The Neglected Contribution of Streptomycin to the Tuberculosis Drug Resistance Problem

The airborne pathogen Mycobacterium tuberculosis is responsible for a present major public health problem worsened by the emergence of drug resistance. M. tuberculosis has acquired and developed streptomycin (STR) resistance mechanisms that have been maintained and transmitted in the population over the last decades. Indeed, STR resistant mutations are frequently identified across the main M. tuberculosis lineages that cause tuberculosis outbreaks worldwide. The spread of STR resistance is likely related to the low impact of the most frequent underlying mutations on the fitness of the bacteria. The withdrawal of STR from the first-line treatment of tuberculosis potentially lowered the importance of studying STR resistance. However, the prevalence of STR resistance remains very high, could be underestimated by current genotypic methods, and was found in outbreaks of multi-drug (MDR) and extensively drug (XDR) strains in different geographic regions. Therefore, the contribution of STR resistance to the problem of tuberculosis drug resistance should not be neglected. Here, we review the impact of STR resistance and detail well-known and novel candidate STR resistance mechanisms, genes, and mutations. In addition, we aim to provide insights into the possible role of STR resistance in the development of multi-drug resistant tuberculosis.

Download Full-text

First line anti-tubercular drug resistance among patients visiting German Nepal Tuberculosis Project, Nepal

International Journal of Infection and Microbiology ◽

10.3126/ijim.v2i2.8321 ◽

2013 ◽

Vol 2 (2) ◽

pp. 45-48

Author(s):

S Regmi ◽

B Shrestha ◽

A Katuwal

Keyword(s):

Drug Resistance ◽

Public Health Problem ◽

Drug Susceptibility ◽

Multidrug Resistant ◽

Sputum Smear ◽

Major Public Health Problem ◽

Drug Resistant ◽

First Line ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis

INTRODUCTION: Tuberculosis is one of the commonest causes of death in the world. It remains a major public health problem in developing countries including Nepal. Despite the reduction in incidence of tuberculosis by the implementation of anti-tuberculosis drugs regimen, TB remains pandemic due to emergence of drug resistant strain of M. tuberculosis. The aim of this study was to evaluate the first line anti-tubercular drug resistance among patients visiting German Nepal Tuberculosis Project, Nepal. MATERIALS AND METHODS: Anti-tubercular drug susceptibility test for first line drugs (Rifampicin, Isonizid, Ethambutol, and Streptomycin) was performed by proportion method (n=141) for new sputum smear positive patients attending German Nepal Tuberculosis Project, Kathmandu, Nepal. RESULTS: 78.1% (n=110.) were sensitive to all 4 drugs. Eight isolates (5.6%), 4(2.8%), 10(7.1%) and 31(21.9%) were resistant to any 4, 3, 2 and 1 drug respectively. Proportion of drug resistant (PDR) to one drug was 12.6%, two drugs 7.6%, three drugs (6.3%) and four drugs was 5.6%. Our result indicates the PDR to the first line drug was 21.9% and multidrug resistant (MDR) was 12 (8.5%). CONCLUSIONS: Drugs resistant cases of tuberculosis in increasing. Surveillance and monitoring of the drug resistant tuberculosis is necessary to prevent emergence of MDR, extensively drug resistant and so-called totally drug resistant tuberculosis. DOI: http://dx.doi.org/10.3126/ijim.v2i2.8321 Int J Infect Microbiol 2013;2(2):45-48

Download Full-text

Assessing the Impact of Drug Resistance on the Transmission Dynamics of Typhoid Fever

Computational Biology Journal ◽

10.1155/2013/303645 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 2

Author(s):

S. Mushayabasa ◽

C. P. Bhunu ◽

E. T. Ngarakana-Gwasira

Keyword(s):

Public Health ◽

Mathematical Model ◽

Drug Resistance ◽

Typhoid Fever ◽

Public Health Problem ◽

Transmission Dynamics ◽

Reproductive Number ◽

Major Public Health Problem ◽

Drug Resistant ◽

The Impact

Typhoid fever continues to be a major public health problem in the developing world. Antibiotic therapy has been the main stay of treating typhoid fever for decades. The emergence of drug-resistant typhoid strain in the last two decades has been a major problem in tackling this scourge. A mathematical model for investigating the impact of drug resistance on the transmission dynamics of typhoid fever is developed. The reproductive number for the model has been computed. Numerical results in this study suggest that when a typhoid outbreak occurs with more drug-sensitive cases than drug-resistant cases, then it may take 10–15 months for symptomatic drug-resistant cases to outnumber all typhoid cases, and it may take an average of 15–20 months for nonsymptomatic drug-resistant cases to outnumber all drug-sensitive cases.

Download Full-text

Molecular Mechanisms of Drug Resistance in Mycobacterium tuberculosis: Role of Nanoparticles Against Multi-drug-Resistant Tuberculosis (MDR-TB)

NanoBioMedicine ◽

10.1007/978-981-32-9898-9_12 ◽

2020 ◽

pp. 285-314

Author(s):

Amit Singh ◽

Anil Kumar Gupta ◽

Sarman Singh

Keyword(s):

Drug Resistance ◽

Mycobacterium Tuberculosis ◽

Molecular Mechanisms ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

Download Full-text

Drug-sensitivity profile of clinical Mycobacterium tuberculosis isolates – a retrospective study from a chest-disease institute in India

Journal of Medical Microbiology ◽

10.1099/jmm.0.45635-0 ◽

2005 ◽

Vol 54 (3) ◽

pp. 269-271 ◽

Cited By ~ 5

Author(s):

T Dam ◽

M Isa ◽

M Bose

Keyword(s):

Retrospective Study ◽

Drug Sensitivity ◽

Public Health Problem ◽

Major Public Health Problem ◽

Sensitivity Testing ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Chest Disease ◽

Mdr Tb ◽

Proportion Method

Multi-drug-resistant tuberculosis (MDR-TB) is a major public-health problem, because treatment is complicated and patients remain infectious for months or years, despite receiving the best available therapy. To gain better understanding of MDR-TB, a retrospective study was initiated to determine the level of drug resistance among patients in a chest-disease institute in India. Two hundred and sixty-three isolates from treatment-failure pulmonary tuberculosis patients (20–70 years) were studied. Drug-sensitivity testing was performed by the modified-proportion method. First- and second-line drugs, along with two quinolone drugs (ofloxacin and ciprofloxacin), were tested. Patients included in this study did not improve with therapy; however, 151 isolates (57.5 %) were susceptible to all four first-line antituberculosis drugs. This study reports low resistance to fluoroquinolones among the strains present in these patients.

Download Full-text

Pattern of Anti-Tuberculosis Drug Resistance in HIV-Associated Tuberculous Meningitis Patients

Myanmar Health Sciences Research Journal ◽

10.34299/mhsrj.00922 ◽

2019 ◽

Vol 31 (1) ◽

pp. 52-58

Keyword(s):

Drug Resistance ◽

Tuberculous Meningitis ◽

Susceptibility Testing ◽

Public Health Problem ◽

Drug Susceptibility ◽

Drug Susceptibility Testing ◽

Major Public Health Problem ◽

First Line ◽

Cross Sectional ◽

Cd4 Cell Count

Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem worldwide. Human immunodeficiency virus (HIV) infection-associated tuberculous meningitis (TBM) further complicates the patient management and causes poor prognosis. A cross-sectional study was carried out to determine anti-TB drug susceptibility pattern of Mycobacterium tuberculosis (MTB) isolates from HIV-associated TBM patients at Waibagi, Thakayta and Mingaladon Specialist Hospitals in Yangon, Myanmar. From January to October 2017, cerebrospinal fluid (CSF) specimens collected from 140 HIV infected patients with clinically presumptive TBM were applied for isolation and drug susceptibility testing. First-line drug susceptibility testing were carried out by solid culture-based proportion method. Drug susceptibility patterns of pyrazinamide, fluoroquinolones and second-line injectable drugs were determined by liquid culture-based Mycobacterial Growth Indicator Tube method. There were 17 culture positives and confirmed as MTB out of 140 specimens. Among them,10 isolates (58.8%) were resistant to at least one of the first-line anti-TB drugs. Eight isolates (47.1%) showed multidrug resistance but there was no extensively drug resistance. HIV-associated TBM patients with previous anti-TB treatment history and CD4 cell count of less than 100 cells/μl were significantly more prone to develop drug resistance. These findings highlight burdens of anti-TB drug resistance among HIVassociated TBM patients and support the need of elaborative management strategies.

Download Full-text

Crucial role of physiotherapy in treating COVID-19 patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3300 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 967-971

Author(s):

Poonam Thakre ◽

Waqar M. Naqvi ◽

Trupti Deshmukh ◽

Nikhil Ingole ◽

Sourabh Deshmukh

Keyword(s):

Public Health ◽

Distress Syndrome ◽

Public Health Problem ◽

Public Health Emergency ◽

High Rate ◽

Major Public Health Problem ◽

Front Line ◽

The Many ◽

Sixth International

The emergence in China of 2019 of severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) previously provisionally names 2019-nCoV disease (COVID19) caused major global outbreak and is a major public health problem. On 30 January 2020, the WHO declared COVID19 to be the sixth international public health emergency. This present pandemic has engrossed the globe with a high rate of mortality. As a front line practitioner, physiotherapists are expected to be getting in direct contact with patients infected with the virus. That’s why it is necessary for understanding the many aspects of their role in the identification, contains, reduces and treats the symptoms of this disease. The main presentation is the involvement of respiratory system with symptoms like fever, cough, sore throat, sneezing and characteristics of pneumonia leads to ARDS(Acute respiratory distress syndrome) also land up in multiorgan dysfunction syndrome. This text describes and suggests physiotherapy management of acute COVID-19 patients. It also includes recommendations and guidelines for physiotherapy planning and management. It also covers the guidelines regarding personal care and equipment used for treatment which can be used in the treatment of acute adult patients with suspected or confirmed COVID-19.

Download Full-text

Spatio-temporal dynamics of schistosomiasis in Rwanda between 2001 and 2012: impact of the national Neglected Tropical Disease control programme

Geospatial health ◽

10.4081/gh.2017.514 ◽

2017 ◽

Vol 12 (1) ◽

Author(s):

Elias Nyandwi ◽

Tom Veldkamp ◽

Frank Badu Osei ◽

Sherif Amer

Keyword(s):

Temporal Dynamics ◽

Public Health Problem ◽

Incidence Rates ◽

Control Programme ◽

Scan Statistics ◽

Major Public Health Problem ◽

Implementation Phase ◽

Incidence Data ◽

Spatio Temporal ◽

The Impact

Schistosomiasis is recognised as a major public health problem in Rwanda. We aimed to identify the spatio-temporal dynamics of its distribution at a fine-scale spatial resolution and to explore the impact of control programme interventions. Incidence data of Schistosoma mansoni infection at 367 health facilities were obtained for the period 2001-2012. Disease cluster analyses were conducted using spatial scan statistics and geographic information systems. The impact of control interventions was assessed for three distinct sub-periods. Findings demonstrated persisting, emerging and re-emerging clusters of schistosomiasis infection across space and time. The control programme initially caused an abrupt increase in incidence rates during its implementation phase. However, this was followed by declining and disappearing clusters when the programme was fully in place. The findings presented should contribute to a better understanding of the dynamics of schistosomiasis distribution to be used when implementing future control activities, including prevention and elimination efforts.

Download Full-text

A review of the evidence to explain pharmacological basis of injection (ab)use of buprenorphine–naloxone tablets

Journal of Opioid Management ◽

10.5055/jom.2021.0651 ◽

2021 ◽

Vol 17 (7) ◽

pp. 141-152

Author(s):

Tamoud Modak, MD, DM ◽

Siddharth Sarkar, MD, MRCPsych ◽

Yatan Pal Singh Balhara, MD

Keyword(s):

Public Health Problem ◽

Opioid Use Disorder ◽

Critical Examination ◽

Evidence Based ◽

Major Public Health Problem ◽

Opioid Use ◽

Evidence Based Treatment ◽

Opioid Replacement Therapy ◽

Pharmacological Basis

Opioid use disorder is a major public health problem, and opioid replacement therapy with buprenorphine (BPN) is a clinically effective and evidence-based treatment for it. To deter misuse of the tablet through the injecting route, BPN coformulated with naloxone (BNX) in 4:1 ratio is available in many countries. Despite this, significant diversion and injecting use of the BNX combination has been reported from across the world. In this article, the pharmacological properties of BPN and BNX and the evidence for their diversion are reviewed. Also, a critical examination is made of the evidence supporting the role of naloxone in reducing the agonist effects of BPN when used through the injecting route. Based on this evidence, a hypothesis explaining the continued diversion of BNX has been proposed.

Download Full-text