently, this study aimed to ascertain the predictors of MDR-TB in Sudan to provide future guidance. An unmatched case-control study to assess the predictors of MDR-TB infections among the Sudanese population was conducted from August 2017 to January 2018 at Abu-Anga referral hospital. Patients’ data was gathered from patients’ cards and via interviews. A structured pre-validated questionnaire was used to gather pertinent information, which included sociodemographic characteristics and other relevant clinical data. Univariate and multivariate logistic regression analysis was employed to determine the predictors of MDR-TB infection. 76 of the 183 patients interviewed (41.5%) had MDR-TB cases. The independent predictors for MDR-TB were living in rural areas [adjusted odds ratio (aOR) = 3.1 (95% confidence interval (CI): 1.2–8.2)], treatment failure [aOR = 56.9 (10.2–319.2)], and smoking [(aOR = 4 (1.2–13.2)], whereas other sociodemographic factors did not predict MDR-TB. In conclusion, the study showed that a history of smoking, living in rural areas, and a previous treatment failure were the predictors of MDR-TB in Sudan. The latter factors are most likely due to issues that are related to access and adherence to treatment and lifestyle. The existence of any of these factors among newly diagnosed TB patients should alert clinicians for the screening of MDR-TB. The implementation of directly observed treatment (DOT) and health education are crucial in stopping the spread of MDR-TB in Sudan.
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Husada, M. Surya, Bahagia Loebis, and Ariwan Selian. "Total Score Differences of Hospital Anxiety and Depression Scale – Depression (HADS-D) in Patients with Multidrug-Resistant Tuberculosis (MDR-TB) Based on Gender at H. Adam Malik General Hospital Medan." Budapest International Research and Critics Institute (BIRCI-Journal): Humanities and Social Sciences 4, no. 1 (March 2, 2021): 1461–66. http://dx.doi.org/10.33258/birci.v4i1.1774.
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Tuberculosis (TB) is a contagious and airborne disease. Over the decades, psychiatric morbidity in patients with MDR-TB has become increasingly recognized. Resistant tuberculosis is currently a serious health problem worldwide. This chronic disease takes a long time and causes various side effects, often causing symptoms of depression and anxiety in patients with Multidrug-resistant tuberculosis (MDR-TB) and pulmonary tuberculosis (TB). However, there are still relatively few who focus on psychiatric disorders in patients with MDR-TB. To find out the total score differences of Hospital Anxiety and Depression Scale - Depression (HADS-D) in patients with Multidrug-Resistant Tuberculosis (MDR-TB) based on gender. This study is an Unpaired Two Group Numerical Comparative Analytical study with a cross-sectional approach, namely by describing and analyzing a situation at a certain time using the Hospital Anxiety and Depression Scale - Depression (HADS-D) instrument. The results of the analysis with the Pearson test obtained a p-value <0.001 (p <0.05). There is a difference in the total score of Hospital Anxiety and Depression Scale - Depression (HADS-D) in patients with Multidrug-resistant tuberculosis (MDR-TB) based on gender at the H. Adam Malik General Hospital Medan.
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Malini, Hema, Emil Huriani, Devia Putri Lenggogeni, and Shinta Herlina. "Health education on multidrug-resistant tuberculosis prevention among tuberculosis patients." International Journal of Public Health Science (IJPHS) 10, no. 1 (March 1, 2021): 27. http://dx.doi.org/10.11591/ijphs.v10i1.20423.
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The high incidence of multidrug-resistant tuberculosis (MDR-TB) in the community due to the lack of socialization or the provision of health education about MDR-TB. During this time, health education is only focused on tuberculosis (TB) generally. The purpose of this study was to determine the effect of health education on the behavior of MDR-TB prevention in patients with pulmonary tuberculosis in two Community Health Centers in Padang. This study design is quasi-experimental with pre and post-test groups only. The program intervention of health education was conducted for a month with lecture method and group discussion using flipchart and video as media. The sampling technique used purposive sampling were 29 patients with TB who are still in the phase of treatment. Data collection used a set of questionnaires. The data analysis in this study using statistical tests t-test. The results showed, there is a significance influence of health education on knowledge with p-value=0.000 (p≤0.05) and attitude with p-value=0.000 (p≤0.05). The result also showed that 65.5% of patients taking medication regularly. It was also that there is the effect of health education on the behavior of MDR-TB prevention in TB patients. It is expected that the providing of health education on the prevention of behavior on MDR-TB is emphasized on the motivation and self-efficacy of the patients and involvement of supervision on taking medication.
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Damayanti, Aswita, and Alfi Raudatil Jannah. "Case Report: Multidrug-resistant Tuberculosis (MDR TB)." Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) 1, no. 3 (December 9, 2018): 147. http://dx.doi.org/10.22146/rpcpe.41700.
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...................... The patient lived with her husband, her three children, and a very old mother-in-law. The patient was the first child of 2 siblings with a history of spontaneous birth and was assisted by a birth attendant with cry spontaneously. Her mother-in-law had the same history of the disease, i.e., the first category of pulmonary TB. Her mother-in-law was treated at the primary health care facility for six months and was declared cured by the primary health care facility ten years ago. Her sister-in-law also suffered from the third category of pulmonary TB and did not regularly take the medication, and she died two years ago. The patients have a history of miscarriage once, which was during her fourth pregnancy. Her mother and father were Javanese. The patient's husband worked as a laborer on a coconut farm. So, the income was uncertain every day. The patient came from the lower socio-economic class, so the patient had health insurance for low-income people or JAMKESMAS (Health Coverage). The patient's social relationship with the community was not good because the neighborhood marginally ostracized the patient's family due to her family history which suffered from pulmonary tuberculosis........................
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Chaudhari, Kavita S., Harun M. Patel, and Sanjay J. Surana. "Pyridines: Multidrug-resistant tuberculosis (MDR-TB) inhibitors." Indian Journal of Tuberculosis 64, no. 2 (April 2017): 119–28. http://dx.doi.org/10.1016/j.ijtb.2016.11.012.
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Aygün, Deniz, Tarık Yıldırım, Özlem Başoğlu Öner, Sezer Toprak, Aylin Babalık, Zeki Kılıçaslan, and Rengin Şiraneci. "Multidrug-Resistant Tuberculosis in Children: A Single-Center Experience." Journal of Pediatric Infection 54, no. 4 (December 15, 2020): 208–14. http://dx.doi.org/10.5578/ced.69525.
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Objective: Resistance to at least isoniazid and rifampicin, which are the most important drugs in TB treatment, is called multidrug-resistant tuberculosis (MDR-TB). MDR-TB is a life-threatening condition that affects children as well as adults. Material and Methods: The medical records of children diagnosed with MDR-TB between June 2015 and October 2018 were analyzed retrospectively. Results: Seven female (77.8%) and two male (22.2%) patients were included into the study. Their mean age was 11.58 ± 4.23 years (3.75-15 years). Five patients (55.5%) had family members with MDR-TB. All of them had pulmonary tuberculosis. Acid-resistant bacteria (ARB) were observed in three (33.3%) patients, nucleic acid amplification tests were positive in four (44.4%) patients, and positive cultures were observed in seven (77.7%) patients. Seven patients had microbiologically and two patients had clinically confirmed MDR-TB. Five patients (55.5%) had isoniazid and rifampicin resistance, two patients (22.2%) had isoniazid, rifampicin and streptomycin resistance. A treatment protocol consisting of pyrazinamide, ethambutol, amikacin, protionamide and moxifloxacin was started after evaluating the culture results of the patients and family members. Cycloserine was added to the treatment protocol of four (44.4%) patients. The total treatment process was continued for 18 months. Conclusion: Management of childhood MDR-TB is a long and difficult process, but it is a preventable and treatable disease.
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Aygün, Deniz, Tarık Yıldırım, Özlem Başoğlu Öner, Sezer Toprak, Aylin Babalık, Zeki Kılıçaslan, and Rengin Şiraneci. "Multidrug-Resistant Tuberculosis in Children: A Single-Center Experience." Journal of Pediatric Infection 54, no. 4 (December 15, 2020): 188–94. http://dx.doi.org/10.5578/ced.202063.
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Objective: Resistance to at least isoniazid and rifampicin, which are the most important drugs in TB treatment, is called multidrug-resistant tuberculosis (MDR-TB). MDR-TB is a life-threatening condition that affects children as well as adults. Material and Methods: The medical records of children diagnosed with MDR-TB between June 2015 and October 2018 were analyzed retrospectively. Results: Seven female (77.8%) and two male (22.2%) patients were included into the study. Their mean age was 11.58 ± 4.23 years (3.75-15 years). Five patients (55.5%) had family members with MDR-TB. All of them had pulmonary tuberculosis. Acid-resistant bacteria (ARB) were observed in three (33.3%) patients, nucleic acid amplification tests were positive in four (44.4%) patients, and positive cultures were observed in seven (77.7%) patients. Seven patients had microbiologically and two patients had clinically confirmed MDR-TB. Five patients (55.5%) had isoniazid and rifampicin resistance, two patients (22.2%) had isoniazid, rifampicin and streptomycin resistance. A treatment protocol consisting of pyrazinamide, ethambutol, amikacin, protionamide and moxifloxacin was started after evaluating the culture results of the patients and family members. Cycloserine was added to the treatment protocol of four (44.4%) patients. The total treatment process was continued for 18 months. Conclusion: Management of childhood MDR-TB is a long and difficult process, but it is a preventable and treatable disease.
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Wulandari, Citra, and Ziske Maritska. "DETECTION OF FLUOROQUINOLONE RESISTANCE IN MYCOBACTERIUM TUBERCULOSIS ISOLATE CAUSED BY MUTATION IN THE GYRA GENE." Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya 9, no. 1 (March 16, 2022): 117–22. http://dx.doi.org/10.32539/jkk.v9i1.16554.
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Drug-resistant tuberculosis is a public health concern. TB that is drug-resistant to rifampin and isoniazid is known as MDR-TB, whereas XDR-TB is MDR-TB that is also resistant to second-line medicines, such as fluoroquinolones (levofloxacin, ofloxacin, and moxifloxacin). rifampin-resistant tuberculosis (RR-TB), of which 78 percent had multidrug-resistant tuberculosis (MDR-TB) (MDR-TB). Fluoroquinolones are a class of broad-spectrum antimicrobials that have become increasingly popular in recent years. Fluoroquinolones have activity against Mycobacterium tuberculosis both in vitro and in vivo. Fluoroquinolones might cause resistance if they are used inappropriately or excessively. According to several investigations, the majority of fluoroquinolone-resistant M. tuberculosis isolates (approximately 50-90 percent) had mutations in the gyrA gene QRDR Quinolone Resistance Determination Region. However, the genetic involvement of various gyrA gene mutations in resistant Mycobacterium TB isolates against fluoroquinolone resistance remains an unknown gyrA gene mutation pattern in resistant Mycobacterium tuberculosis isolates. In the previous investigation, mutations in the gyrA gene were discovered at codons 90 and 94.
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Nugraha, Rhea Veda, Vycke Yunivita, Prayudi Santoso, Rob E. Aarnoutse, and Rovina Ruslami. "Clofazimine as a Treatment for Multidrug-Resistant Tuberculosis: A Review." Scientia Pharmaceutica 89, no. 2 (May 18, 2021): 19. http://dx.doi.org/10.3390/scipharm89020019.
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Multidrug-resistant tuberculosis (MDR-TB) is an infectious disease caused by Mycobacterium tuberculosis which is resistant to at least isoniazid and rifampicin. This disease is a worldwide threat and complicates the control of tuberculosis (TB). Long treatment duration, a combination of several drugs, and the adverse effects of these drugs are the factors that play a role in the poor outcomes of MDR-TB patients. There have been many studies with repurposed drugs to improve MDR-TB outcomes, including clofazimine. Clofazimine recently moved from group 5 to group B of drugs that are used to treat MDR-TB. This drug belongs to the riminophenazine class, which has lipophilic characteristics and was previously discovered to treat TB and approved for leprosy. This review discusses the role of clofazimine as a treatment component in patients with MDR-TB, and the drug’s properties. In addition, we discuss the efficacy, safety, and tolerability of clofazimine for treating MDR-TB. This study concludes that the clofazimine-containing regimen has better efficacy compared with the standard one and is also well-tolerated. Clofazimine has the potential to shorten the duration of MDR-TB treatment.
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Nugrahaeni, Dyan Kunthi, and Salma Zaqiya. "The Relationship between Previous Tuberculosis Treatment and HIV Status with Multidrug-Resistant Tuberculosis." Jurnal Kesehatan Masyarakat 14, no. 3 (May 21, 2019): 347–52. http://dx.doi.org/10.15294/kemas.v14i3.14087.
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Multidrug-resistant tuberculosis (MDR-TB) is becoming major public health issues in the world. Among the causes are history of previous TB treatment and increased co-infection of TB-HIV (Human Immunodeficiency Virus). This study aimed to identify the relationship between history of previous TB treatment and HIV status with MDR-TB. This is a case control study. The sample case was patients with MDR-TB, while sample control was patient who have drug-sensitive TB. Secondary data was obtained from patient medical records and laboratory results at Rotinsulu Pulmonary Hospital Bandung. Data were analyzed using chi-square. Multiple logistic regression was used to identify the dominant factor that influence the occurrence of MDR-TB. This study showed that the history of previous TB treatment was statistically significant with MDR-TB (p value= 0.001; OR= 18.889; 95% CI= 4.093-87.172) and it is the dominant factor that influence MDR-TB (p value= 0.0001; OR= 56.84; 95% CI= 6.9- 468.87). HIV infection at control group (who contracted drug-sensitive TB) was 26.1% (p value= 0.022). This finding suggested that HIV testing should be performed to each TB and MDR-TB patients and increased collaboration TB-HIV program between the other health care facilities should ensue. Drug sensitivity testing should be conducted at the start of TB treatment for patients with previous TB treatment and TB-HIV co-infection.
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Yang, Yan, and Jianqing Wu. "Significance of the Differential Peptidome in Multidrug-Resistant Tuberculosis." BioMed Research International 2019 (January 17, 2019): 1–12. http://dx.doi.org/10.1155/2019/5653424.
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Most multidrug-resistant tuberculosis (MDR-TB) patients fail to receive a timely diagnosis and treatment. Therefore, we explored the differentially expressed peptides in MDR-TB compared with drug-susceptible tuberculosis (DS-TB) patients using LC-MS/MS and Ingenuity Pathway Analysis (IPA) to analyse the potential significance of these differentially expressed peptides. A total of 301 peptides were differentially expressed between MDR-TB and DS-TB groups. Of these, 24 and 16 peptides exhibited presented high (fold change ≥ 2.0, P < 0.05) and low (fold change ≤ −2.0, P < 0.05) levels in MDR-TB. Significant canonical pathways included the prothrombin activation system, coagulation system, and complement system. In the network of differentially expressed precursor proteins, lipopolysaccharide (LPS) regulates many precursor proteins, including four proteins correlated with organism survival. These four important differentially expressed proteins are prothrombin (F2), complement receptor type 2 (CR2), collagen alpha-2(V) chain (COL5A2), and inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4). After addition of CR2 peptide, IL-6 mRNA expression in THP-1 cells decreased significantly in dose- and time-dependent manners. Cumulatively, our study proposes potential biomarkers for MDR-TB diagnosis and enables a better understanding of the pathogenesis of MDR-TB. The functions of differentially expressed peptides, especially CR2, in MDR-TB require further investigation.
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Kobayashi, Kazuo, Manabu Ato, and Sohkichi Matsumoto. "Global Threats and the Control of Multidrug-Resistant Tuberculosis." Journal of Disaster Research 6, no. 4 (August 1, 2011): 443–50. http://dx.doi.org/10.20965/jdr.2011.p0443.
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About one-third of the world’s population has been infected with Mycobacterium tuberculosis. Active disease develops in about 9 million people per year, and tuberculosis is responsible for 2 million deaths per year. The disease caused by this bacterium, tuberculosis (TB), remains one of the leading causes of mortality caused by infection worldwide and is a major threat to global health. The situation of TB is recently exacerbated by the emergence of highly drug-resistant forms of the disease-causing pathogen and synergy with human immunodeficiency virus/acquired immune deficiency syndrome, which greatly increases the risk of latent M. tuberculosis infection progressing to active disease. Multidrug-resistant (MDR) tuberculosis is defined as disease caused by strains of M. tuberculosis that are at least resistant to isoniazid and rifampicin; extensively drug-resistant (XDR) tuberculosis refers to disease caused by MDR strains that are also resistant to any fluoroquinolone and any of the injectable drugs used in treatment with second-line anti-tuberculosis drugs (amikacin, capreomycin, and kanamycin). MDR- and XDR-TB are serious threats to the progress that has been made in the control of tuberculosis worldwide over the past decade. In this review, we focus on threats of MDR-TB and the research and development of improved diagnostics, new chemotherapeutic agents, and vaccine candidates for MDR-TB.
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Td, Neethu, and Mebin Alias. "CURRENT STRATEGIES IN THE TREATMENT OF MULTIDRUG-RESISTANT TUBERCULOSIS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 7 (July 7, 2018): 70. http://dx.doi.org/10.22159/ajpcr.2018.v11i7.25651.
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Objective: The objective of the study was to analyze and review the current knowledge about the principles of treatment of multidrug-resistant tuberculosis (MDR-TB), World Health Organization treatment regimen to treat MDR-TB, mechanism of resistance, and risk factors for emergence of resistance, and novel antitubercular drugs (ATDs) available and control measures to improve treatment outcomes of MDR-TB.Methods: Various articles were reviewed from PubMed and other databases and were analyzed to write the review.Results: Mycobacterium is a largely curable infectious disease if proper treatment should be followed. The success of the treatment depends on the designing of proper treatment regimen and patient adherence to that medication.Conclusion: Mycobacterium tuberculosis is now the most lethal infectious pathogen. Drug resistance has become a major problem in the treatment of TB. In MDR-TB, the bacteria is resistant to at least isoniazid (INH) and rifampicin (RIF), and in extensively drug-resistant TB the bacteria is resistant to INH, RIF, any fluoroquinolone, and at least one of three injectable second-line drugs for TB such as kanamycin, capreomycin, and amikacin. More recently, a more worrying situation has emerged with the description of M. tuberculosis strains that have been found resistant to all antibiotics that were available for testing, a situation labeled as totally drug resistant-TB. Other reasons like poor planning by the authorities and the government may also result in the emergence of resistant strain. Rather than the effective chemotherapy and the moderately protective vaccine, new anti-TB agents, and novel controlled release nanoparticulate system like polymeric nanocarrier systems containing existing ATDs are urgently needed to decrease the global incidence of TB.
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Arifah, Nur, Tintin Sukartini, and Harmayetty Harmayetty. "Karakteristik Pasien Multidrug Resistant Tuberculosis (MDR-TB) di RSUD Makassar." Jurnal Penelitian Kesehatan "SUARA FORIKES" (Journal of Health Research "Forikes Voice") 10, no. 4 (June 27, 2019): 253. http://dx.doi.org/10.33846/sf10401.
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The case of multidrug resistant tuberculosis (MDR-TB) has become a threat to world health security. MDR / RR-TB causes 230,000 deaths in 2017 and most cases and deaths occur in Asia including Indonesia. MDR-TB cases that fail or are lost to treatment are one of the problems controlling MDR-TB because they can be a source of spread of treatment-resistant Mycobacterium Tuberculosis. This study aims to describe the characteristics of MDR-TB patients undergoing treatment at Makassar Hospital. This study uses qualitative studies with a phenomenological approach. The participants in this study were 18 people using purposive sampling. The study was conducted in February until April 2019. The results of this research show that there are no gender differences and productive age is more at risk of MDR-TB. Low education levels do not guarantee the risk of transmission of MDR-TB depends on the willingness to be able to obtain health information such as the internet or conventional information (leaflets or health education). The duration of treatment makes participants unable to work because they have to focus on routine treatment every day for up to 18-20 months. Families living with patients have a greater risk of contracting but are a source of patient support for completing treatment. description of patient characteristics can be a source of data to find out groups at risk of infection so that they can develop MDR-TB prevention interventions that are right on target.
Keywords: characteristics; multidrug tuberculosis; qualitative.
ABSTRAK
Kasus MDR-TB menjadi ancaman keamanan kesehatan dunia. MDR/RR-TB menyebabkan 230.000 kasus kematian 2017 dan sebagian besar kasus dan kematian terjadi di Asia termasuk Indonesia. Kasus MDR-TB yang gagal atau mangkir dari pengobatan menjadi salah satu masalah pengendalian MDR-TB karena dapat menjadi sumber penyebaran Mycobacterium Tuberculosis yang resisten terhadap pengobatan. Penelitian ini bertujuan untuk mendekripsikan karakteristik pasien MDR TB yang sedang menjalani pengobatan di RSUD Makassar. Penelitian ini menggunakan studi kualitatif deskriptif. Partisipan dalam penelitian ini sebanyak 18 orang dengan menggunakan purposive sampling. Penelitian dilakukan pada februari hingga april 2019. Hasil penelitioan ini menunjukkan bahwa tidak adaperbedaan jenis kelamin sedangkan partisipan usia produktif lebih beresiko MDR-TB. Tingkat pendidikan rendah tidak menjamin resiko penularan MDR-TB tergantung kemauan untuk dapat memperoleh informasi kesehatan seperti internet ataupun informasi konvensional (leaflet atau penyuluhan kesehatan). Lamanya pengobatan membuat partisipan tidak dapat bekerja karena harus fokus dengan pengobatan rutin setiap hari hingga 18-20 bulan. Keluarga yang tinggal bersama penderita memiliki resiko yang lebih besar untuk tertular tetapi menjadi sumber dukungan pasien untuk dapat menyelesaikan pengobatan. gambaran karakteristik pasien dapat menjadi sumber data untuk mengetahui kelompok beresiko terinfeksi sehingga dapat mengembangkan intervensi pencegahan kejadian MDR-TB yang tepat sasaran
Kata kunci: karakteristik; multidrug resistant tuberculosis; kualitatif.
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LIU, C. H., H. M. LI, L. LI, Y. L. HU, Q. WANG, N. YANG, S. WANG, and B. ZHU. "Anti-tuberculosis drug resistance patterns and trends in a tuberculosis referral hospital, 1997–2009." Epidemiology and Infection 139, no. 12 (January 27, 2011): 1909–18. http://dx.doi.org/10.1017/s0950268810003158.
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SUMMARYInformation about the changing epidemiology of drug-resistant tuberculosis (TB) in hospitals in China over the past decade remains largely unknown. This study examined the susceptibility patterns and trends of drug-resistant TB cases in the 309 Hospital in Beijing, China. Mycobacterium tuberculosis isolates were retrospectively identified, drug susceptibility test (DST) results and clinical data were analysed for the period 1997–2009. Of the 5523 culture-positive TB patients, 47·1% had resistance to any anti-TB drug, 14·8% had mono-resistant TB, 19·8% had poly-resistant TB, 19·4% had multidrug-resistant TB (MDR-TB), and 1·3% had extensively drug-resistant TB (XDR-TB). Drug-resistant TB was significantly associated with age group, residential situation, and TB treatment history (P<0·001). During 1997–2000, the percentage of TB patients with any resistance, mono-resistant TB, poly-resistant TB, MDR-TB and XDR-TB all increased significantly (P<0·001). During 2000–2003, the increasing trends of MDR-TB and XDR-TB cases were reversed. During 2004–2009, the percentage of TB patients with any resistance, mono-resistant TB, poly-resistant TB, MDR-TB and XDR-TB all declined significantly (P<0·001), but the prevalence of MDR-TB and poly-resistant TB cases remained high. Our study provides evidence demonstrating that intensive TB control measures have helped reverse the increasing trends of drug-resistant TB in China, but continuous surveillance of drug-resistant TB and better case management are still needed to further reduce the remaining high prevalence of drug-resistant TB.
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van Rijn, Sander P., Richard van Altena, Onno W. Akkerman, Dick van Soolingen, Tridia van der Laan, Wiel C. M. de Lange, Jos G. W. Kosterink, Tjip S. van der Werf, and Jan-Willem C. Alffenaar. "Pharmacokinetics of ertapenem in patients with multidrug-resistant tuberculosis." European Respiratory Journal 47, no. 4 (January 7, 2016): 1229–34. http://dx.doi.org/10.1183/13993003.01654-2015.
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Treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is becoming more challenging because of increased levels of drug resistance against second-line TB drugs. One promising group of antimicrobial drugs is carbapenems. Ertapenem is an attractive carbapenem for the treatment of MDR- and XDR-TB because its relatively long half-life enables once-daily dosing.A retrospective study was performed for all patients with suspected MDR-TB at the Tuberculosis Center Beatrixoord of the University Medical Center Groningen (Haren, the Netherlands) who received ertapenem as part of their treatment regimen between December 1, 2010 and March 1, 2013. Safety and pharmacokinetics were evaluated.18 patients were treated with 1000 mg ertapenem for a mean (range) of 77 (5–210) days. Sputum smear and culture were converted in all patients. Drug exposure was evaluated in 12 patients. The mean (range) area under the concentration–time curve up to 24 h was 544.9 (309–1130) h·mg·L−1. The mean (range) maximum observed plasma concentration was 127.5 (73.9–277.9) mg·L−1.In general, ertapenem treatment was well tolerated during MDR-TB treatment and showed a favourable pharmacokinetic/pharmacodynamic profile in MDR-TB patients. We conclude that ertapenem is a highly promising drug for the treatment of MDR-TB that warrants further investigation.
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Barroso, Elizabeth Clara, Rosa Maria Salani Mota, Raimunda Oliveira Santos, Ana Lúcia Oliveira Sousa, Joana Brasileiro Barroso, and Jorge Luís Nobre Rodrigues. "Risk factors for acquired multidrug-resistant tuberculosis." Jornal de Pneumologia 29, no. 2 (April 2003): 89–97. http://dx.doi.org/10.1590/s0102-35862003000200008.
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Multidrug-resistant tuberculosis (MDR-TB) is a severe and feared problem, that is difficult to control and has shown a tendency to increase worldwide. OBJECTIVE: To analyze the risk factors for acquired MDR-TB. CASUISTIC AND METHODS: A retrospective population-based case-control study was conducted. A bacillus was considered multidrug-resistant whenever it was resistant at least to rifampin (RFP) + isoniazid (INH), and a case was considered as sensitive tuberculosis (TB) if it had undergone the first treatment during a similar period as the first treatment of an MDR-TB case, but was cured at the time of the interview. Case selection was made based on the list of Sensitivity Tests (ST) performed at the Central Public Health Laboratory of the State of Ceará, from 1990 through 1999. The Proportion Method was used to investigate resistance to the six antituberculosis drugs (isoniazid, rifampin, pyrazinamide, ethambutol, ethionamide, streptomycin) used as the standard treatment in Brazil. Controls were selected from the registry of the TB Control Program. Univariate and multivariate analysis were performed, with p < 0.05 considered significant. RESULTS: Out of the 1,500 STs performed during the studied period, 266 strains were multidrug-resistant; 153 patients were identified, 19 of which were excluded. The Group of Cases comprised 134 patients, and the Group of Controls comprised 185. Multivariate analysis helped to detect the following risk factors: lack of home sewer system, alcoholism + smoking, number of previous treatments, irregular treatment, and lung cavities. CONCLUSION: These five factors are important for the development of acquired MDR-TB, and an attempt to neutralize them might contribute to control TB.
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Abdulmughni, Jihan, Esam Mohammed Mahyoub, Abdulaziz Thabit Alaghbari, Abdulwahed Abdelgabar Al Serouri, and Yousef Khader. "Performance of Multidrug-Resistant Tuberculosis Surveillance in Yemen: Interview Study." JMIR Public Health and Surveillance 5, no. 4 (October 3, 2019): e14294. http://dx.doi.org/10.2196/14294.
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Background Multidrug-resistant tuberculosis (MDR-TB) is a major challenge to ending TB occurrence by 2035. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The National Tuberculosis Control Program (NTCP) established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. In Yemen, the 2011 survey showed an MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The NTCP established four MDR-TB sentinel surveillance sites in 2013 to monitor the MDR-TB situation. Objective This study aimed to assess the performance of MDR-TB surveillance and determine its strengths and weaknesses. Methods We used the updated Center for Diseases Control and Prevention guidelines for evaluating public health surveillance systems. Interviews were conducted with NTCP managers and Regional MDR-TB centers’ staff using a semistructured questionnaire. We used a 5-point Likert scale to assess the usefulness and other attributes (eg, simplicity and flexibility). The mean percentage was calculated for each attribute and used for the final rank of the performance: poor (<60%), average (60%-80%), and good (>80%). Results The MDR-TB surveillance system achieved good performance in usefulness (87%), acceptability (82%), and data quality (91%); average performance in flexibility (61%) and simplicity (72%); and poor performance in stability (55%). The overall performance score was average (74%). Although strong commitment, good monitoring, and well-trained staff are the main strengths, depending on an external fund is a major weakness along with unavailability of the MDR-TB unit at the governorate level. Conclusions Although the MDR-TB surveillance system has achieved an average overall performance, more efforts are required to improve its stability by ensuring constant power supply to enable laboratories to perform necessary diagnostic and follow-up tests. Gradual replacement of donors’ funds by the government is recommended. Scaling up of MDR-TB services and removing access barriers are crucial.
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Poudel, Ajay, Chie Nakajima, Yukari Fukushima, Haruka Suzuki, Basu Dev Pandey, Bhagwan Maharjan, and Yasuhiko Suzuki. "Molecular Characterization of Multidrug-Resistant Mycobacterium tuberculosis Isolated in Nepal." Antimicrobial Agents and Chemotherapy 56, no. 6 (March 26, 2012): 2831–36. http://dx.doi.org/10.1128/aac.06418-11.
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ABSTRACTDespite the fact that Nepal is one of the first countries globally to introduce multidrug-resistant tuberculosis (MDR-TB) case management, the number of MDR-TB cases is continuing to rise in Nepal. Rapid molecular tests applicable in this setting to identify resistant organisms would be an effective tool in reversing this trend. To develop such tools, information about the frequency and distribution of mutations that are associated with phenotypic drug resistance inMycobacterium tuberculosisis required. In the present study, we investigated the prevalence of mutations inrpoBandkatGgenes and theinhApromoter region in 158M. tuberculosisisolates (109 phenotypically MDR and 49 non-MDR isolates collected in Nepal) by DNA sequencing. Mutations affecting the 81-bp rifampin (RIF) resistance-determining region (RRDR) ofrpoBwere identified in 106 of 109 (97.3%) RIF-resistant isolates. Codons 531, 526, and 516 were the most commonly affected, at percentages of 58.7, 15.6, and 15.6%, respectively. Of 113 isoniazid (INH)-resistant isolates, 99 (87.6%) had mutations in thekatGgene, with Ser315Thr being the most prevalent (81.4%) substitution. Mutations in theinhApromoter region were detected in 14 (12.4%) INH-resistant isolates. The results from this study provide an overview of the current situation of RIF and INH resistance inM. tuberculosisin Nepal and can serve as a basis for developing or improving rapid molecular tests to monitor drug-resistant strains in this country.
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Francisco, Christian, Mary Ann Lansang, Edsel Maurice Salvana, and Katerina Leyritana. "Multidrug-resistant tuberculosis (MDR-TB) and multidrug-resistant HIV (MDR-HIV) syndemic: challenges in resource limited setting." BMJ Case Reports 12, no. 8 (August 2019): e230628. http://dx.doi.org/10.1136/bcr-2019-230628.
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Tuberculosis (TB) is common among persons living with HIV. This public health concern is aggravated by infection with multidrug-resistant organisms and adverse effects of polypharmacy. There are few published cases of multidrug-resistant tuberculosis (MDR-TB) in multidrug-resistant HIV (MDR-HIV) infected patients. We report a case of a 29-year-old Filipino man with HIV on zidovudine (AZT)-containing antiretroviral therapy (ART) but was eventually shifted to tenofovir due to anaemia. He presented with left flank tenderness, which was found to be due to an MDR-TB psoas abscess, and for which second-line anti-TB treatment was started. HIV genotyping showed MDR-HIV infection susceptible only to AZT, protease inhibitors and integrase inhibitors. Subsequently, he developed neck abscess that grew Mycobacterium avium complex and was treated with ethambutol and azithromycin. ART regimen was revised to AZT plus lamivudine and lopinavir/ritonavir. Erythropoietin was administered for recurrent AZT-induced anaemia. Both abscesses resolved and no recurrence of anaemia was noted.
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Falzon, Dennis, Fuad Mirzayev, Fraser Wares, Inés Garcia Baena, Matteo Zignol, Nguyen Linh, Karin Weyer, Ernesto Jaramillo, Katherine Floyd, and Mario Raviglione. "Multidrug-resistant tuberculosis around the world: what progress has been made?" European Respiratory Journal 45, no. 1 (September 26, 2014): 150–60. http://dx.doi.org/10.1183/09031936.00101814.
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Multidrug-resistant tuberculosis (MDR-TB) (resistance to at least isoniazid and rifampicin) will influence the future of global TB control. 88% of estimated MDR-TB cases occur in middle- or high-income countries, and 60% occur in Brazil, China, India, the Russian Federation and South Africa.The World Health Organization collects country data annually to monitor the response to MDR-TB. Notification, treatment enrolment and outcome data were summarised for 30 countries, accounting for >90% of the estimated MDR-TB cases among notified TB cases worldwide.In 2012, a median of 14% (interquartile range 6–50%) of estimated MDR-TB cases were notified in the 30 countries studied. In 15 of the 30 countries, the number of patients treated for MDR-TB in 2012 (71 681) was >50% higher than in 2011. Median treatment success was 53% (interquartile range 40–70%) in the 25 countries reporting data for 30 021 MDR-TB cases who started treatment in 2010.Although progress has been noted in the expansion of MDR-TB care, urgent efforts are required in order to provide wider access to diagnosis and treatment in most countries with the highest burden of MDR-TB.
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Zhao, Li-li, Qing Sun, Hai-can Liu, Xiao-cui Wu, Tong-yang Xiao, Xiu-qin Zhao, Gui-lian Li, Yi Jiang, Chun-yan Zeng, and Kang-lin Wan. "Analysis ofembCABMutations Associated with Ethambutol Resistance in Multidrug-Resistant Mycobacterium tuberculosis Isolates from China." Antimicrobial Agents and Chemotherapy 59, no. 4 (January 20, 2015): 2045–50. http://dx.doi.org/10.1128/aac.04933-14.
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ABSTRACTEthambutol (EMB) plays a pivotal role in the chemotherapy of drug-resistant tuberculosis (TB), including multidrug-resistant tuberculosis (MDR-TB). Resistance to EMB is considered to be caused by mutations in theembCABoperon (embC,embA, andembB). In this study, we analyzed theembCABmutations among 139 MDR-TB isolates from China and found a possible association betweenembCABoperon mutation and EMB resistance. Our data indicate that 56.8% of MDR-TB isolates are resistant to EMB, and 82.2% of EMB-resistant isolates belong to the Beijing family. Overall, 110 (79.1%) MDR-TB isolates had at least one mutation in theembCABoperon. The majority of mutations were present in theembBgene and theembAupstream region, which also displayed significant correlations with EMB resistance. The most common mutations occurred at codon 306 inembB(embB306), followed byembB406,embA(−16), andembB497. Mutations atembB306 were associated with EMB resistance. DNA sequencing ofembB306–497 was the best strategy for detecting EMB resistance, with 89.9% sensitivity, 58.3% specificity, and 76.3% accuracy. Additionally,embB306 had limited value as a candidate predictor for EMB resistance among MDR-TB infections in China.
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Admassu, Fantahun, Ermias Abera, Addisalem Gizachew, Tagesse Sedoro, and Taye Gari. "Risk factors of multidrug resistant tuberculosis among patients with tuberculosis at selected multidrug resistance treatment initiative centres in southern Ethiopia: a case-control study." BMJ Open 13, no. 1 (January 2023): e061836. http://dx.doi.org/10.1136/bmjopen-2022-061836.
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ObjectiveTo identify the risk factors for multidrug resistant tuberculosis (MDR-TB) among patients with TB at selected MDR-TB treatment initiative centres, southern Ethiopia, 2021.DesignAn unmatched case-control study was employed.SettingMultidrug resistance treatment initiative centres in southern Ethiopia (Nigist Elen Mohamed Memorial Comprehensive Specialized Hospital and Butajira General Hospital).ParticipantsA total sample size of 392 (79 cases and 313 controls) were selected by the systematic sampling technique. Caseswere all patients with TB with culture proven or line probe assay confirmed Mycobacterium tuberculosis resistant to at least both isoniazid and rifampicin and registered on second-line TB treatment. Controls were all patients with bacteriological (molecular) proven drug-susceptible TB strains and whose recent smear results were turned to negative and registered as cured. Both bivariate and multivariable logistic regression analysis was used to identify risk factors of MDR-TB infections.Main outcome measureIdentifying the risk factors for MDR-TB.ResultsA total of 392 participants (79 cases and 313 controls) were interviewed. Multivariable analysis showed that direct contact with known patients with TB (AOR =4.35; 95% CI: 1.45 to 9.81), history of previous TB treatment (AOR=2.51; 95% CI: 1.50 to 8.24), history of cigarette smoking (AOR=3.24; 95% CI :2.17 to 6.91) and living in rural area (AOR=4.71; 95% CI :3.13 to 9.58) were identified risk factors for MDR-TB infections.ConclusionsThe study findings revealed that direct contact with known patients with TB, previous history of TB treatment, history of cigarette smoking and rural residence were potential risk factors for the occurrence of MDR-TB. In order to reduce the burden of drug resistance, strategies of controlling MDR-TB in the study area should emphasise on enhancing public health education and reducing treatment interruptions of patients with TB and drug-resistant TB.
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Hersi, Ahmed, Kevin Elwood, Robert Cowie, Dennis Kunimoto, and Richard Long. "Multidrug-Resistant Tuberculosis in Alberta and British Columbia, 1989 to 1998." Canadian Respiratory Journal 6, no. 2 (1999): 155–60. http://dx.doi.org/10.1155/1999/456395.
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OBJECTIVE: To describe the extent of the problem of multidrug-resistant tuberculosis (MDR-TB) in Alberta and British Columbia from 1989 to 1998.DESIGN: A retrospective, population-based descriptive study of all notified MDR-TB cases in the context of all notified TB cases, all notified culture-positive TB cases and all notified drug-resistant TB cases.SETTING: Provinces of Alberta and British Columbia, and their TB registries.PATIENTS: All people with TB reported to the TB registries of Alberta and British Columbia between January 1, 1989 and June 30, 1998.MAIN OUTCOME MEASURES: Drug susceptibility testing was performed in all cases of culture-positive TB. Demographic, clinical and laboratory data on all cases of MDR-TB were recorded.RESULTS: Of 4606 notified cases of TB, 3553 (77.1%) were culture positive. Of these, 365 (10.3%) were drug resistant; of the drug-resistant cases, 24 (6.6%) were MDR. Most MDR-TB patients were foreign-born; of the four Canadian-born patients, two were infected while travelling abroad. Although foreign-born patients were significantly more likely to harbour drug-resistant strains, 14.3% versus 4.8%, respectively (P<0.001), among those who were harbouring a drug-resistant strain, the proportion of Canadian-born versus foreign-born patients with an MDR strain was the same (6.7% versus 6.6%, respectively). From 1994 to 1998 versus 1989 to 1993, the proportion of all drug-resistant strains that were MDR was greater (9.0% versus 4.3%, respectively), but the difference was not statistically significant. Isolates from 16 of the 24 MDR-TB cases had been archived. Each of these was fingerprinted and found to be unique. Most MDR-TB cases (88%) were respiratory. Of those tested for human immunodeficiency virus (n=17), only one was seropositive. MDR-TB was ‘acquired’ in 67% and ‘primary’ in 33% of cases. Eight (33%) of the MDR-TB cases received curative courses of treatment, six (25%) are still being treated, and the remainder have either died (five, 21%), transferred out (four, 17%) or become ‘chronic’ (one, 4%). No secondary case of MDR-TB has been identified in Alberta and British Columbia.CONCLUSIONS: Most MDR-TB in Alberta and British Columbia is imported. The proportion of all drug-resistant cases that are MDR appears to be increasing, but not because of disease acquired from recent contact with MDR-TB in Canada.
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Iqbal, Azhar, Muhammad Shafique, Muhammad Asif Zahoor, Saima Muzammil, Zeeshan Nawaz, Abdul Jabbar, Mohsin Khurshid, et al. "The occurrence of multidrug-resistant Mycobacterium tuberculosis from patients of pulmonary tuberculosis." Journal of Infection in Developing Countries 16, no. 04 (April 30, 2022): 698–704. http://dx.doi.org/10.3855/jidc.14990.
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Introduction: Multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is one of the leading causes of death in the world. The resource constraints make it difficult to diagnose and monitor the cases of MDR-TB. GeneXpert is a recognized tool used to diagnose the patients of pulmonary tuberculosis in clinical settings across the globe.
Methodology: The present one-year cross-sectional study was conducted to estimate the occurrence of MDR-TB in patients with pulmonary TB. A total of 1000 patients suspected of pulmonary tuberculosis were included in this study. A random convenient sampling technique was done to collect the sputum samples (twice) from the patients. Samples were processed for the detection of Mycobacterium tuberculosis using conventional detection methods like the Ziehl Nelson staining method and fluorescent microscopy. Additionally, Cepheid GeneXpert was used for molecular detection of MDR-TB in smear-positive samples of pulmonary tuberculosis by amplifying the rifampicin resistance determining region (RRDR; rpoB gene). All the tests were performed in the biosafety level III lab of District Headquarters Hospital Nankana Sahib.
Results: It was observed that 103 (10.3%) individuals were diagnosed as positive for tuberculosis among 1000 patients. Among these 103 TB positive cases, there were 11 (10.7%) patients diagnosed with rifampicin resistance gene (RR-Gene) of Mycobacterium tuberculosis.
Conclusions: Overall findings of the study showed that MDR-TB is prevalent in pulmonary TB patients and GeneXpert is the most sensitive technique for early diagnosis of the disease, which may be very helpful in the treatment and control of this public health menace in low and middle-income countries.
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Chien, Jung-Yien, Shun-Tien Chien, Wei-Yih Chiu, Chong-Jen Yu, and Po-Ren Hsueh. "Moxifloxacin Improves Treatment Outcomes in Patients with Ofloxacin-Resistant Multidrug-Resistant Tuberculosis." Antimicrobial Agents and Chemotherapy 60, no. 8 (May 23, 2016): 4708–16. http://dx.doi.org/10.1128/aac.00425-16.
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ABSTRACTIt is unclear whether the use of moxifloxacin (MFX), a newer synthetic fluoroquinolone, results in better outcomes in patients with ofloxacin (OFX)-resistant multidrug-resistant tuberculosis (MDR-TB). During the period from April 2006 to December 2013, a total of 2,511 patients with culture-confirmed tuberculosis (TB) were treated at a TB referral hospital in southern Taiwan. Of the 2,511 patients, 325 (12.9%) had MDR-TB, and of those 325 patients, 81 (24.9%) had OFX-resistant MDR-TB and were included in the study. Among the 81 patients with OFX-resistant MDR-TB, 50 (61.7%) were successfully treated and 31 (38.3%) had unfavorable outcomes, including treatment failure (n= 25; 30.9%), loss to follow-up (n= 2; 2.5%), and death (n= 4; 4.9%). Patients treated with MFX had a significantly higher rate of treatment success (77.3% versus 43.2%; odds ratio [OR] = 4.46, 95% confidence interval [CI] = 1.710 to 11.646,P= 0.002) than patients not treated with MFX, especially among those infected with MFX-susceptible isolates (40.7%) or isolates with low-level resistance to MFX (28.4%). Multivariate logistic regression analysis showed that treatment with MFX (adjusted odds ratio = 6.54, 95% CI = 1.44 to 29.59,P= 0.015) was the only independent factor associated with treatment success. Mutation at codon 94 in thegyrAgene was the most frequent mutation (68.0%) associated with high-level MFX resistance. Multivariate Cox proportional hazards regression analysis showed that treatment with MFX was also an independent factor associated with early culture conversion (hazard ratio = 3.12, 95% CI = 1.48 to 6.54,P= 0.003). Our results show that a significant proportion of OFX-resistant MDR-TB isolates were susceptible or had low-level resistance to MFX, indicating that patients with OFX-resistant MDR-TB benefit from treatment with MFX.
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Brode, Sarah K., Robert Varadi, Jane McNamee, Nina Malek, Sharon Stewart, Frances B. Jamieson, and Monica Avendano. "Multidrug-Resistant Tuberculosis: Treatment and Outcomes of 93 Patients." Canadian Respiratory Journal 22, no. 2 (2015): 97–102. http://dx.doi.org/10.1155/2015/359301.
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BACKGROUND: Tuberculosis (TB) remains a leading cause of death worldwide and the emergence of multidrug-resistant TB (MDR TB) poses a threat to its control. There is scanty evidence regarding optimal management of MDR TB. The majority of Canadian cases of MDR TB are diagnosed in Ontario; most are managed by the Tuberculosis Service at West Park Healthcare Centre in Toronto. The authors reviewed 93 cases of MDR TB admitted from January 1, 2000 to December 31, 2011.RESULTS: Eighty-nine patients were foreign born. Fifty-six percent had a previous diagnosis of TB and most (70%) had only pulmonary involvement. Symptoms included productive cough, weight loss, fever and malaise. The average length of inpatient stay was 126 days. All patients had a peripherally inserted central catheter for the intensive treatment phase because medications were given intravenously. Treatment lasted for 24 months after bacteriologic conversion, and included a mean (± SD) of 5±1 drugs. A successful outcome at the end of treatment was observed in 84% of patients. Bacteriological conversion was achieved in 98% of patients with initial positive sputum cultures; conversion occurred by four months in 91%.CONCLUSIONS: MDR TB can be controlled with the available anti-TB drugs.
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Huang, Hairong, Nan Ding, Tingting Yang, Cuidan Li, Xinmiao Jia, Guirong Wang, Jun Zhong, et al. "Cross-sectional Whole-genome Sequencing and Epidemiological Study of Multidrug-resistant Mycobacterium tuberculosis in China." Clinical Infectious Diseases 69, no. 3 (October 15, 2018): 405–13. http://dx.doi.org/10.1093/cid/ciy883.
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AbstractBackgroundThe increase in multidrug-resistant tuberculosis (MDR-TB) severely hampers tuberculosis prevention and control in China, a country with the second highest MDR-TB burden globally. The first nationwide drug-resistant tuberculosis surveillance program provides an opportunity to comprehensively investigate the epidemiological/drug-resistance characteristics, potential drug-resistance mutations, and effective population changes of Chinese MDR-TB.MethodsWe sequenced 357 MDR strains from 4600 representative tuberculosis-positive sputum samples collected during the survey (70 counties in 31 provinces). Drug-susceptibility testing was performed using 18 anti-tuberculosis drugs, representing the most comprehensive drug-resistance profile to date. We used 3 statistical and 1 machine-learning methods to identify drug-resistance genes/single-nucleotide polymorphisms (SNPs). We used Bayesian skyline analysis to investigate changes in effective population size.ResultsEpidemiological/drug-resistance characteristics showed different MDR profiles, co-resistance patterns, preferred drug combination/use, and recommended regimens among 7 Chinese administrative regions. These factors not only reflected the serious multidrug co-resistance and drug misuse but they were also potentially significant in facilitating the development of appropriate regimens for MDR-TB treatment in China. Further investigation identified 86 drug-resistance genes/intergenic regions/SNPs (58 new), providing potential targets for MDR-TB diagnosis and treatment. In addition, the effective population of Chinese MDR-TB displayed a strong expansion during 1993–2000, reflecting socioeconomic transition within the country. The phenomenon of expansion was restrained after 2000, likely attributable to the advances in diagnosis/treatment technologies and government support.ConclusionsOur findings provide an important reference and improved understanding of MDR-TB in China, which are potentially significant in achieving the goal of precision medicine with respect to MDR-TB prevention and treatment.
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Nikolenko, N. Yu, D. А. Kudlay, and N. P. Doktorova. "Pharmacoepidemiology and pharmacoeconomics of multidrug- and extensively drug-resistant tuberculosis." FARMAKOEKONOMIKA. Modern Pharmacoeconomic and Pharmacoepidemiology 14, no. 2 (July 27, 2021): 235–48. http://dx.doi.org/10.17749/2070-4909/farmakoekonomika.2021.089.
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Treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is a current problem worldwide. Currently, special attention is paid to the possibility of using new high-cost chemotherapy regimens in the treatment of MDR/XDR-TB. Numerous studies have shown that, from a clinical point of view, the effectiveness of MDR/XDR-TB therapy increases with the inclusion of bedaquiline, delamanid, linezolid, fluoroquinolones (moxifloxacin, levofloxacin), and pretomanid. At the same time, there is an assumption that the use of new and repurposed anti-tuberculosis drugs (ATDs) may be associated with an increase in overall costs. This paper demonstrates the potential of pharmacoepidemiology and pharmacoeconomics to evaluate the widespread introduction of new anti-tuberculosis drugs (ATDs), taking into account all the typical features of MDR/XDR-TB therapy. The authors analyzed studies of pharmacoeconomic feasibility of using expensive drugs in treatment regimens of pulmonary tuberculosis patients with MDR/XDR pathogen. It was shown that the use of chemotherapy regimens containing new high-cost and highly effective drugs (moxifloxacin, linizolid, and bedaquiline) in rational combinations with other drugs of the basic and reserve series, selected concerning drug resistance of the pathogen, is associated with a significant economic effect. From the applicability of pharmacoeconomic analysis point of view, the introduction of short-term MDR-TB treatment regimens is also a promising direction in phthisiology. The key link to achieve effective MDR/XDR-TB treatment is the use of new drugs. Considering the specificity of pharmacoeconomic analysis in phthisiology and results of existing clinical and economic studies, the authors have formed recommendations aimed at a more complete realization of pharmacoeconomic analysis potential in MDR- and XDR-TB treatment.
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Mulyanto, Heri. "Relationship Five Behavioral Indicators and Healthy Living with Tuberculosis Multidrug-Resistant." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 355. http://dx.doi.org/10.20473/jbe.v2i3.2014.355-367.
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ABSTRACTClean and healthy life style is a behavior that is closely related to the emergence of infectious diseases, including TB continued into MDR-TB. This study aimed to determine the relationship between the 5 behavioral indicators of clean and healthy living with MDR-TB in Dr. Saiful Anwar Hospital. Research was conducted used a retrospective analytic designed by case control study. Subjects drawn from a population with a simple random sampling with a ratio of 1: 1 between cases and controls, patients of MDR-TB in TB clinic as many as 27 patients as cases group and patients who had undergone TB treatment for at least 6 months with a negative smear results by 27 patients as a control group. The variables in this study were healthy and hygienic behavior, and several other variable and MDR-TB The variables in this study were healthy and hygienic behavior, demographic variables and MDR-TB. Research results calculated used Chi Square test with a confidence level of 95% (α = 0.05) showed age, gender, education level and marital status was not associated with MDR- TB, nutritional eating life style associated with MDR-TB (OR = 0,25 and p = 0.014), exercise life style (physical activity) associated with MDR-TB (OR = 0,16 and p = 0.00), utilizing life style health care facilities associated with MDR-TB (OR= 0,091 and p = 0.01), life style to prevent co-infections was not associated with MDR-TB (p = 0.78), and the provision of a healthy home environment behaviors associated with TB multidrug-resistant (OR = 0,28 and p = 0.03). There are four variables of clean and healthy life style associated with MDR-TB, so that health care facilities are advised to give the promotion of clean and healthy life style TB patients to prevent progression to MDR-TB.Keywords: Clean and Healthy Life Style, multidrug resistant tuberculosis
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Mulyanto, Heri. "Relationship Five Behavioral Indicators and Healthy Living with Tuberculosis Multidrug-Resistant." Jurnal Berkala Epidemiologi 2, no. 3 (September 1, 2014): 355. http://dx.doi.org/10.20473/jbe.v2i32014.355-367.
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ABSTRACTClean and healthy life style is a behavior that is closely related to the emergence of infectious diseases, including TB continued into MDR-TB. This study aimed to determine the relationship between the 5 behavioral indicators of clean and healthy living with MDR-TB in Dr. Saiful Anwar Hospital. Research was conducted used a retrospective analytic designed by case control study. Subjects drawn from a population with a simple random sampling with a ratio of 1: 1 between cases and controls, patients of MDR-TB in TB clinic as many as 27 patients as cases group and patients who had undergone TB treatment for at least 6 months with a negative smear results by 27 patients as a control group. The variables in this study were healthy and hygienic behavior, and several other variable and MDR-TB The variables in this study were healthy and hygienic behavior, demographic variables and MDR-TB. Research results calculated used Chi Square test with a confidence level of 95% (α = 0.05) showed age, gender, education level and marital status was not associated with MDR- TB, nutritional eating life style associated with MDR-TB (OR = 0,25 and p = 0.014), exercise life style (physical activity) associated with MDR-TB (OR = 0,16 and p = 0.00), utilizing life style health care facilities associated with MDR-TB (OR= 0,091 and p = 0.01), life style to prevent co-infections was not associated with MDR-TB (p = 0.78), and the provision of a healthy home environment behaviors associated with TB multidrug-resistant (OR = 0,28 and p = 0.03). There are four variables of clean and healthy life style associated with MDR-TB, so that health care facilities are advised to give the promotion of clean and healthy life style TB patients to prevent progression to MDR-TB.Keywords: Clean and Healthy Life Style, multidrug resistant tuberculosis
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Chen, M. P., R. Miramontes, and J. S. Kammerer. "Multidrug-resistant tuberculosis in the United States, 2011–2016: patient characteristics and risk factors." International Journal of Tuberculosis and Lung Disease 24, no. 1 (January 1, 2020): 92–99. http://dx.doi.org/10.5588/ijtld.19.0173.
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OBJECTIVE: To determine risk factors for multidrug-resistant tuberculosis (MDR-TB) and describe MDR-TB according to three characteristics: previous TB disease, recent transmission of MDR-TB, and reactivation of latent MDR-TB infection.SETTING and DESIGN: We used 2011–2016 surveillance data from the US National Tuberculosis Surveillance System and National Tuberculosis Genotyping Service and used logistic regression models to estimate risk factors associated with MDR-TB.RESULTS: A total of 615/45 209 (1.4%) cases were confirmed as MDR-TB; 111/615 (18%) reported previous TB disease; 41/615 (6.7%) were attributed to recent MDR-TB transmission; and 449/615 (73%) to reactivation. Only 12/41 (29%) patients with TB attributed to recent transmission were known to be contacts of someone with MDR-TB. For non-US-born patients, the adjusted odds ratios of having MDR-TB were 32.6 (95%CI 14.6–72.6) among those who were known to be contacts of someone with MDR-TB and 6.5 (95%CI 5.1–8.3) among those who had had previous TB disease.CONCLUSION: The majority of MDR-TB cases in the United States were associated with previous TB disease or reactivation of latent MDR-TB infection; only a small proportion of MDR-TB cases were associated with recent transmission.
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Elmi, Omar Sald, Habsah Hasan, Sarimah Abdullah, Mat Zuki Mat Jeab, Zilfalil Bin Alwi, and Nyi Nyi Naing. "Multidrug-resistant tuberculosis and risk factors associated with its development: a retrospective study." Journal of Infection in Developing Countries 9, no. 10 (October 29, 2015): 1076–85. http://dx.doi.org/10.3855/jidc.6162.
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Introduction: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major clinical public health threat and challenges the national TB control program in Malaysia. Data that elaborates on the risk factors associated with the development of MDR-TB is highly limited in this country. This study was aimed to determine the risk factors associated with the development of MDR-TB patients in peninsular Malaysia. Methodology: This was a case control study; the data were collected from medical records of all the registered MDR-TB patients at five referral TB hospitals in peninsular Malaysia from January 2010 to April 2014. The 105 cases were all confirmed by a positive sputum culture of Mycobacterium tuberculosis for MDR-TB and extensively drug-resistant (XDR)-TB. As a comparison, a total of 209 non-MDR-TB cases were randomly selected as controls. Results: A total of 105 MDR-TB and 209 non MDR-TB patients were studied. The risk factors associated with MDR-TB within the multivariate analysis were previous tuberculosis treatment, HIV infection, being an immigrant, and high load of positive for acid-fast bacillus (AFB) smear. Conclusions: The findings of this study revealed that patients who had received previous treatment for tuberculosis, were infected with HIV, were immigrants, and had a high burden of positive testing for AFB smear were more likely to have MDR-TB. An enhanced understanding of the risk factors associated with MDR-TB strains is imperative in the development of a national policy for public health interventions.
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Field, Stephen K. "Safety and Efficacy of Delamanid in the Treatment of Multidrug-Resistant Tuberculosis (MDR-TB)." Clinical Medicine Insights: Therapeutics 5 (January 2013): CMT.S11675. http://dx.doi.org/10.4137/cmt.s11675.
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Globally, the incidence of tuberculosis (TB) is declining but the proportion of drug-resistant cases has increased. Strains resistant to both isoniazid and rifampin, and possibly other antibiotics, called multidrug-resistant (MDR), are particularly difficult to treat. Poorer outcomes, including increased mortality, occur in patients infected with MDR strains and the costs associated with treatment of MDR-TB are substantially greater. The recent recognition of MDR-TB and strains with more complex resistance patterns has stimulated the development of new TB medications including fluoroquinolones, oxazolidinones, diarylquinolines, nitroimidazopyrans, ethylenediamines, and benzothiazinones. Bedaquiline, a diarylquinoline, was approved for the treatment of MDR-TB in 2012. Addition of delamanid to WHO-approved treatment improved outcomes for MDR-TB and for extensively drug-resistant TB in a large randomized, controlled phase II clinical trial and is undergoing evaluation in a large international phase III study. This review will focus on MDR-TB and the role of delamanid in its treatment.
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Yang, Chongguang, Benjamin Sobkowiak, Vijay Naidu, Alexandru Codreanu, Nelly Ciobanu, Kenneth S. Gunasekera, Melanie H. Chitwood, et al. "Phylogeography and transmission of M. tuberculosis in Moldova: A prospective genomic analysis." PLOS Medicine 19, no. 2 (February 22, 2022): e1003933. http://dx.doi.org/10.1371/journal.pmed.1003933.
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Background The incidence of multidrug-resistant tuberculosis (MDR-TB) remains critically high in countries of the former Soviet Union, where >20% of new cases and >50% of previously treated cases have resistance to rifampin and isoniazid. Transmission of resistant strains, as opposed to resistance selected through inadequate treatment of drug-susceptible tuberculosis (TB), is the main driver of incident MDR-TB in these countries. Methods and findings We conducted a prospective, genomic analysis of all culture-positive TB cases diagnosed in 2018 and 2019 in the Republic of Moldova. We used phylogenetic methods to identify putative transmission clusters; spatial and demographic data were analyzed to further describe local transmission of Mycobacterium tuberculosis. Of 2,236 participants, 779 (36%) had MDR-TB, of whom 386 (50%) had never been treated previously for TB. Moreover, 92% of multidrug-resistant M. tuberculosis strains belonged to putative transmission clusters. Phylogenetic reconstruction identified 3 large clades that were comprised nearly uniformly of MDR-TB: 2 of these clades were of Beijing lineage, and 1 of Ural lineage, and each had additional distinct clade-specific second-line drug resistance mutations and geographic distributions. Spatial and temporal proximity between pairs of cases within a cluster was associated with greater genomic similarity. Our study lasted for only 2 years, a relatively short duration compared with the natural history of TB, and, thus, the ability to infer the full extent of transmission is limited. Conclusions The MDR-TB epidemic in Moldova is associated with the local transmission of multiple M. tuberculosis strains, including distinct clades of highly drug-resistant M. tuberculosis with varying geographic distributions and drug resistance profiles. This study demonstrates the role of comprehensive genomic surveillance for understanding the transmission of M. tuberculosis and highlights the urgency of interventions to interrupt transmission of highly drug-resistant M. tuberculosis.
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Sagonda, Tichaona, Lucy Mupfumi, Rumbidzai Manzou, Beauty Makamure, Mqondisi Tshabalala, Lovemore Gwanzura, Peter Mason, and Reggie Mutetwa. "Prevalence of Extensively Drug Resistant Tuberculosis among Archived Multidrug Resistant Tuberculosis Isolates in Zimbabwe." Tuberculosis Research and Treatment 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/349141.
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We conducted a cross-sectional study of second line drug resistance patterns and genetic diversity of MDR-TB isolates archived at the BRTI-TB Laboratory, Harare, between January 2007 and December 2011. DSTs were performed for second line antituberculosis drugs. XDR-TB strains were defined as MDR-TB strains with resistance to either kanamycin and ofloxacin or capreomycin and ofloxacin. Strain types were identified by spoligotyping. No resistance to any second line drugs was shown in 73% of the isolates, with 23% resistant to one or two drugs but not meeting the definition of XDR-TB. A total of 26 shared types were identified, and 18 (69%) matched preexisting shared types in the current published spoligotype databases. Of the 11 out of 18 clustered SITs, 4 predominant (>6 isolates per shared type) were identified. The most and least abundant types were SIT 1468 (LAM 11-ZWE) with 12 (18%) isolates and SIT 53 (T1) with 6 (9%) isolates, respectively. XDR-TB strains are rare in Zimbabwe, but the high proportion of “pre-XDR-TB” strains and treatment failure cases is of concern. The genetic diversity of the MDR-TB strains showed no significant association between SITs and drug resistance.
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Furin, Jennifer, and Silvia Chiang. "Treatment of Multidrug-Resistant Tuberculosis in Children and Adolescents." Journal of Pediatric Infectious Diseases 13, no. 02 (October 15, 2017): 153–68. http://dx.doi.org/10.1055/s-0037-1607234.
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AbstractAlthough tens of thousands of children and adolescents become sick with multidrug-resistant tuberculosis (MDR-TB) each year, fewer than 1,500 cases documenting treatment have been reported in the literature. Children treated for MDR-TB tend to have excellent clinical outcomes, but they suffer from the adverse events associated with current management strategies. This article will review the recommendations, evidence base, and future directions for MDR-TB therapy in children and adolescents.
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Zellweger, Jean-Pierre. "Tuberculosis Multidrug-resistant Tuberculosis – From Epidemiology to Treatment Design." European Respiratory & Pulmonary Diseases 01, no. 01 (2015): 20. http://dx.doi.org/10.17925/erpd.2015.01.01.20.
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Multidrug-resistant tuberculosis (MDR-TB) and extensively resistant tuberculosis (XDR-TB) are present in most regions of the world and represent a serious threat to the control of tuberculosis. They usually result from errors somewhere along the chain of management of the disease that favoured the selection of resistant mutants, progressively replacing drug-sensitive strains and transmitted to further patients. The currently recommended strategies for the control of this serious situation is the rapid identification of drug-resistant strains, careful drug management of patients with second-line drugs and prevention of the transmission of mycobacteria to contacts. Optimal selection and number of drugs and duration of treatment are not clearly defined. Prevention of the creation of additional cases of MDR-TB is crucial.