Determination of Duration of the Intensive Phase of Chemotherapy for Respiratory Tuberculosis in Children without Bacterial Excretion and at No Risk of Multiple and Extensive Drug Resistance

The objective of the study: to develop criteria to evaluate the duration of the intensive phase of chemotherapy for respiratory tuberculosis in children without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria.Subjects and methods. Totally, 93 patients with newly diagnosed respiratory tuberculosis without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria. Their age varied from 2 to 12 years old. Regimen III was used: the intensive phase – 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol – HRZE).Results. The intensive phase lasted for 2 months in 39.8% of cases – the main criteria were achieved (relief of intoxication symptoms, normal blood rates, positive or stable CT changes) after 2 months and there was no indication to extend the duration of it. The intensive phase lasted for 3 months in 37.6% of cases – the main criteria were achieved after 2 months and there was at least one additional indication to extend it (17.2%); and the main criteria were achieved after 3 months and there was no indication to extend the duration of it (20.4%). The intensive phase lasted for more than 3 months (4 to 6 months) in 22.6% of cases – the main criteria were achieved after 3 months and there was at least one additional indication to extend it (12.9%), as well as in the case of failure to achieve the main criteria after 3 months regardless of the presence/absence of additional indications to extend its duration (9.7%).Conclusion. Various combinations of the main criteria and additional indications made the basis for differential approach to determining the duration of the intensive phase of chemotherapy in children with respiratory tuberculosis

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Drugresistance of Mycobacterium tuberculosis from surgical material taken from patients with pulmonary tuberculosis

MedAlliance ◽

10.36422/23076348-2021-9-1-6-10 ◽

2021 ◽

Vol 9 (1) ◽

pp. 6-10

Keyword(s):

Drug Resistance ◽

Mycobacterium Tuberculosis ◽

Molecular Genetic ◽

Study Drug ◽

Newly Diagnosed ◽

Duration Of Treatment ◽

Nutrient Media ◽

Number Of Patients ◽

Extensive Drug Resistance ◽

Resis Tance

At present, with the improvement of epidemic indicators for tuberculosis, the number of patients with drug-resis- tant forms of tuberculosis is increasing, which compli- cates and increases the duration of treatment of suchpatients. The aim of the work is to study drug resistance of mycobacterium tuberculosis (MBT) obtained from sur- gical material. Methods. 74 patients with radical and di- agnostic operations on the chest organs were included into the study. All patients were examined by standard me thods: microscopy, molecular genetic methods, cul- turing on so lid and liquid nutrient media of sputum, and, in case of bronchoscopy, BALF. The diagnosis of tuber- culosis was confirmed morphologically in all patients by histological examination of the surgical material. When analyzing the results of DR MBT, it was found that among the newly diagnosed patients, more than half (59.3%) had multiple (44.6%; p<0.001) and extensive drug resistance (14.7%; p=0.003), while in 74.5% (n=35/47) before the op- eration MBT were not detected in sputum. The frequency of development of drug resistance to anti-tuberculosis drugs of the first and reserve lines, and the structure of drug resis tance depending on the group of dispensary registration are presented. Comparative analysis of MBT LS isolated from sputum before operations and from the operating material was conducted. The results of the study showed a high percentage of MBT drug resistance obtained in the operating material in patients with nega- tive MBT tests. More than half of patients who did not receive antibiotic therapy before surgery have MDR and XDR, which suggests a high regional primary drug resist- ance of Mycobacterium tuberculosis.

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Drug resistance to anti-tuberculotics in children - three years status in Slovakia

Acta Medica Martiniana ◽

10.2478/acm-2013-0018 ◽

2014 ◽

Vol 13 (3) ◽

pp. 18-22 ◽

Cited By ~ 3

Author(s):

I Porvaznik ◽

J Mokry ◽

I Solovic

Keyword(s):

Drug Resistance ◽

Slovak Republic ◽

Hiv Infections ◽

Mycobacterium Tuberculosis Infection ◽

Primary Resistance ◽

Resistant Tuberculosis ◽

Therapeutic Principles ◽

Proportion Method ◽

Tuberculosis In Children

Abstract Drug resistant tuberculosis is a serious and increasing problem worldwide, particularly in countries with a high incidence of tuberculosis and HIV infections. Resistant tuberculosis in children is usually due to the transmission of resistant strains from the environment where they live. Most often it is a transfer from the parents, or other relatives. A paucibacillary nature of the disease in children associated with difficulties in a collection of adequate sputum samples means that the samples are often microscopically negative. If the cultivation is negative, any bacteriological confirmation of the drug resistance is impossible. The aim of this study was to review current diagnostic and therapeutic principles in tuberculosis in children and to demonstrate its incidence in population of the Slovak Republic during 2010-2012. We have retrospectively analyzed all children sputum samples from children with diagnosed tuberculosis in Slovakia. The classical bacteriological analysis (culture on solid eggs-based media) was used to confirm the mycobacterium tuberculosis infection and the proportion method was applied to test its susceptibility or resistance to mostly used antituberculotics. In years 2010-2012, three cases of resistant form of tuberculosis have been diagnosed in Slovakia among 16 children with cultivation positive to tuberculosis. In all of the cases the INH mono-resistance was confirmed (with the same strains present in their relatives), suggesting primary resistance origin of infection. To ensure an appropriate and successful treatment of tuberculosis in children, accurate and timely diagnostics and determination of susceptibility to anti-tuberculotics is essential.

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Are Carbonic Anhydrases Suitable Targets to Fight Protozoan Parasitic Diseases?

Current Medicinal Chemistry ◽

10.2174/0929867325666180326160121 ◽

2019 ◽

Vol 25 (39) ◽

pp. 5266-5278 ◽

Cited By ~ 9

Author(s):

Katia D'Ambrosio ◽

Claudiu T. Supuran ◽

Giuseppina De Simone

Keyword(s):

Drug Resistance ◽

Animal Models ◽

Carbonic Anhydrase ◽

Drug Target ◽

Treatment Options ◽

Parasitic Diseases ◽

Carbonic Anhydrases ◽

Extensive Drug Resistance ◽

Protozoan Infections

Protozoans belonging to Plasmodium, Leishmania and Trypanosoma genera provoke widespread parasitic diseases with few treatment options and many of the clinically used drugs experiencing an extensive drug resistance phenomenon. In the last several years, the metalloenzyme Carbonic Anhydrase (CA, EC 4.2.1.1) was cloned and characterized in the genome of these protozoa, with the aim to search for a new drug target for fighting malaria, leishmaniasis and Chagas disease. P. falciparum encodes for a CA (PfCA) belonging to a novel genetic family, the η-CA class, L. donovani chagasi for a β-CA (LdcCA), whereas T. cruzi genome contains an α-CA (TcCA). These three enzymes were characterized in detail and a number of in vitro potent and selective inhibitors belonging to the sulfonamide, thiol, dithiocarbamate and hydroxamate classes were discovered. Some of these inhibitors were also effective in cell cultures and animal models of protozoan infections, making them of considerable interest for the development of new antiprotozoan drugs with a novel mechanism of action.

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The Frequency of HIV-1 Infection in Iranian Children and Determination of the Transmitted Drug Resistance in Treatment-Naïve Children

Current HIV Research ◽

10.2174/1570162x17666191106111211 ◽

2020 ◽

Vol 17 (6) ◽

pp. 397-407

Author(s):

Maryam Jarchi ◽

Farah Bokharaei-Salim ◽

Maryam Esghaei ◽

Seyed Jalal Kiani ◽

Fatemeh Jahanbakhsh ◽

...

Keyword(s):

Drug Resistance ◽

Pediatric Patients ◽

Phylogenetic Analyses ◽

Rna Extraction ◽

Transmitted Drug Resistance ◽

The Arts ◽

Treatment Naïve ◽

Iranian Children ◽

Hiv 1

Background: The advent of resistance-associated mutations in HIV-1 is a barrier to the success of the ARTs. Objective: In this study, the abundance of HIV-1 infection in Iranian children, and also detection of the TDR in naïve HIV-1 infected pediatric (under 12 years old) were evaluated. Materials: From June 2014 to January 2019, a total of 544 consecutive treatment-naïve HIV-1- infected individuals enrolled in this study. After RNA extraction, amplification, and sequencing of the HIV-1 pol gene, the DRM and phylogenetic analysis were successfully performed on the plasma specimens of the ART-naïve HIV-1-infected-children under 12 years old. The DRMs were recognized using the Stanford HIV Drug Resistance Database. Results: Out of the 544 evaluated treatment-naïve HIV-1-infected individuals, 15 (2.8%) cases were children under 12 years old. The phylogenetic analyses of the amplified region of pol gene indicated that all of the 15 HIV-1-infected pediatric patients were infected by CRF35_AD, and a total of 13.3% (2/15) of these children were infected with HIV-1 variants with SDRMs (one child harbored two related SDRMs [D67N, V179F], and another child had three related SDRMs [M184V, T215F, and K103N]), according to the last algorithm of the WHO. No PIs-related SDRMs were observed in HIV-1-infected children. Conclusion: The current study demonstrated that a total of 13.3% of treatment-naïve HIV-1-infected Iranian pediatrics (under 12 years old) were infected with HIV-1 variants with SDRMs. Therefore, it seems that screening to recognize resistance-associated mutations before the initiation of ARTs among Iranian children is essential for favorable medication efficacy and dependable prognosis.

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THE TRENDS OF TUBERCULOSIS IN CHILDREN AGED 1- 12 YEARS AND ITS MANAGEMENT FROM 2011 TO 2015 AT ARTHUR DAVISON CHILDRENS HOSPITAL IN NDOLA: Retrospective study (Preprint)

10.2196/preprints.16897 ◽

2019 ◽

Author(s):

Martin Greta

Keyword(s):

The Body ◽

Smear Microscopy ◽

Newly Diagnosed ◽

X Ray ◽

Children's Hospital ◽

Co Morbidity ◽

Children’S Hospital ◽

Childhood Tb ◽

Tuberculosis In Children ◽

Age Range

BACKGROUND Tuberculosis is a widespread and in many cases a fatal, infectious disease caused by many strains of mycobacterium complex usually mycobacterium tuberculosis. It can affect any part of the body but mainly the lungs hence called pulmonary tuberculosis. Tuberculosis in children has been less of a public health priority in the recent years despite the fact that TB has been a major cause of childhood morbidity and mortality worldwide with difficulties in diagnosis. Data on trends of childhood TB is rarely in published literature hence need for this research which will help in publishing OBJECTIVE To establish the trends in TB among children aged 1-12 years and its management over a period of five years from 2011- 2015 at Arthur Davison children’s hospital in Ndola and also to determine the proportion of TB in these children and to establish the age group most affected by TB over the period of five years and lastly to assess the proportion of TB and HIV as a co-morbidity METHODS The study reviewed all records that were registered in the MOH TB register at ADH from 2011 to 2015 coming up with a total number of 483 TB records and these records had satisfied the inclusion and exclusion criteria. The data capturing tool was used to collect the data. RESULTS : This study determined the trends of TB in children aged 1 to 12 over the five years period from a total of 483 reviewed paediatric TB cases , its proportion in these children, the age range most affected by TB and lastly assessed TB and HIV as a co-morbidity at Arthur Davison Children’s hospital. It revealed that the trends were decreasing and that out of 483 TB patient, the majority 157(32.5%) of the TB patients were seen in the year 2011, followed by 129(26.7%), 84(17.4%), 57(11.8%) and 56(11.6%) representing the year 2012, 2013, 2014 and 2015 respectively. Findings on the age range most affected are that the majority 282(58.4%) of the TB patients were aged (5-12) years old while 201(41.6%) were aged between (1-5) years old. Therefore, the age range most affected by TB was between (5-12) years. The TB proportion results showed that Out of 483, the majority 467(96.7%) of the TB patient type were newly diagnosed, followed by 13(2.7%), 2(.4%) and the rest 1(.2%) that were Relapse, Trans-in and Treatment resumed respectively. And that many 467(96.7%) of TB condition types were PTB while 16(3.3%) were EPTB. Furthermore, the majority of 463(95.9%) were diagnosed by X-ray while 20(4.1%) were diagnosed by smear microscopy. And lastly In terms of HIV as a co-morbidity, the majority 175(36.2%) of the TB patients were HIV positive, followed by 173(35.8%) that were HIV negative while the rest 135(28%) of the TB patients were not tested for HIV CONCLUSIONS This study reports that the trends of TB in children aged 1-12 years have been decreasing from 2015 to 2011 .And the age range most affected was found to have been 5-12 years and the proportion of TB cases were mostly newly diagnosed and the diagnosis was made by use x-ray and lastly the large proportion of TB patients had tested positive for HIV as a co-morbidity. Therefore efforts should be made to sustain this decreasing trend of childhood TB.

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Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018

BMC Infectious Diseases ◽

10.1186/s12879-021-06312-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhen Wang ◽

Bin Zhao ◽

Minghui An ◽

Wei Song ◽

Xue Dong ◽

...

Keyword(s):

Drug Resistance ◽

Hiv Infection ◽

Northeast China ◽

Transmitted Drug Resistance ◽

Newly Diagnosed ◽

Resistance Mutations ◽

Shenyang City ◽

Subtype B ◽

Recent Hiv Infection ◽

Hiv 1

Abstract Background To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China. Methods Demographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay. Results A total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%). Conclusions The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.

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