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 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 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 Endobronchial valve in complex treatment of patients with drug resistant fibrous cavernous pulmonary tuberculosis

2020 ◽  
Vol 98 (1) ◽  
pp. 35-40
Author(s):  
O. Yu. Askalonova ◽  
E. A. Tseymakh ◽  
A. V. Levin ◽  
P. E. Zimonin
Keyword(s):  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Drug Resistant ◽  
Complex Treatment ◽  
X Ray ◽  
Endobronchial Valve ◽  
Sputum Conversion ◽  
Valve Implantation ◽  
Valve Block

The objective of the study: to assess the efficacy of complex treatment with endobronchial valve implantation in the patients suffering from drug resistant fibrous cavernous pulmonary tuberculosis.Subjects and methods. Treatment outcomes in 97 patients with limited fibrous cavernous pulmonary tuberculosis were analyzed. Main Group included 42 patients who had bronchial valve block implanted. Comparison Group included 55 patients. Artificial pneumoperitoneum was used in both groups.Results. In Main Group, sputum conversion was achieved in 12 months in 40 (95.2%) patients, and in 32 patients (58.2%) in Comparison Group (p < 0.01). In 12 months after treatment start, positive X-ray changes were observed in 42 (100%) patients of Main Group and 40 (72.7%) patients of Comparison Group. Healing of cavities in 12 months was observed only in the patients from Main Group (26 (61.9%) patients). Upon completion of the study, surgery was still indicated to 4 (9.5%) of patients from Main Group and to 35 (63.6%) patients from Comparison Group.

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 Analysis of drug resistant cases of pulmonary tuberculosis with special reference to causes

2020 ◽  
Vol 7 (10) ◽  
pp. 1570
Author(s):  
Surendra Kumar ◽  
Ganesh Patel ◽  
Mukesh Kalera ◽  
J. K. Choudhary
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Negative Attitude ◽  
Alcoholic Cirrhosis ◽  
Control Programme ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
Drug Resistant ◽  
Hepatic Disorder ◽  
Adequate Treatment

Background: Despite advancement of newer diagnostic tools and medicine Drug resistant tuberculosis (DRTB) is a challenge which cannot be eliminated without public participation. This study was designed to know etiology of the drug resistant pulmonary tuberculosis cases.Methods: Prospective observational study was undertaken among adult patients in a tertiary care hospital 50 patients were studied and analyzed, all patients who were drug resistant either mono or poly from Revised national tuberculosis control programme (RNTCP) accredited lab were included in the study. Factors leading to resistance were analyzed.Results: Of the 50 patients included in this study majority were male 72%, 68% rural population, 34% were daily wedge worker and 14% were farmer. 78% patients of study group had income <50,000 per annum or dependent to others, associated comorbidities were alcoholic cirrhosis (18%), diabetes mellitus (16%), pyothorax (16%) and hepatic disorder (12%). Cause of default included side effect 26%, longer duration 34%, feeling well (26%), social stigma (12%), financial problem in (20%), poor supply of anti-tubercular drugs (8%) and negative attitude of drug provider (6%).Conclusions: Poor education lead to less awareness about tuberculosis its diagnosis and adequate treatment, financial crisis leads to early termination in non-Dots. Drug default was most important factor for drug resistance. RNTCP provides free medication by DOTS leading to less default and early diagnosis of DRTB.

scholarly journals Drug resistance pattern of M. tuberculosis in category II treatment failure pulmonary tuberculosis patients

2014 ◽  
Vol 7 (1) ◽  
pp. 9-11
Author(s):  
Fahmida Rahman ◽  
Sadia Sharmin ◽  
Md Mustafa Kamal ◽  
Md Ruhul Amin Miah
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Treatment Failure ◽  
Drug Susceptibility ◽  
High Rate ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Drug Resistance Pattern ◽  
Lowenstein Jensen ◽  
Proportion Method

This study was designed to determine the extent of drug resistance of M. tuberculosis (MTB) isolated from category II treatment failure pulmonary tuberculosis (PTB) patients. A total of 100 Ziehl-Neelsen (Z-N) smear positive category II failure PTB patients were included in this study. Sputum culture was done in Lowenstein-Jensen (L-J) media. Conventional proportion method on Lowenstein-Jensen (L-J) media was used to determine the drug susceptibility of M. tuberculosis to isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KA). Out of 100 sputum  samples, a total of 87 samples were positive by culture. Drug susceptibility test (DST) revealed that 82 (94.25%) isolates were resistant to one or more anti -TB drugs. Resistance to isoniazide (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KA) was 94.25%, 82.75%, 29.90% and 3.45% respectively. Among these isolates, 79.31% and 3.45% isolates were multi-drug resistant (MDR) and extended drug resistant (XDR) M. tuberculosis respectively. High rate of anti-tubercular drug resistance was observed among the category II treatment failure TB patients.DOI: http://dx.doi.org/10.3329/imcj.v7i1.17741 Ibrahim Med. Coll. J. 2013; 7(1): 9-11

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