scholarly journals Development of Drug Resistance among Comorbid and Non-Comorbid HIV-Negative Relapsed Cases of Tuberculosis in Lahore, Pakistan

2020 ◽  
Author(s):  
Arslan Ahmed Salam ◽  
Aamer Ikram ◽  
Maha Fatima ◽  
Najma Javed Awan
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Rifampicin Resistance ◽  
Drug Susceptibility Test ◽  
Health Crisis ◽  
Mdr Tb ◽  
History Of ◽  
Xpert Assay ◽  
Hiv Negative

Abstract Background: Mycobacterium tuberculosis sometimes become resistant to the drugs that are used to treat it. Drug resistant TB (DR-TB) is spread in the same way as drug susceptible TB. DR-TB is a public health crisis. This study aims to find the pattern of drug resistance and correlations between drug resistance and comorbid/non-comorbid conditions in patients with a relapse of TB. Methodology: A cross-sectional study was conducted among 200 HIV-negative relapsed TB patients from 2016-2017 in Mayo Hospital Lahore. The patients’ sputum samples were tested by Ziehl-Neelsen staining to observe acid-fast bacilli. The demographics and medical history of patients was recorded, who were positive for AFB in their sputum samples. Molecular procedure of Gene-Xpert assay was conducted to detect the presence of MTB and rifampicin resistance in the samples. Whereas, the drug susceptibility test (DST) was conducted on the LJ culture medium containing drugs.Results: Out of 200 relapsed TB cases; 97 were comorbid, 99 were non-comorbid. The most prevalent comorbidities were hypertension (42 cases- 43.3%), diabetes (45 cases-46.4%) and hepatitis B (14 cases-14.4%). Among 97 comorbid patients; 37 worked as laborers, 43 earned less than 20,000 PKR and 23 were found to have a history of imprisonment. Whereas in non-comorbid patients; 20 worked as laborers, 28 earned less than 20,000 PKR and 12 had been in prison before. The Gene-Xpert test detected rifampicin resistance (RR) in 20 comorbid (20.6%) and 33 non-comorbid (33.3%) patients. Whereas, the drug susceptibility test (DST) showed that 22 comorbid (22.7%) and 33 non-comorbid (33.3%) patients were RR. A contrast was seen in the results of Gene-Xpert and DST; Gene-Xpert detected 3 cases of RR-negative whereas the same 3 cases were found to be RR-positive on DST. Only 1 case was RR-positive on Gene-Xpert but RR-negative on DST. 17 comorbid patients (17.5%) were diagnosed with MDR-TB and 5 (5.2%) with XDR-TB. Whereas, in non-comorbid patients, there were 26 cases of MDR-TB (26.3%) and 5 cases of XDR-TB (5.1%). There were 2 patients (2.1%) resistant to all drugs.Conclusion: There was a deviation in the results of molecular Gene-Xpert assay compared to the conventional culture methods. Drug resistance was relatively higher in non-comorbid patients than comorbid patients, however, the difference between the two is not very significant.

scholarly journals Patterns of Drug Resistance Among Tuberculosis Patients in West and Northwestern Iran

2016 ◽  
Vol 10 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Leyla Sahebi ◽  
Khalil Ansarin ◽  
Parviz Mohajeri ◽  
Majid Khalili ◽  
Amir Monfaredan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Effective Control ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Hiv Negative

Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases. Objective: The goal of this cross-sectional study (2011-2013;2013) was to examine the patterns of TB drug resistance among HIV-negative pulmonary TB patients in regions near the Iranian border. Method: To this end, MTB isolates were harvested from 300 HIV-negative, pulmonary smear-positive TB patients from the northwest and west Iranian border provinces. Isolates were subjected to first and second-line drug susceptibility testing by the 1% proportion method. Demographic and clinical data were provided using a questionnaire and information from patient records. Results were analyzed using SPSS-18. Results: The mean age of the patients was 52.03 years and 54.3% were male. The prevalence of resistance to any TB drug was 13.6% (38 cases). Eleven percent of the new treatment TB group (28 patients) and 40.7% of the retreatment TB group (11 patients) were resistant to all TB drugs. Twelve (4.3%) patients had multidrug-resistant tuberculosis (MDR-TB) (2.38% in the new TB treatment group and 23.1% in the retreatment group). One patient had extensively drug-resistant tuberculosis (XDR-TB). There was a statistically significant relationship between TB drug resistance and smoking (p=0.02) and a history of migration from village to city (p=0.04), also between TB drug resistance and recurrence of TB in patients that had previously received treatment (p<0.001). Conclusion: Knowledge of drug resistance patterns for new and previously treated cases is critical for effective control of MDR-TB in different regions of the country. The burden of MDR-TB in retreatment cases was high. Previous TB treatment was one of the most important mokers and those who had a history of rural to urban migration were at high risk for the occurrence of TB drug resistance.

Performance Assessment of Advansure™ MDR-TB Genoblot Assay Kit for Anti-tuberculosis Drug Susceptibility Test

2012 ◽  
Vol 2 (1) ◽  
pp. 34 ◽  
Author(s):  
Sang Bong Han ◽  
Yongjun Jo ◽  
Jin Kyung Yu ◽  
Yonggoo Kim ◽  
Yeon-Joon Park
Keyword(s):  
Performance Assessment ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Drug Susceptibility Test ◽  
Mdr Tb

scholarly journals Targeted-Sequencing Workflows for Comprehensive Drug Resistance Profiling of Mycobacterium tuberculosis Cultures Using Two Commercial Sequencing Platforms: Comparison of Analytical and Diagnostic Performance, Turnaround Time, and Cost

2020 ◽  
Vol 66 (6) ◽  
pp. 809-820 ◽  
Author(s):  
Ketema Tafess ◽  
Timothy Ting Leung Ng ◽  
Hiu Yin Lao ◽  
Kenneth Siu Sing Leung ◽  
Kingsley King Gee Tam ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Variant Calling ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Targeted Sequencing ◽  
Patient Treatment ◽  
Drug Susceptibility Test ◽  
Bioinformatics Pipeline ◽  
Clinical Sensitivity

Abstract Background The emergence of Mycobacterium tuberculosis with complex drug resistance profiles necessitates a rapid and comprehensive drug susceptibility test for guidance of patient treatment. We developed two targeted-sequencing workflows based on Illumina MiSeq and Nanopore MinION for the prediction of drug resistance in M. tuberculosis toward 12 antibiotics. Methods A total of 163 M. tuberculosis isolates collected from Hong Kong and Ethiopia were subjected to a multiplex PCR for simultaneous amplification of 19 drug resistance-associated genetic regions. The amplicons were then barcoded and sequenced in parallel on MiSeq and MinION in respective batch sizes of 24 and 12 samples. A web-based bioinformatics pipeline, BacterioChek-TB, was developed to translate the raw datasets into clinician-friendly reports. Results Both platforms successfully sequenced all samples with mean read depths of 1,127× and 1,649×, respectively. The variant calling by MiSeq and MinION could achieve 100% agreement if variants with an allele frequency of &lt;40% reported by MinION were excluded. Both workflows achieved a mean clinical sensitivity of 94.8% and clinical specificity of 98.0% when compared with phenotypic drug susceptibility test (pDST). Turnaround times for the MiSeq and MinION workflows were 38 and 15 h, facilitating the delivery of treatment guidance at least 17–18 days earlier than pDST, respectively. The higher cost per sample on the MinION platform ($71.56) versus the MiSeq platform ($67.83) was attributed to differences in batching capabilities. Conclusion Our study demonstrates the interchangeability of MiSeq and MinION platforms for generation of accurate and actionable results for the treatment of tuberculosis.

scholarly journals The study of cross-resistance of MTB to certain anti-tuberculosis drugs among tuberculosis patients in Tomsk Region

2020 ◽  
Vol 97 (12) ◽  
pp. 7-12 ◽  
Author(s):  
P. N. Golubchikov ◽  
E. A. Kruk ◽  
S. P. Mishustin ◽  
V. E. Pavlova ◽  
D. Yu. Schegertsov ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Cross Resistance ◽  
Drug Susceptibility Test ◽  
Tuberculosis Patients ◽  
The Past ◽  
Tomsk Region ◽  
The Cross

The objective of the study: to assess the prevalence of drug resistance of tuberculous mycobacteria (MTB) to pyrazinamide, linezolid, cross-resistance to fluoroquinolones, and cross-resistance to injectable anti-tuberculosis drugs among tuberculosis patients in Tomsk Region.Subjects and methods. The data of 814 patients with tuberculosis were analyzed. Of them, drug susceptibility test to pyrazinamide was performed in 812 patients; ofloxacin, levofloxacin, moxifloxacin – in 475 patients; kanamycin, amikacin, capreomycin – in 301 patients, and linezolid – in 423 patients.Results. The frequency of resistance to pyrazinamide is the highest in patients who were treated with pyrazinamide in the past (relapses and chronic cases). In the patients resistant to ofloxacin, the frequency of susceptibility to levofloxacin is low (16.9%), while susceptibility to moxifloxacin is higher (41.3%). The cross-resistance of MTB to kanamycin and amikacin makes less than 50% in the cases resistant to one of these two drugs. 38.6% of patients with poly-resistance to kanamycin and capreomycin, remain sensitive to amikacin. The level of MTB resistance to linezolid was minimal – 2.8% of those examined.

scholarly journals GENOTYPE AND RESISTANCE PATTERNS OF ANTI TUBERCULOSIS TREATMENT (ATT) IN Mycobacterium tuberculosis ISOLATES FROM TUBERCULOSIS CASES WHICH NOT TAKEN ATT

2016 ◽  
Vol 1 (2) ◽  
pp. 79
Author(s):  
Maria Silvia Merry ◽  
Ning Rintiswati ◽  
Yanri Wijayanti S
Keyword(s):  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Tuberculosis Treatment ◽  
Resistance Pattern ◽  
Drug Susceptibility Test ◽  
Chi Square ◽  
Double Burden ◽  
Cross Sectional ◽  
Resistance Patterns ◽  
Mdr Tb

Background: Tuberculosis (TB) is still a prominent health problem which need to be controlled worldwide. In Indonesia, the incidences of TB cases in 2011 were 450.000 cases with mortality rate 175 person per day. The emergence of mycobacterium’s resistance against Anti Tuberculosis Treatment (ATT) gives a double burden to prevent the disease. This resistance against ATT is caused by several things, one of which is the nature of mycobacterium, mutations and genotype strain variation. Objective: The aim of this study is to get a description of ATT’s resistance pattern, genotype of M. tuberculosis, and determined the correlation between M. tuberculosis’ genotypes and the resistance pattern against ATT. Methods: The research methods were cross-sectional and analytical descriptions. Samples used in this research were clinical isolates, which were taken from patients who hadn’t received ATT therapy before. Patients were recruited from BP4 (Balai Pengobatan Penyakit Paru = Health Center for Lung’s Diseases) at Minggiran and Kotagede area, for the period of June 2010 - December 2010. Drug susceptibility test for ATT were done for Isoniazid, Rifampicin, Streptomycin, and Ethambutol using LJ’s proportion method. Whereas for genotyping, we were using PCR-based Spoligotyping, with Dra and Drb primers. Data processing for genotypes and resistance pattern were in descriptive form, while the analysis of the ATT resistance and genotypes correlation were using chi square. Results: From 33 samples collected and tested for resistancy, 17 samples (51,52%) were sensitive to INH, RIF, STREP, and ETAMB while 16 samples (48,48%) were resistant to one or more ATT. We found 1 isolate (3.03%) was MDR TB. Genotype patterns description are 30% (10 isolates) were Beijing strain and 70% (23 isolates) were Non Beijing with a variety of EAI, LAM, U, Harleem, T, Manu, and Miscellanous. The chi square’s analysis results are p = 0,034 (p < 0,05), ratio prevalence 2,96 (95 CI 0,26 – 0,57). Conclusion: The result from drug susceptibility test for ATT are 48,48%, resistant to one regimen or more ATT, while sensitivity 51,52%. Beijing strains were predominant strain (30%). There were significant correlation between the patterns of resistance against ATT and genotype patterns, Beijing strains tend to be resistant by 2,96 times greater than non-Beijing strains.

scholarly journals Targeted Sequencing Workflows for Comprehensive Drug Resistance Profiling of Mycobacterium tuberculosis cultures using Illumina MiSeq and Nanopore MinION: Comparison of analytical and diagnostic performance, turnaround time and cost

2019 ◽  
Author(s):  
Ketema Tafess ◽  
Timothy Ting Leung Ng ◽  
Hiu Yin Lao ◽  
Kenneth Siu Sing Leung ◽  
Kingsley King Gee Tam ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Illumina Miseq ◽  
Drug Susceptibility ◽  
Susceptibility Test ◽  
Targeted Sequencing ◽  
Diagnostic Strategy ◽  
Drug Susceptibility Test ◽  
Bioinformatics Pipeline ◽  
Complex Drug

AbstractThe emergence of Mycobacterium tuberculosis strains with complex drug resistance profiles necessitates a rapid and extensive drug susceptibility test for comprehensive guidance of patient treatment. Here, we developed two targeted-sequencing workflows based on Illumina MiSeq and Nanopore MinION for the prediction of drug resistance in M. tuberculosis towards 12 anti-tuberculous agents.A total of 163 M. tuberculosis cultured isolates collected from Hong Kong and Ethiopia were subjected to a multiplex PCR for simultaneous amplification of 19 drug-resistance associated genetic regions. The amplicons were then barcoded and sequenced in parallel on MiSeq and MinION in respective batch sizes of 24 and 12 samples. Both platforms successfully sequenced all samples with average depths of coverage of 1,127× and 1,649× respectively. Utilizing a self-developed Web-based bioinformatics pipeline, Bacteriochek-TB, for variant analysis, we found that the MiSeq and MinION result could achieve 100% agreement if variants with an allele frequency of <40% reported by MinION were excluded. For drug resistance prediction, both workflows achieved an average sensitivity of 94.8% and specificity of 98.0% when compared with phenotypic drug susceptibility test. The turnaround times for the MiSeq and MinION workflows were 38 and 15 hours, facilitating the delivery of treatment guidance at least 17-18 days earlier than pDST respectively. The higher cost per sample on the MinION platform (US$71.56) versus the MiSeq platform (US$67.83) was attributed to differences in batching capabilities.Our study demonstrated the interchangeability of MiSeq and MinION sequencing workflows for generation of accurate and actionable results for the treatment of tuberculosis.ImportanceTB therapy involving different combinations of antibiotics have been introduced to address the issue of drug resistance. However, this practice has led to increasing numbers of M. tuberculosis with complex drug resistance profiles. Molecular assays for rapid and comprehensive drug resistance profiling of M. tuberculosis are lacking.Here, we described targeted-sequencing workflows based on Illumina MiSeq and Nanopore MinION for the detection of drug resistance mutations scattered across 19 genetic regions in M. tuberculosis. A bioinformatics pipeline was also developed to translate raw datasets into clinician-friendly reports that provide comprehensive genetic information for the prediction of drug resistance towards 12 antibiotics.This is the first study to evaluate and compare the uses of Illumina and Nanopore platforms for diagnosis of drug-resistant tuberculosis. Remarkably, our diagnostic strategy is compatible with different sequencing platforms that can be applied in diagnostic centres with different levels of throughput and financial support for TB diagnosis.

Antimalarial drug resistance markers in human immunodeficiency virus (HIV)-positive and HIV-negative adults with asymptomatic malaria infections in Port Harcourt, Nigeria

2021 ◽  
Author(s):  
Ifeyinwa Chijioke-Nwauche ◽  
Mary C Oguike ◽  
Chijioke A Nwauche ◽  
Khalid B Beshir ◽  
Colin J Sutherland
Keyword(s):  
Human Immunodeficiency Virus ◽  
Drug Resistance ◽  
Drug Susceptibility ◽  
Blood Film ◽  
University Hospital ◽  
Hiv Positive ◽  
Asymptomatic Malaria ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Hiv Negative

Abstract Background In Nigeria, indiscriminate use of antimalarial drugs may contribute to the threat of drug resistance, but this has not been evaluated among people living with human immunodeficiency virus (HIV). Methods HIV-positive adults attending a university hospital HIV clinic and HIV-negative adult volunteers from the university hospital community with a positive blood film were treated with artemether–lumefantrine. Parasite DNA from before and after treatment was polymerase chain reaction amplified to identify molecular markers of drug susceptibility. Results The pfcrt76T genotype was prevalent among both HIV-positive and HIV-negative participants (78.6% and 68.2%, respectively). Three new mutations in the pfmdr1 gene—F73S, S97L and G165R—and the uncommon pfdhps S436F variant were detected, whereas pfdhps K540E and pfdhfr I164L were absent. The A437G allele of pfdhps predominated (62/66 [94%]). The I431 V mutation was found in 19 of 66 pretreatment pfdhps sequences (28.8%). The pfmdr1 86N allele was significantly more common at day 3 post-treatment than at baseline (odds ratio 8.77 [95% confidence interval 1.21 to 380]). Conclusions We found evidence of continued chloroquine use among HIV-positive individuals. Selection for the pfmdr1 86N after artemether–lumefantrine treatment was observed, indicating a possible threat to antimalarial efficacy in the study area. The complexity of pfdhps haplotypes emphasises the need for careful monitoring of anti-folate susceptibility in Nigeria.

Sign in / Sign up

Export Citation Format

Share Document