scholarly journals Epidemiological profile of multidrug-resistant and extensively drug-resistant Mycobacterium Tubrculosis among Congolese patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Darrel Ornelle Elion Assiana ◽  
Jabar Babatunde Pacôme Achimi Abdul ◽  
Laure Stella Ghoma Linguissi ◽  
Micheska Epola ◽  
Jeannhey Christevy Vouvoungui ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
High Rate ◽  
Rifampicin Resistance ◽  
Assay Method ◽  
Drug Resistant ◽  
Molecular Tools ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Reference Hospital

Abstract Background There is paucity of data on the prevalence and distribution of multidrug- Resistant-Tuberculosis (MDR-TB) in the Republic of Congo. Among the challenges resides the implementation of a robust TB resistance diagnostic program using molecular tools. In resource limited settings there is a need to gather data to enable prioritization of actions. The objective of this study was is to implement molecular tools as a best of diagnosing MDR and XDR-TB among presumptive tuberculosis patients referred to reference hospital of Makelekele in Brazzaville, Republic of the Congo. Methods We have conducted a cross-sectional study, including a total of 92 presumptive pulmonary tuberculosis patients and who had never received treatment recruited at the reference hospital of Makelekele from October 2018 to October 2019. The socio-demographic and clinical data were collected as well as sputum samples. Rifampicin resistance was investigated using Xpert (Cepheid) and second-line TB drugs Susceptibility testing were performed by the Brucker HAIN Line Probe Assay (GenoType MTBDRsl VER 2.0 assay) method. Results From the 92 recruited patients, 57 (62%) were found positive for the Mycobacterium tuberculosis complex. The prevalence of rifampicin-resistant tuberculosis (RR-TB) was 9.8% (9/92) and importantly 2.2% were pre-XDR/XDR. Conclusion This study showed a high rate of rifampicin resistance and the presence of extensively drug-resistant tuberculosis in the study area in new patients. This study highlights the need for further studies of TB drug resistance in the country.

scholarly journals Epidemiological profile of multidrug-resistant and extensively drug-resistant Mycobacterium Tubrculosis among Congolese patients 

2021 ◽  
Author(s):  
Darrel ELION ASSIANA ◽  
Pacôme ACHIMI ABDUL ◽  
Laure Stella GHOMA LINGUISSI ◽  
Micheska EPOLA ◽  
Jeannhey VOUVOUNGU ◽  
...  
Keyword(s):  
Public Health Problem ◽  
High Rate ◽  
Rifampicin Resistance ◽  
Assay Method ◽  
Molecular Diagnostic ◽  
Diagnostic Tools ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Epidemiological Profile

Abstract Background Tuberculosis (TB) remains a public health problem and early detection of drug resistance is crucial to prevent transmission of drug-resistant TB and avoid mortality. There is paucity of data on the prevalence and distribution of MDR-TB at the Republic of Congo. However, the challenges of establishing a robust testing program are significant. In resource limited settings there is a need to gather data to enable prioritization of actions. The objective of this study was to characterize the epidemiological profile of MDR and XDR-TB among presumptive tuberculosis patients referred to Makélékélé hospital in Brazzaville, Republic of the Congo. Methods We have conducted a cross-sectional study, including a total of 92 patients recruited at the Makélékélé hospital from October 2018 to October 2019. The socio-demographic and clinical data were collected as well as sputum samples. Rifampicin resistance was investigated using Xpert (Cepheid) and second-line TB drugs Susceptibility testing were performed by the Brucker HAIN Line Probe Assay (GenoType MTBDRsl VER 2.0 assay) method. Results From the 92 recruited patients, 57 (62%) were found positive for the Mycobacterium tuberculosis complex. The prevalence of rifampicin-resistant tuberculosis (RR-TB) was 9.8% (9/92) and importantly 2.2% were pre-XDR/XDR. Conclusion This study showed a high rate of rifampicin resistance and the presence of extensively drug-resistant tuberculosis in the study area in new patients. This study suggests early diagnosis of resistant tuberculosis should be considered using more sensitive diagnostic tools. Rapid molecular diagnostic tools such as GeneXpert need to be installed in health centers for better management of resistant tuberculosis.

scholarly journals High treatment success rate for multidrug-resistant and extensively drug-resistant tuberculosis using a bedaquiline-containing treatment regimen

2018 ◽  
Vol 52 (6) ◽  
pp. 1801528 ◽  
Author(s):  
Norbert Ndjeka ◽  
Kathryn Schnippel ◽  
Iqbal Master ◽  
Graeme Meintjes ◽  
Gary Maartens ◽  
...  
Keyword(s):  
Treatment Success ◽  
Multidrug Resistant ◽  
High Rate ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Background Regimen ◽  
Access Programme ◽  
African Patients ◽  
Lost To Follow Up

South African patients with rifampicin-resistant tuberculosis (TB) and resistance to fluoroquinolones and/or injectable drugs (extensively drug-resistant (XDR) and preXDR-TB) were granted access to bedaquiline through a clinical access programme with strict inclusion and exclusion criteria.PreXDR-TB and XDR-TB patients were treated with 24 weeks of bedaquiline within an optimised, individualised background regimen that could include levofloxacin, linezolid and clofazimine as needed. 200 patients were enrolled: 87 (43.9%) had XDR-TB, 99 (49.3%) were female and the median age was 34 years (interquartile range (IQR) 27–42). 134 (67.0%) were living with HIV; the median CD4+ count was 281 cells·μL−1 (IQR 130–467) and all were on antiretroviral therapy.16 out of 200 patients (8.0%) did not complete 6 months of bedaquiline: eight were lost to follow-up, six died, one stopped owing to side effects and one was diagnosed with drug-sensitive TB. 146 out of 200 patients (73.0%) had favourable outcomes: 139 (69.5%) were cured and seven (3.5%) completed treatment. 25 patients (12.5%) died, 20 (10.0%) were lost from treatment and nine (4.5%) had treatment failure. 22 adverse events were attributed to bedaquiline, including a QT interval corrected using the Fridericia formula (QTcF) >500 ms (n=5), QTcF increase >50 ms from baseline (n=11) and paroxysmal atrial flutter (n=1).Bedaquiline added to an optimised background regimen was associated with a high rate of successful treatment outcomes for this preXDR-TB and XDR-TB cohort.

High rate of extensively drug-resistant tuberculosis in Indian AIDS patients

AIDS ◽  
2007 ◽  
Vol 21 (17) ◽  
pp. 2345-2347 ◽  
Author(s):  
Sarman Singh ◽  
Manimuthu Mani Sankar ◽  
Krishnamoorthy Gopinath
Keyword(s):  
High Rate ◽  
Drug Resistant ◽  
Aids Patients ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

scholarly journals Tuberculose Multirresistente por Estirpes da Família Beijing, em Doentes de Lisboa, Portugal: Estudo Preliminar

2017 ◽  
Vol 30 (3) ◽  
pp. 175 ◽  
Author(s):  
Fernando Maltez ◽  
Teresa Martins ◽  
Diana Póvoas ◽  
João Cabo ◽  
Helena Peres ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Past History ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Beijing Family ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Number Of Patients ◽  
Drug Resistant Strains

Introduction: Beijing family strains of Mycobacterium tuberculosis are associated with multidrug-resistance. Although strains of the Lisboa family are the most common among multidrug-resistant and extensively drug-resistant patients in the region, several studies have reported the presence of the Beijing family. However, the features of patients from whom they were isolated, are not yet known.Material and Methods: Retrospective study involving 104 multidrug-resistant and extensively drug-resistant strains of Mycobacterium tuberculosis, from the same number of patients, isolated and genotyped between 1993 and 2015 in Lisbon. We assessed the prevalence of strains of both families and the epidemiologic and clinical features of those infected with Beijing family strains.Results: Seventy-four strains (71.2%) belonged to the Lisboa family, 25 (24.0%) showed a unique genotypic pattern and five (4.8%) belonged to the Beijing family, the latter identified after 2009. Those infected with Beijing family strains were angolan (n = 1), ukrainian (n = 2) and portuguese (n = 2), mainly young-aged and, four of five immunocompetent and with no past history of tuberculosis. All had multidrug-resistant tuberculosis. We did not find any distinctive clinical or radiological features, neither a predominant resistance pattern. Cure rate was high (four patients).Discussion: Although the number of infected patients with Beijing strains was small, it suggests an important proportion of primary tuberculosis, a potential for transmission in the community but also a better clinical outcome when compared to other reported strains, such as W-Beijing and Lisboa.Conclusion: Although Lisboa family strains account for most of the multidrug and extensively drug-resistant tuberculosis cases in Lisbon area, Beijing strains are transmitted in the city and might change the local characteristics of the epidemics.

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