Prediction of 1-year treatment outcome using the early sputum culture conversion status in Mycobacterium abscessus pulmonary disease

Abstract Background Pyrazinamide (PZA) resistance in multidrug-resistant tuberculosis (MDR-TB) is common; yet, it is not clear how it affects interim and treatment outcomes. Although rarely performed, phenotypic drug susceptibility testing (pDST) is used to define PZA resistance, but genotypic DST (gDST) and minimum inhibitory concentration (MIC) could be beneficial. We aimed to assess the impact of PZA gDST and MIC on time to sputum culture conversion (SCC) and treatment outcome in patients with MDR-TB. Methods Clinical, microbiological, and treatment data were collected in this cohort study for all patients diagnosed with MDR-TB in Sweden from 1992–2014. MIC, pDST, and whole-genome sequencing of the pncA, rpsA, and panD genes were used to define PZA resistance. A Cox regression model was used for statistical analyses. Results Of 157 patients with MDR-TB, 56.1% (n = 88) had PZA-resistant strains and 49.7% (n = 78) were treated with PZA. In crude and adjusted analysis (hazard ratio [HR], 0.49; 95% conficence interval [CI], .29-.82; P = .007), PZA gDST resistance was associated with a 29-day longer time to SCC. A 2-fold decrease in dilutions of PZA MIC for PZA-susceptible strains showed no association with SCC in crude or adjusted analyses (HR, 0.98; 95% CI, .73–1.31; P = .89). MIC and gDST for PZA were not associated with treatment outcome. Conclusions In patients with MDR-TB, gDST PZA resistance was associated with a longer time to SCC. Rapid PZA gDST is important to identify patients who may benefit from PZA treatment.

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Factors affecting time to sputum culture conversion and treatment outcome of patients with multidrug-resistant tuberculosis in China

BMC Infectious Diseases ◽

10.1186/s12879-018-3021-0 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 7

Author(s):

Qiao Liu ◽

Peng Lu ◽

Leonardo Martinez ◽

Haitao Yang ◽

Wei Lu ◽

...

Keyword(s):

Treatment Outcome ◽

Multidrug Resistant ◽

Sputum Culture ◽

Factors Affecting ◽

Sputum Culture Conversion ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Culture Conversion

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800. Drug-Resistant TB: An Experience From Qatar

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.807 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S287-S287

Author(s):

Maisa Ali ◽

Faraj Alhowady ◽

Waqar Munir ◽

Muna Almaslamani ◽

Abdulatif Alkhal ◽

...

Keyword(s):

Drug Resistance ◽

Treatment Outcome ◽

Indian Subcontinent ◽

Disease Patient ◽

Sputum Culture ◽

Multi Drug Resistance ◽

Drug Resistant ◽

Sputum Culture Conversion ◽

Culture Conversion

Abstract Background Drug-resistant tuberculosis (DR-TB) is an important issue for public health. This study was conducted to evaluate the characteristics, treatment outcome, and risk factors associated with 223 DR-TB cases in the State of Qatar. Methods A descriptive records-based retrospective study was conducted on patients registered at Communicable Disease Centre (CDC), Qatar to all consecutive microbiologically confirmed tuberculosis cases for the period January 2010–March 2015. Demographic and clinical data extracted included: patient’s age, sex, and country of origin; disease site (pulmonary or extra-pulmonary); presence of comorbidities, HIV/AIDS status, previous chemoprophylaxis and/or previous treatment for TB, and anti-TB drug resistance the resistance pattern of isolated mycobacteria. The sputum culture conversion rate and treatment outcome was assessed for the patient who completed their treatment in Qatar Results Of 3,301 patients with positive M. tuberculosis culture were analyzed; 223 (6.7%) were resistant to one or more first-line drugs, to isoniazid in 3.1% (n = 102), streptomycin in 1.2% (n = 41), rifampicin in 0.2% (n = 6), ethambutol in 0.15% (n = 5), and multi-drug resistance in 1.2% (n = 38) of patients. Among the resistant TB patients, more common demographic characteristics were former resident of Indian subcontinent (64.1%). A history of anti-TB treatment was not a risk factor with drug resistance in our cohort. Only 111 (49.7%) patients were tested for HIV antibodies and the results were all negative. There was significant correlation between the type of drug-resistance and CXR finding (23.3% had cavity—P = 0.019). Sputum culture conversion to negative at 2 month of therapy was 94% (n = 101), whereas 122 cases lost follow-up. The outcome of treatment was assessed for 85 resistant cases with follow-up after completion of treatment, show cure rate of 97.6%, and relapse of 2.4%. However, 137 cases (61.4% from total) they left the country before completion of therapy. Conclusion Drug-resistant TB in Qatar is influenced by migration, especially from the Indian subcontinent, where the patients were probably infected. Rapid sputum sampling performed in the early stages of the disease, patient isolation, and drug susceptibility testing should be the standard of care to avoid further transmission and improve TB control. Disclosures All authors: No reported disclosures.

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Time to sputum culture conversion and treatment outcome among the first cohort of multidrug resistant tuberculosis patients in a high burden country

Indian Journal of Tuberculosis ◽

10.1016/j.ijtb.2018.07.006 ◽

2018 ◽

Vol 65 (4) ◽

pp. 322-328 ◽

Cited By ~ 1

Author(s):

O.M. Ige ◽

Regina E. Oladokun

Keyword(s):

Treatment Outcome ◽

Multidrug Resistant ◽

Sputum Culture ◽

Tuberculosis Patients ◽

High Burden ◽

Sputum Culture Conversion ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Culture Conversion

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Time to sputum culture conversion as a prognostic marker for end-of-treatment outcome in the first cohorts of MDR-TB patients managed in a Nigerian tertiary hospital

10.1183/13993003.congress-2016.pa2685 ◽

2016 ◽

Author(s):

Olusoji Ige ◽

Regina Oladokun

Keyword(s):

Treatment Outcome ◽

Prognostic Marker ◽

Tertiary Hospital ◽

Sputum Culture ◽

Sputum Culture Conversion ◽

End Of Treatment ◽

Mdr Tb ◽

Culture Conversion

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A Subset of Circulating Blood Mycobacteria-Specific CD4 T Cells Can Predict the Time to Mycobacterium tuberculosis Sputum Culture Conversion

PLoS ONE ◽

10.1371/journal.pone.0102178 ◽

2014 ◽

Vol 9 (7) ◽

pp. e102178 ◽

Cited By ~ 16

Author(s):

Catherine Riou ◽

Clive M. Gray ◽

Masixole Lugongolo ◽

Thabisile Gwala ◽

Agano Kiravu ◽

...

Keyword(s):

T Cells ◽

Mycobacterium Tuberculosis ◽

Cd4 T Cells ◽

Sputum Culture ◽

Sputum Culture Conversion ◽

Culture Conversion

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Impact of susceptibility to injectable antibiotics on the treatment outcomes of Mycobacterium abscessus pulmonary disease

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab215 ◽

2021 ◽

Author(s):

Youngmok Park ◽

Yea Eun Park ◽

Byung Woo Jhun ◽

Jimyung Park ◽

Nakwon Kwak ◽

...

Keyword(s):

Treatment Outcomes ◽

Pulmonary Disease ◽

Drug Susceptibility ◽

Mycobacterium Abscessus ◽

Beta Lactams ◽

In Vitro Susceptibility ◽

Referral Hospitals ◽

Microbiological Cure ◽

Culture Conversion

Abstract Objectives Current guidelines recommend a susceptibility-based regimen for Mycobacterium abscessus subspecies abscessus pulmonary disease (MAB-PD), but the evidence is weak. We aimed to investigate the association between treatment outcomes and in vitro drug susceptibility to injectable antibiotics in MAB-PD patients. Methods We enrolled MAB-PD patients treated with intravenous amikacin and beta-lactams for ≥4 weeks at four referral hospitals in Seoul, South Korea. Culture conversion and microbiological cure at one year were evaluated based on susceptibility to injectable antibiotics among patients treated with those antibiotics for ≥ 2 weeks. Results A total of 82 patients were analysed. The mean age was 58.7 years, and 65.9% were women. Sputum culture conversion and microbiological cure were achieved in 52.4% and 41.5% of patients, respectively. Amikacin was the most common agent to which the M. abscessus subspecies abscessus isolates were susceptible (81.7%); 9.8% and 24.0% of the isolates were resistant to cefoxitin and imipenem, respectively. The clarithromycin-inducible resistance (IR) group (n = 65) had a lower microbiological cure rate than the clarithromycin-susceptible group (35.4% vs. 64.7%). The treatment outcomes appeared to be similar regardless of in vitro susceptibility results with regard to intravenous amikacin, cefoxitin, imipenem, and moxifloxacin. In the subgroup analysis of the clarithromycin-IR group, the treatment outcomes did not differ according to antibiotic susceptibility. Conclusions We did not find evidence supporting the use of susceptibility-based treatment with intravenous amikacin and beta-lactams in patients with MAB-PD. Further research would be required.

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