scholarly journals Treatment of multiple drug resistant pulmonary tuberculosis in a diabetic patient with renal allograft

2021 ◽  
Vol 99 (2) ◽  
pp. 52-57
Author(s):  
E. V. Korzh ◽  
N. A. Podchos ◽  
T. V. Ivanitskaya
Keyword(s):  
Pulmonary Tuberculosis ◽  
Glomerular Filtration ◽  
Chronic Renal Disease ◽  
Left Lung ◽  
Immunosuppressive Drugs ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Multiple Drug Resistant ◽  
Sputum Conversion ◽  
End Stage

The article describes a clinical case of treatment of multiple drug resistant tuberculosis in the patient with type 1 diabetes mellitus who had received a kidney transplant (from his mother) 3 years before tuberculosis was diagnosed due to diabetic nephroangiosclerosis and the development of end-stage chronic renal disease. Pulmonary tuberculosis developed while taking immunosuppressive drugs, it manifested by an infiltrate with destruction of lung tissue in the upper lobe of the left lung, infiltrative tuberculosis of the left upper lobe and segmental bronchi, bacterial excretion confirmed by microscopy and culture. The strain of tuberculosis was resistant to 5 drugs including isoniazid and rifampicin. The chemotherapy regimen included pyrazinamide, capreomycin, levofloxacin, ethionamide, cycloserine, and paraaminosalicylic acid. Glomerular filtration rate was monitored every month. The full course of anti-tuberculosis chemotherapy (556 doses) was effectively completed, glomerular filtration by that time was 77.0 ml/min. Stable sputum conversion was achieved (confirmed by sputum culture), the cavity was healed, and some areas of pneumosclerosis and single solid foci persisted.

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 Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

2019 ◽  
Author(s):  
Xi-Ling Huang ◽  
Aliaksandr Skrahin ◽  
Pu-Xuan Lu ◽  
Sofia Alexandru ◽  
Valeriu Crudu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Testing ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Pulmonary Tb ◽  
Injectable Drugs ◽  
Resistant Tuberculosis ◽  
Multiple Drug Resistant ◽  
Previously Treated Patients

AbstractMultidrug-resistant tuberculosis (mdrtb) refers to TB infection resistant to at least two most powerful anti-TB drugs, isoniazid and rifampincin. It has been estimated that globally 3.5% (which can be much higher in some regions) of newly diagnosed TB patients, and 20.5% of previously treated patients had mdrtb. Extensively drug-resistant TB (xdrtb) has resistance to rifampin and isoniazid, as well as to any member of the quinolone family and at least one of the second line injectable drugs: kanamycin, amikacin and capreomycin. xdrtb accounts for 4-20% of mdrtb. Early detection and targeted treatment are priorities for mdrtb/xdrtb control. The suspicion of mdr/xdr -pulmonary TB (mdrptb or xdrptb) by chest imaging shall suggest intensive diagnostic testing for mdrptb/xdrptb. We hypothesize that multiple nodular consolidation (NC) may serve one of the differentiators for separating dsptb vs mdrptb/xdrptb cases. For this study, mdrptb cases (n=310) and XDR-PTB cases (⋂=I58) were from the NIAID TB Portals Program (TBPP) <https://tbportals.niaid.nih.gov>. Drug sensitive pulmonary TB (dsptb) cases were from the TBPP collection (n=112) as well as the Shenzhen Center for Chronic Disease Control (n=111), Shenzhen, China, and we excluded patients with HIV(+) status. Our study shows NC, particularly multiple NCs, is more common in mdrptb than in dsptb, and more common in xdrptb than in mdrptb. For example, 2.24% of dsptb patients, 13.23% of mdrptb patients, and 20.89% of xdrptb patients, respectively, have NCs with diameter >= 10mm equal or more than 2 in number.

Multi-Drug-Resistant Pulmonary Tuberculosis

1979 ◽  
Vol 13 (7-8) ◽  
pp. 430-436
Author(s):  
Brock G. Guernsey ◽  
Michael R. Alexander
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Self Medication ◽  
Primary Resistance ◽  
Appropriate Treatment ◽  
Short Course ◽  
Multiple Drug Resistant ◽  
Drug Regimens ◽  
Sensitivity Studies

A case of multiple-drug-resistant pulmonary tuberculosis (TB) is presented. The patient's refusal to complete a course of drug therapy culminated in numerous relapses, treatment failures, and finally, death. Noncompliant drug behavior is probably the major cause of treatment failure. Supervised intermittent and short-course regimens can be utilized when patients demonstrate poor cooperation in self-medication programs. Resistance to first-line agents complicates retreatment of TB. Drug selection in these cases should be based on the results of sensitivity studies, and effective regimens frequently require the use of more toxic secondary agents. Although published guidelines for appropriate treatment of TB are available, inappropriate therapy continues to occur. Resistant organisms can be transmissible and virulent, and patients infected with them may serve as infector pools that produce new cases of primary resistance. The control of resistant TB depends on our ability to identify these individuals and to insure that they comply with effective drug regimens.

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