ISONIAZID MONORESISTANCE : THE NEW CHALLENGE IN DRUG RESISTANT TUBERCULOSIS

2021 ◽  
pp. 38-39
Author(s):  
Paulami Palchowdhury ◽  
Anindita Rakshit ◽  
Aitihya Chakraborty ◽  
Banya Chakraborty
Keyword(s):  
Multidrug Resistant ◽  
Drug Resistant ◽  
Isoniazid Resistance ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Rapid Tests ◽  
Probe Assay ◽  
Global Threat ◽  
Line Drug

Background: Drug resistant tuberculosis is a global threat to overall tuberculosis control. Isoniazid is a critically important rst line drug. Isoniazid monoresistance increases the incidence of treatment failure and relapse. Method: A total of 100 sputum samples positive for acid fast bacilli by Ziehl-Neelsen staining were collected from pulmonary tuberculosis patients between September 2019 to January 2020 (four months) and subjected to Line probe assay (LPA). Result: Mycobacterium tuberculosis complex was detected in all the 100 samples by LPA. It was found that 82 (82%) samples were sensitive to both Isoniazid and Rifampicin, 9(9%) of them were multidrug resistant ,8(8%) were Isoniazid monoresistant and 1(1%) was Rifampicin monoresistant.Out of the Isoniazid monoresistance cases mutation in katG was seen in 87% cases and inhA mutation in 13%. Conclusion: Isoniazid resistance is surprisingly increasing and is missed out by rapid tests.

scholarly journals Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

2004 ◽  
Vol 132 (6) ◽  
pp. 1099-1108 ◽  
Author(s):  
S. J. CONATY ◽  
A. C. HAYWARD ◽  
A. STORY ◽  
J. R. GLYNN ◽  
F. A. DROBNIEWSKI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multidrug Resistance ◽  
Hiv Infection ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Isoniazid Resistance ◽  
Drug Resistant Tuberculosis ◽  
England And Wales ◽  
Resistance Risk ◽  
Resistant Tuberculosis

Drug-resistant tuberculosis can be transmitted (primary) or develop during the course of treatment (secondary). We investigated risk factors for each type of resistance. We compared all patients in England and Wales with isoniazid- and multidrug-resistant tuberculosis in two time-periods (1993–1994 and 1998–2000) with patients with fully sensitive tuberculosis, examining separately patients without and with previous tuberculosis (a proxy for primary and secondary drug-resistant tuberculosis). Patients with previous tuberculosis smear positivity and arrival in the United Kingdom <5 years were strongly associated with multidrug resistance and isoniazid resistance. In patients with no previous tuberculosis HIV infection, residence in London and foreign birth were risk factors for multidrug resistance, and non-white ethnicity, residence in London and HIV infection for isoniazid resistance. Risk factors for each type of resistance differ. Elevated risks associated with London residence, HIV positivity, and ethnicity were mainly seen in those without previous tuberculosis (presumed transmission).

scholarly journals Drug resistance and its risk factors among extrapulmonary tuberculosis in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258295
Author(s):  
Getu Diriba ◽  
Habteyes Hailu Tola ◽  
Ayinalem Alemu ◽  
Bazezew Yenew ◽  
Dinka Fikadu Gamtesa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Drug Resistance ◽  
Meta Analysis ◽  
Extrapulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis

Background Drug-resistant tuberculosis and extrapulmonary tuberculosis are the world major public health issues. Although some primary studies have been reported on the burden of drug-resistant tuberculosis in extrapulmonary tuberculosis patients in Ethiopia, there is no systematic review and meta-analysis that attempt to summarize the available literature. Thus, we aimed to estimates the prevalence of drug-resistance in extrapulmonary tuberculosis patients and summarize the risk factors associated with the occurrence of extrapulmonary tuberculosis in Ethiopia. Methods We conducted a systematic review of the published primary studies on extrapulmonary drug-resistant tuberculosis in Ethiopia. Results Eight observational studies were included in this review from different regions of Ethiopia. The overall pooled prevalence of rifampicin resistance was 6% (95% CI 0.03–0.10), while isoniazid resistance was 7% (95% CI 0.03–0.12). The pooled prevalence of multidrug-resistant tuberculosis was 4% (95% CI 0.01–0.07). Previous tuberculosis treatment history and male gender are frequently reported risk factors for developing drug-resistant tuberculosis in extrapulmonary tuberculosis patients. Conclusion The current review has identified a high proportion of resistance to rifampicin, isoniazid, and multidrug-resistant tuberculosis in patients with extrapulmonary tuberculosis in Ethiopia. Clinicians should request drug susceptibility testing for all patients with presumptive extrapulmonary tuberculosis to detect drug-resistance.

Optimized loading dose strategies for bedaquiline when restarting interrupted drug-resistant tuberculosis treatment

2022 ◽  
Author(s):  
Simon E Koele ◽  
Stijn W van Beek ◽  
Gary Maartens ◽  
James C. M. Brust ◽  
Elin M Svensson
Keyword(s):  
Treatment Interruption ◽  
Loading Dose ◽  
Drug Resistant ◽  
Time Curve ◽  
Resistance Development ◽  
Drug Resistant Tuberculosis ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Starting Point ◽  
One Year

Interruption of treatment is common in drug-resistant tuberculosis patients. Bedaquiline has a long terminal half-life therefore, restarting after an interruption without a loading dose could increase the risk of suboptimal treatment outcome and resistance development. We aimed to identify the most suitable loading dose strategies for bedaquiline restart after an interruption. A model-based simulation study was performed. Pharmacokinetic profiles of bedaquiline and its metabolite M2 (associated with QT-prolongation) were simulated for 5000 virtual patients for different durations and starting points of treatment interruption. Weekly bedaquiline area under the concentration-time curve (AUC) and M2 maximum concentration (Cmax) deviation before interruption and after reloading were assessed to evaluate the efficacy and safety respectively of the reloading strategies. Bedaquiline weekly AUC and M2 Cmax deviation were mainly driven by the duration of interruption and only marginally by the starting point of interruption. For interruptions with a duration shorter than two weeks, no new loading dose is needed. For interruptions with durations between two weeks and one month, one month and one year, and longer than one year, reloading periods of three days, one week, and two weeks, respectively, are recommended. This reloading strategy results in an average bedaquiline AUC deviation of 1.88% to 5.98% compared with -16.4% to -59.8% without reloading for interruptions of two weeks and one year respectively, without increasing M2 Cmax. This study presents easy-to-implement reloading strategies for restarting a patient on bedaquiline treatment after an interruption.

scholarly journals Use of fluorescein diacetate (FDA) staining to detect viable Mycobacterium tuberculosis

2012 ◽  
Vol 11 (4) ◽  
pp. 322-330 ◽  
Author(s):  
Shamima Islam ◽  
Farjana Rahman ◽  
Saurab Kisore Munshi ◽  
Jewel Ahmed ◽  
S M Mostafa Kamal ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Treatment Failure ◽  
Medical Science ◽  
Multidrug Resistant ◽  
Fluorescein Diacetate ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Auramine O

Objective: Drug resistant tuberculosis has long been a common problem prevailing in developing countries including Bangladesh. Present study focused on the rapid identification of live Mycobacterium tuberculosis among treatment failure cases.Materials and Methods: Sputum samples from a total of 100 category-I and category-II treatment failure cases, assumed as multidrug resistant tuberculosis, were studied through fluorescein diacetate (FDA) staining under light emitting diode (LED) fluorescence microscope. Considering culture method as gold standard, we also compared the results of FDA staining with that of auramine O staining.Results: A total of 85% acid-fast bacilli were detected by FDA staining, 82% by auramine O staining and a total of 85% isolates were detected in Lowenstein-Jensen (LJ) culture. The sensitivity of FDA staining (96.47%) was estimated to be slightly higher than that of auramine O staining (91.76%). Moreover,76.47% cases were detected as multidrug resistant tuberculosis (MDR-TB). Conclusion: Taken together, FDA staining method has been proposed to be appropriate for the rapid diagnosis of drug resistant tuberculosis. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12605 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12

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