Drug-sensitivity profile of clinical Mycobacterium tuberculosis isolates – a retrospective study from a chest-disease institute in India

Multi-drug-resistant tuberculosis (MDR-TB) is a major public-health problem, because treatment is complicated and patients remain infectious for months or years, despite receiving the best available therapy. To gain better understanding of MDR-TB, a retrospective study was initiated to determine the level of drug resistance among patients in a chest-disease institute in India. Two hundred and sixty-three isolates from treatment-failure pulmonary tuberculosis patients (20–70 years) were studied. Drug-sensitivity testing was performed by the modified-proportion method. First- and second-line drugs, along with two quinolone drugs (ofloxacin and ciprofloxacin), were tested. Patients included in this study did not improve with therapy; however, 151 isolates (57.5 %) were susceptible to all four first-line antituberculosis drugs. This study reports low resistance to fluoroquinolones among the strains present in these patients.

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Uji Diagnostik Genexpert Mtb/Rif Di Rumah Sakit Umum Pusat Haji Adam Malik Medan

JURNAL BIOSAINS ◽

10.24114/jbio.v1i2.2783 ◽

2016 ◽

Vol 1 (2) ◽

pp. 19

Author(s):

Elva Susanty ◽

Zainuddin Amir ◽

Parluhutan Siagian ◽

Rina Yunita ◽

Putri Chairani Eyanoer

Keyword(s):

Drug Sensitivity ◽

Surrogate Marker ◽

Multidrug Resistant ◽

Sensitivity Testing ◽

Standard Drug ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

Lowenstein Jensen ◽

Proportion Method

Background: Cases of multidrug resistant tuberculosis (MDR TB) is increasing in number in the world and requires early detection to prevent further transmission. GeneXpert MTB/RIF is a tool that can be used for detection of rifampicin resistance, as a surrogate marker for MDR TB. This study aims to assess the sensitivity and specificity of the GeneXpert MTB/RIF in diagnosis of MDR TB. Methods: diagnostic test study was conducted at a poly MDR TB General Hospital Haji Adam Malik Medan. The subjects were all suspected MDR TB who had results positive GeneXpert MTB/ RIF with sensitive rifampin or resistant rifampin and had a drug sensitivity test results with the proportion method Lowenstein Jensen medium. Data retrieved from the medical records, between January until December 2013. Results: founded 64 samples that had results of GeneXpert MTB/RIF test positive and had the results of drug sensitivity, 87.5% of rifampin-resistant samples were also resistant to isoniazid. The GeneXpert MTB/RIF examination showed the sensitivity of 92.86% and the specificitu of 59.09%. Conclusion: GeneXpert MTB/ RIF has a high sensitivity for diagnosing MDR TB compared the gold standard drug sensitivity testing proportion method on Lowenstein Jensen medium. This study recommends the GeneXpert MTB/RIF be used for MDR TB screening tool. Keywords: GeneXpert MTB/RIF, multidrug resistant tuberculosis, drug susceptibility test, Lowenstein Jensen medium

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The Potential Impact of Up-Front Drug Sensitivity Testing on India’s Epidemic of Multi-Drug Resistant Tuberculosis

PLoS ONE ◽

10.1371/journal.pone.0131438 ◽

2015 ◽

Vol 10 (7) ◽

pp. e0131438 ◽

Cited By ~ 21

Author(s):

Kuldeep Singh Sachdeva ◽

Neeraj Raizada ◽

Radhey Shyam Gupta ◽

Sreenivas Achuthan Nair ◽

Claudia Denkinger ◽

...

Keyword(s):

Drug Sensitivity ◽

Drug Resistant ◽

Sensitivity Testing ◽

Drug Resistant Tuberculosis ◽

Drug Sensitivity Testing ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Potential Impact

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Paediatric Multidrug-Resistant Tuberculosis with HIV Coinfection: A Case Report

Case Reports in Medicine ◽

10.1155/2013/756152 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

Huldah I. Nwokeukwu ◽

Paulinus N. Okafor ◽

Onuka Okorie ◽

Ihuoma K. Ukpabi

Keyword(s):

Public Health Problem ◽

Multidrug Resistant ◽

Active Tuberculosis ◽

Recurrent Fever ◽

Major Public Health Problem ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Hiv Coinfection ◽

Mdr Tb ◽

History Of

Background.Tuberculosis is a major public health problem, and its control has been facing a lot of challenges with emergence of HIV. The occurrence of multidrug-resistant strain has also propounded the problem especially in children where diagnosis is difficult to make. Multidrug-resistant tuberculosis (MDR-TB) isin vitroresistant to isoniazid (H) and rifampicin (R). Paediatric multi-drug resistant tuberculosis with HIV coinfection is rare, and there is no documented report from Nigeria.Objective.To report a case of paediatric MDR-TB in Nigeria about it.Methods.The case note of the patient was retrieved, and relevant data were extracted and summarized.Results.A 9-year-old female HIV-positive pupil with a year history of recurrent cough, 3 months history of recurrent fever, and generalized weight loss was diagnosed and treated for tuberculosis but failed after retreatment. She was later diagnosed with MDR-TB and is presently on DOT-Plus regimen.Conclusion.Paediatric MDR-TB with HIV co-infection is rare. Early diagnosis and treatment is important to prevent spread of the disease. The use of Isoniazid preventive therapy is recommended for children who come in contact with patients with active tuberculosis and also for HIV patients without active tuberculosis.

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Early detection of Pre-XDR TB with line probe assay in a high TB burden country

African Health Sciences ◽

10.4314/ahs.v21i3.2 ◽

2021 ◽

Vol 21 (3) ◽

pp. 968-974

Author(s):

Laura Madukaji ◽

Isaac Okohu ◽

Saheed Usman ◽

Uche Oyedum ◽

Abdullah Enagi ◽

...

Keyword(s):

Public Health Problem ◽

Multidrug Resistant ◽

Major Public Health Problem ◽

Drug Resistant ◽

Line Probe Assay ◽

North Central ◽

Resistant Tuberculosis ◽

Mdr Tb ◽

Probe Assay ◽

And Control

Background: Worldwide, tuberculosis (TB) is one of the top 10 causes of death. Drug resistant tuberculosis has lately become a major public health problem that threatens progress made in Tuberculosis (TB) care and control worldwide. The aim of this study was to determine the prevalence of Pre-extensive drug resistant TB among MDR TB in North Central of Nigeria. Methods: This study was conducted from October, 2018 to August, 2019 with 150 samples. In Nigeria, guidelines for DR-TB as recommended by WHO is followed. All the samples from the patients who gave their consent were transported to a zonal reference TB laboratory (ZRL). Results: Mean age was 38.6 ± 13.4 years with peak age at 35-44. Out of these 103 samples processed with LPA, 101(98%) were rifampicin resistant and 2 were rifampicin sensitive, 99(96%) were INH resistant and 4 (4%) were INH sensitive, 5(5%) were fluoroquinolone resistant, 98(95%) were fluoroquinolone sensitive, 12 (12%) were Aminoglycoside + Capreomycin resistant, 91(83%) were Aminoglycoside + Capreomycin sensitive. Conclusion: Multidrug resistant TB and its severe forms (Pre-extensive & extensively drug resistant TB) can be detected early with rapid tool- Line Probe Assay rapid and prevented timely by early initiation on treatment. Keywords: Pre-XDR TB; line probe assay in a high TB burden country.

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Socio-demographic determinants of treatment outcome in multidrug resistant tuberculosis cases registered under Programmatic management of drug resistant tuberculosis services in Amritsar, Punjab

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192345 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2688

Author(s):

Manisha Nagpal ◽

Sarthak Chawla ◽

Priyanka Devgun ◽

Naresh Chawla

Keyword(s):

Treatment Outcome ◽

Treatment Success ◽

Public Health Problem ◽

Educational Status ◽

Multidrug Resistant ◽

Major Public Health Problem ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb

Background: Multidrug resistant tuberculosis (MDR-TB) has become a major public health problem. It is associated with significant morbidity and mortality. The treatment success rate worldwide is around 50%.Methods: This cross-sectional study was conducted on all MDR-TB patients who were registered and being treated under PMDT services in Amritsar district from 1st April 2014 to 31st March 2015. The treatment outcome with their socio-demographic determinants was ascertained. Data management and analysis was done by using Microsoft excel and SPSS.Results: Out of 87 MDR-TB patients, 57 (65.5%) were males and 30 (34.4%) were females. The various treatment outcomes observed were- 30 (34.5%) cured, 19 (21.8%) treatment completed, 18 (20.7%) died, 13 (14.9%) defaulted, 4 (4.6%) shifted to XDR TB regime and 3 (3.4%) failure.Conclusions: On statistical analysis, it was observed that age (p=0.000), marital status (p=0.024), educational status (p=0.011) and occupation (p=0.002) were significantly associated with the treatment outcome. Other factors like sex, type of family and socio-economic status did not affect the treatment outcome.

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TREATMENT OUTCOMES OF MULTIDRUG RESISTANT TUBERCULOSIS PATIENTS IN EAST JAVA FROM 2014 TO 2017

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v8i22020.141-148 ◽

2020 ◽

Vol 8 (2) ◽

pp. 141

Author(s):

Lailatul Fitriya ◽

Kurnia Dwi Artanti

Keyword(s):

Treatment Outcomes ◽

Health Workers ◽

Treatment Success ◽

Public Health Problem ◽

Secondary Data ◽

Multidrug Resistant ◽

Major Public Health Problem ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb

Background: Multidrug resistant tuberculosis (MDR TB) is a major public health problem marked by the Mycobacterium tuberculosis strain that is resistant to first line anti TB drugs, including rifampicin and isoniazid simultaneously. A patient confirmed as having MDR TB can transmit this form of TB to other individuals. Therefore, treatment success is the main target when addressing MDR TB. Purpose: This study aimed to assess the treatment outcomes of MDR TB patients in East Java Province from 2014 to 2017. Method: This is a quantitative-descriptive study using the secondary data of drug resistant TB patients sourced from the e-TB Manager website in the East Java Province Health Office. Results: The results show that the average MDR TB patients was 47 years old, 57.44% were male, 37.52% had a negative HIV status, 44.87% were relapse patients, 71.95% had undergone two or less previous treatments, and 69.24% had sputum culture conversion. The treatment outcomes included 161 patients (31.14%) confirmed as cured, 27 patients (5.22%) completing treatment, 174 patients (33.65%) defaulting, two patients (0.38%) confirmed as having failed treatment, and 59 patients (11.41%) dying during the treatment period. Conclusion: The treatment success rate was low and the number of defaults was high. Therefore, it is hoped that there will be support from those closest to the patient and health workers who will maintain and increase the patient's motivation to complete the treatment.

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The Neglected Contribution of Streptomycin to the Tuberculosis Drug Resistance Problem

Genes ◽

10.3390/genes12122003 ◽

2021 ◽

Vol 12 (12) ◽

pp. 2003

Author(s):

Deisy M. G. C. Rocha ◽

Miguel Viveiros ◽

Margarida Saraiva ◽

Nuno S. Osório

Keyword(s):

Drug Resistance ◽

Public Health Problem ◽

Resistance Mechanisms ◽

Major Public Health Problem ◽

First Line ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

The Impact ◽

Very High

The airborne pathogen Mycobacterium tuberculosis is responsible for a present major public health problem worsened by the emergence of drug resistance. M. tuberculosis has acquired and developed streptomycin (STR) resistance mechanisms that have been maintained and transmitted in the population over the last decades. Indeed, STR resistant mutations are frequently identified across the main M. tuberculosis lineages that cause tuberculosis outbreaks worldwide. The spread of STR resistance is likely related to the low impact of the most frequent underlying mutations on the fitness of the bacteria. The withdrawal of STR from the first-line treatment of tuberculosis potentially lowered the importance of studying STR resistance. However, the prevalence of STR resistance remains very high, could be underestimated by current genotypic methods, and was found in outbreaks of multi-drug (MDR) and extensively drug (XDR) strains in different geographic regions. Therefore, the contribution of STR resistance to the problem of tuberculosis drug resistance should not be neglected. Here, we review the impact of STR resistance and detail well-known and novel candidate STR resistance mechanisms, genes, and mutations. In addition, we aim to provide insights into the possible role of STR resistance in the development of multi-drug resistant tuberculosis.

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Burden of drug-resistant pulmonary tuberculosis in Pakistani children: A cross-sectional study

F1000Research ◽

10.12688/f1000research.18507.2 ◽

2019 ◽

Vol 8 ◽

pp. 344

Author(s):

Ghulam Shabbir Laghari ◽

Zahid Hussain ◽

Lavina Khemani ◽

Syed Zohaib Maroof Hussain ◽

Uzair Yaqoob

Keyword(s):

Drug Sensitivity ◽

Sputum Smear ◽

P Value ◽

Drug Resistant ◽

Duration Of Treatment ◽

Sensitivity Testing ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

Mdr Tb ◽

History Of

Introduction: The incidence of drug-resistant tuberculosis (TB) is rapidly increasing worldwide. Children in high TB burden countries are rapidly being reported to be affected by Mycobacterium tuberculosis resistant to isoniazid and rifampicin. The aim of this study is to evaluate the pattern of drug sensitivity among children suffering with TB. Methods: Known cases of pulmonary TB, with sputum smear positive for acid-fast bacilli after two months of compliance to 1st line anti-tuberculous therapy were included after gaining informed consent. Specimens used for drug sensitivity testing were either sputum or bronchoalveolar lavage. Patient age, gender, history of TB contact, and duration of treatment were also recorded. Data was entered and analyzed using SPSS v.22. Results: Fifty children, 32 male (64%) and 18 female (36%) were included in the study. Their mean age was 12.84 ± 2.54 years. History of household TB contact was positive in 29 (58%) children. Among 1st line anti-tuberculous therapy, rifampicin resistance was highest at 33/50 (66%), and resistance to streptomycin and ethambutol were the lowest (6/50; 12%). There were 18 (36%) children with multidrug-resistant tuberculosis (MDR-TB). A positive history of household TB contact (either resistant or non-resistant) was seen to have a statistically significant impact on incidence of MDR-TB (p value=0.03) Conclusion: Pediatric drug-resistant TB is a rising concern. Awareness programs on national and international levels are needed to educate general population regarding the importance of preventing TB household contact, especially amongst children. With the selected method used to identify mainly older children with drug resistance, the yield for drug-resistant TB was found to be high.

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