scholarly journals MANAGEMENT OF PREGNANCY, DELIVERY AND POST-NATAL PERIOD IN THE PATIENT WITH DRUG RESISTANT DESTRUCTIVE PULMONARY TUBERCULOSIS AFTER SEVERAL SURGERIES

2018 ◽  
Vol 96 (6) ◽  
pp. 58-63
Author(s):  
S. I. Kayukova ◽  
O. G. Komissarova ◽  
N. L. Karpina ◽  
V. V. Romanov ◽  
E. V. Uvarova ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Female Patient ◽  
Clinical Case ◽  
Drug Resistant ◽  
Successful Management ◽  
The Past ◽  
Advanced Form ◽  
Extensive Drug Resistance

The article describes a clinical case of the successful management of pregnancy, delivery and post-natal period in the female patient with fibrous cavernous tuberculosis with extensive drug resistance and multiple thoracic surgeries in the past. This clinical case demonstrates that it is possible for a mother with the advanced form of tuberculosis to give birth to a healthy mature newborn.

scholarly journals A Clinical Case of Extensive Drug Resistant Pulmonary Tuberculosis Using an Endobronchial Valve. Analysis of Errors in the Choice of Chemotherapy Regimen

2021 ◽  
Vol 99 (11) ◽  
pp. 66-71
Author(s):  
I. A. Burmistrovа ◽  
E. V. Ezhovа ◽  
Kh. B. Dаdаshevа ◽  
E. V. Vаniev ◽  
O. V. Lovаchevа ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Clinical Case ◽  
Chemotherapy Regimen ◽  
Total Duration ◽  
Drug Resistant ◽  
Adequate Treatment ◽  
Late Initiation ◽  
Extensive Drug Resistance ◽  
Endobronchial Valve

The article describes a clinical case of a female patient with respiratory tuberculosis exposed to several cases of extensive drug resistance in their family. Tuberculosis progressed in this patient due to the late initiation of adequate treatment. Therefore, the total duration of chemotherapy made 5 years till cure was achieved and an endobronchial valve was used to heal persisting (for 3 years) lung destruction.

scholarly journals A clinical case of successful combined treatment of a patient with fibrous cavernous pulmonary tuberculosis and extensive drug resistance

2020 ◽  
Vol 98 (6) ◽  
pp. 52-59
Author(s):  
P. N. Golubchikov ◽  
D. Yu. Schegertsov ◽  
T. I. Melnikovа ◽  
D. V. Krаsnov ◽  
D. A. Skvortsov ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Successful Treatment ◽  
Clinical Case ◽  
Chemotherapy Regimen ◽  
Combined Treatment ◽  
Extensive Drug Resistance

The article describes a clinical case of successful treatment of a patient with disseminated bilateral fibrous cavernous tuberculosis and extensive drug resistance, with preserved sensitivity to only one anti-tuberculosis drug; the fifth chemotherapy regimen and pleuropneumonectomy were used.

scholarly journals Risk factors for drug-resistant tuberculosis, the association between comorbidity status and drug-resistant patterns: a retrospective study of previously treated pulmonary tuberculosis in Shandong, China, during 2004–2019

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044349
Author(s):  
Ning-ning Tao ◽  
Yi-fan Li ◽  
Wan-mei Song ◽  
Jin-yue Liu ◽  
Qian-yun Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Resistance ◽  
Retrospective Study ◽  
Pulmonary Tuberculosis ◽  
Logistic Models ◽  
Smoking History ◽  
Categorical Variables ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

ObjectiveThis study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).DesignA retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.ResultsA total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).ConclusionSmoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.

scholarly journals Biological microchips for detection of multiple drug resistant M. tuberculosis strains isolated in Kyrgyz Republic

2008 ◽  
pp. 64-66
Author(s):  
J. T. Isakova ◽  
Z. K. Goncharova ◽  
A. A. Aldashev
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Gene Mutations ◽  
Rpob Gene ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Kyrgyz Republic ◽  
Newly Diagnosed ◽  
Single Drug ◽  
Multiple Drug Resistant

The aim of the study was to estimate spread of primary and secondary multiple drug resistant Mycobacterium tuberculosis (MBT) and to characterize rpoB, katG, inhA, and ahpC gene mutations of rifampicin (RIF) and isoniazid (INH) resistant MBT strains isolated from tuberculosis patients in Kyrgyz. We obtained 493 specimens from patients with pulmonary tuberculosis which were diagnosed based on clinical, X-ray, and bacteriological examination. Among them, newly diagnosed pulmonary tuberculosis was in 445 patients (90.2 %), and 48 of the patients (9.8 %) have already been treated for tuberculosis. Mutations of rpoB, KatG, inhA, and ahpC genes associated with RIF and INH resistance were detected by biological chip test. Sensitive MBT strains were detected in 47 % and resistant strains were in 53 % of the newly diagnosed patients. Single-drug resistance to RIF only was detected in 3 % of cases; resistance to INH was found in 20 %, resistance to both the drugs was detected in 30 % of the patients. In pre-treated patients single-drug resistance to RIF was defined in 4 % of cases, resistance to INH was in 8 %, resistance to both the drugs was estimated in 75 % of the patients. Therefore, we suppose that there is a high prevalence of multi-drug resistant MBT in Kyrgyz Republic: 30 % among newly diagnosed patients and 75 % among pre-treated patients. The main cause of RIF-resistance of MBT is Ser531→Leu mutation of rpoB gene, and the main cause of INHresistance is Ser315→Thr mutation of katG gene.

scholarly journals Antimicrobial drug resistance and infection prevention/control: lessons from tuberculosis

2021 ◽  
Author(s):  
J. Peter Cegielski ◽  
Carrie Tudor ◽  
Grigory V. Volchenkov ◽  
Paul A. Jensen
Keyword(s):  
Public Health ◽  
Drug Resistance ◽  
Infection Prevention ◽  
Antimicrobial Drug ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Antimicrobial Drug Resistance ◽  
The Past ◽  
Resistant Tuberculosis

Antimicrobial drug resistance (AMR) is increasing rapidly worldwide, causing an estimated 700,000 deaths annually over the past decade, en route to becoming the leading global threat to public health by 2050 with an estimated 10 million deaths per year (more than heart disease, cancer, and stroke), while reducing global wealth by US$100 trillion. Yet AMR has not received the attention and action required to change this trajectory. Appropriate infection prevention and control (IPC) measures are needed to prevent transmission of infections to healthcare workers (HCWs), other patients, families, and the general public. In this review, we discuss a notable case study of AMR: highly drug-resistant tuberculosis (TB) has emerged repeatedly over the past 70 years as new drugs have been introduced, leading to new diagnostics, therapeutics, funding, public health strategies, and, in high-income countries, effective IPC measures that curtailed transmission. We review current efforts to control and prevent AMR using the example of drug-resistant tuberculosis to highlight important themes including laboratory systems, surveillance, control and prevention of healthcare-associated infections (especially among HCWs), better coordination across disciplines and diseases, and powerful advocacy/social change initiatives grounded in social and behavioral sciences. These strategies are the foundation of an effective response to the AMR threat to public health.

scholarly journals Ulcerative Necrobiosis Lipoidica: Is There a Place for Anti-TNFα Treatment?

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Rita Guedes ◽  
Inês Leite ◽  
Armando Baptista ◽  
Natividade Rocha
Keyword(s):  
Adverse Events ◽  
Female Patient ◽  
Inflammatory Disease ◽  
Alternative Treatment ◽  
Clinical Case ◽  
Necrobiosis Lipoidica ◽  
The Past ◽  
Systemic Treatments ◽  
Efficient Alternative

Necrobiosis lipoidica is a rare granulomatous and inflammatory disease. Its management is particularly difficult when ulceration is present. The authors describe the clinical case of a 65-year-old female patient with necrobiosis lipoidica, who had been submitted in the past to several topical and systemic treatments with little or no improvement. She started treatment with subcutaneous etanercept and showed significant improvement without adverse events until today. The aim of this article is to report a valid and efficient alternative treatment to recalcitrant cases.

scholarly journals Beta-lactam antibiotics as reserve medications for the treatment of drug-resistant tuberculosis

2021 ◽  
Vol 66 (5-6) ◽  
pp. 78-85
Author(s):  
G. N. Mozhokina ◽  
A. G. Samoilova ◽  
I. A. Vasilyeva
Keyword(s):  
Drug Resistance ◽  
Review Article ◽  
Drug Resistant ◽  
Beta Lactam ◽  
Drug Resistant Tuberculosis ◽  
Beta Lactam Antibiotics ◽  
Resistant Tuberculosis ◽  
Extensive Drug Resistance ◽  
Tuberculosis Activity

The review article presents an analysis of literature data on the necessity to expand the range of medications possessing anti-tuberculosis activity for the treatment of the most severe forms of drug-resistant tuberculosis through the use of beta-lactam antibiotics in chemotherapy regimens. The mechanism of action of beta- lactam antibiotics on mycobacterium tuberculosis is shown, and the results of in vitro studies to assess their anti-tuberculosis activity are presented. Clinical studies on the use of carbapenems prove the feasibility of their use for the treatment of patients with tuberculosis with multiple and extensive drug resistance of the pathogen.

scholarly journals DRUG-RESISTANT EPILEPSY IN CASE OF CRANIOCEREBRAL DISPROPORTION. A PILOT STUDY

2021 ◽  
Vol 83 (3) ◽  
pp. 19-23
Author(s):  
Oleg Biketov
Keyword(s):  
Drug Resistance ◽  
Drug Therapy ◽  
Pilot Study ◽  
Antiepileptic Drugs ◽  
Pathological Process ◽  
Research Trends ◽  
Drug Resistant ◽  
The Past ◽  
Craniocerebral Disproportion ◽  
Drug Resistant Epilepsy

The problem of ineff ective drug therapy of epilepsy continues to be relevant during many decades and determines many key research trends in clinical and fundamental epileptology. Despite the emergence of a large number of various antiepileptic drugs the eff ectiveness of drug therapy for epilepsy has remained almost unchanged over the past decades. In this article drug-resistance in epilepsy is considered as a consequence of a concomitant pathological process in the form of craniocerebral disproportion.

scholarly journals The Combination of Sulfamethoxazole, Trimethoprim, and Isoniazid or Rifampin Is Bactericidal and Prevents the Emergence of Drug Resistance in Mycobacterium tuberculosis

2012 ◽  
Vol 56 (10) ◽  
pp. 5142-5148 ◽  
Author(s):  
Catherine Vilchèze ◽  
William R. Jacobs
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Multidrug Resistant ◽  
New Drugs ◽  
Drug Resistant ◽  
Content Type ◽  
The Past ◽  
Tb Treatment

ABSTRACTThe challenges of developing new drugs to treat tuberculosis (TB) are indicated by the relatively small number of candidates entering clinical trials in the past decade. To overcome these issues, we reexamined two FDA-approved antibacterial drugs, sulfamethoxazole (SMX) and trimethoprim (TMP), for use in TB treatment. SMX and TMP inhibit folic acid biosynthesis and are used in combination to treat infections of the respiratory, urinary, and gastrointestinal tracts. The MICs of SMX and TMP, alone and in combination, were determined for drug-susceptible, multidrug-resistant (MDR), and extensively drug-resistantMycobacterium tuberculosisstrains. While TMP alone was not effective againstM. tuberculosis, the combination of TMP and SMX was bacteriostatic againstM. tuberculosis. Surprisingly, the combination of SMX and TMP was also active against a subset of MDRM. tuberculosisstrains. Treatment ofM. tuberculosiswith TMP-SMX and a first-line anti-TB drug, either isoniazid or rifampin, was bactericidal, demonstrating that the combination of TMP and SMX with isoniazid or rifampin was not antagonistic. Moreover, the addition of SMX-TMP in combination with either isoniazid or rifampin also prevented the emergence of drug resistancein vitro. In conclusion, this study further illustrates the opportunity to reevaluate the activity of TMP-SMXin vivoto prevent the emergence of drug-resistantM. tuberculosis.

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