Multidrug-resistant tuberculosis in Russia: clinical characteristics, analysis of second-line drug resistance and development of standardized therapy

2005 ◽  
Vol 24 (2) ◽  
pp. 136-139 ◽  
Author(s):  
Y. Balabanova ◽  
M. Ruddy ◽  
J. Hubb ◽  
M. Yates ◽  
N. Malomanova ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Clinical Characteristics ◽  
Multidrug Resistant ◽  
Second Line ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Characteristics Analysis ◽  
Line Drug

scholarly journals High Levels of Treatment Success and Zero Relapse in Multidrug-Resistant Tuberculosis Patients Receiving a Levofloxacin-Based Shorter Treatment Regimen in Vietnam

2020 ◽  
Vol 5 (1) ◽  
pp. 43
Author(s):  
Le T. N. Anh ◽  
Ajay M. V. Kumar ◽  
Gomathi Ramaswamy ◽  
Thurain Htun ◽  
Thuy Thanh Hoang Thi ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Regimen ◽  
Treatment Success ◽  
Scale Up ◽  
Multidrug Resistant ◽  
Second Line ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Line Drug

Vietnam has been using a levofloxacin-based shorter treatment regimen (STR) for rifampicin resistant/multidrug-resistant tuberculosis (RR/MDR-TB) patients since 2016 on a pilot basis. This regimen lasts for 9–11 months and is provided to RR/MDR-TB patients without second-line drug resistance. We report the treatment outcomes and factors associated with unsuccessful outcomes. We conducted a cohort study involving secondary analysis of data extracted from electronic patient records maintained by the national TB program (NTP). Of the 302 patients enrolled from April 2016 to June 2018, 259 (85.8%) patients were successfully treated (246 cured and 13 ‘treatment completed’). Unsuccessful outcomes included: treatment failure (16, 5.3%), loss to follow-up (14, 4.6%) and death (13, 4.3%). HIV-positive TB patients, those aged ≥65 years and patients culture-positive at baseline had a higher risk of unsuccessful outcomes. In a sub-group of patients enrolled in 2016 (n = 99) and assessed at 12 months after treatment completion, no cases of relapse were identified. These findings vindicate the decision of the Vietnam NTP to use a levofloxacin-based STR in RR/MDR-TB patients without second-line drug resistance. This regimen may be considered for nationwide scale-up after a detailed assessment of adverse drug events.

Second-line drug susceptibilities of multidrug-resistant tuberculosis strains isolated in Thailand: an update

2014 ◽  
Vol 18 (8) ◽  
pp. 961-963 ◽  
Author(s):  
A. Chaiprasert ◽  
S. Srimuang ◽  
N. Tingtoy ◽  
N. Makhao ◽  
P. Sirirudeeporn ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Second Line ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Line Drug

scholarly journals Frequent suboptimal thermocycler ramp rate usage negatively impacts MTBDRsl performance for second-line drug resistant tuberculosis diagnosis

2021 ◽  
Author(s):  
Brigitta Derendinger ◽  
Margaretha de Vos ◽  
Samantha Pillay ◽  
Rouxjeane Venter ◽  
John Metcalfe ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Second Line ◽  
Ramp Rate ◽  
Dilution Series ◽  
Resistant Tuberculosis ◽  
Assay Performance ◽  
Mdr Tb ◽  
Line Drug

Strengthening the detection of second-line drug-resistance is a key tuberculosis (TB) control priority. The performance of MTBDRplus, a multidrug-resistant (MDR)-TB assay is reduced when suboptimal ramp rates are used. We investigated ramp rate's effect on MTBDRsl; the most widely-used molecular second-line drug-resistant TB assay. We tested 52 smear-negative Xpert MTB/RIF Ultra-positive sputa and a Mycobacterium tuberculosis (Mtb) dilution series at manufacturer recommended (2.2 ° C/s) or most common suboptimal ramp rate (4.0 ° C/s; identified via an earlier survey). Mtb-complex DNA (TUB-band)-positivity, indeterminate rates, fluoroquinolone- and second-line injectable-resistance accuracy, banding differences and, separately, inter-reader variability were assessed. 39% of re-surveyed laboratories (5/13) did not use the manufacturer-recommended MTBDRsl ramp rate. On sputum, this ramp rate improved indeterminates vs. 4.0 ° C/s (0/52 vs. 7/51; p=0.006), false drug-resistance calls (0/104 vs. 6/102; p=0.013), and incorrect banding calls (0/1300 vs. 55/1275; p<0.001). Valid results (neither TUB negative, indeterminate, nor any false drug-resistance calls) (52/52 vs. 41/51; p=0.001) on sputa hence improved by +21% (95% CI: 8-34%) with optimal ramp rate usage. Suboptimal ramp rate increased banding call inter-reader variability [52/1300 (4%) vs. 34/1300 (3%); p=0.030] on sputa but not dilution series; highlighting the importance of using clinical specimens for assay performance evaluations. Suboptimal ramp rate contributes to poor MTBDRsl performance. Ramp rate correction will improve second line drug-resistant TB diagnoses. Laboratories must ensure the optimal manufacturer-recommended ramp rate is used.

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