The effectiveness of the main course of chemotherapy for drug-resistant tuberculosis

MedAlliance ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 22-28
Keyword(s):  
Laboratory Data ◽  
Age Groups ◽  
Control Group ◽  
Outpatient Basis ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Treat Ment ◽  
Urgent Task ◽  
Mdr Tb ◽  
First Time

SummaryThe article is devoted to the effectiveness of treatment of tuberculosis with MDR-TB and XDR-TB mycobacteria after the main course of chemotherapy. The treatment of tuberculosis with multiple and broad MD MBT is a com-plex and urgent task. Prescribing the latest generation of drugs (thioureidoiminomethylpyridinium perchlorate, bedaquiline, linezolid) in the complex composition of tu-berculosis therapy with MDR and XDR-MBT significantly increases the effectiveness of the main course of treat-ment, compared with the control group, respectively (85.0% and 65.8%). Мaterials and methods. The main course of chemotherapy was completed by 119 patients with pulmonary tuberculosis with drug-resistant patho-gen, who were diagnosed for the first time, treated in anti-tuberculosis hospitals in St. Petersburg and on an outpatient basis in St. Petersburg “Inter-district Petro-grad-Primorsky TB dispensary No 3”. Clinical, radiological, and laboratory data are presented. All patients were iden-tified with Mycobacterium tuberculosis with multiple and broad drug resistance MBT. The patients were divided into 2 groups: the main group (OG) — 40 people, received the latest generation drugs; 79 patients (KG) — received standard therapy without the inclusion of the latest gen-eration of drugs. Half of the patients in all age groups were identified during a preventive examination (50.4%), a third when applying for complaints (31.9%), and one — when examining for contact with a patient with tubercu-losis. Infiltrative tuberculosis was most often diagnosed in 75 (63.0%), disseminated tuberculosis was detected in 20 (16.8%), and fibrocavernous pulmonary tuberculo-sis — in 24 (20.2%). The decay phase was diagnosed in 88 (73.9%) patients. Three-quarters of the studied patients had 90 comorbidities (75.6%). Results and discussion. The groups are comparable in terms of clinical, radiologi-cal, and bacteriological parameters. By the fourth month of the therapy, the cessation of bacterial excretion was significantly more often determined in patients taking bedaquiline, thioureidoiminomethylpyridinium perchlo-rate, linezolid as part of HT, compared with the group not receiving the above drugs 47.5% and 35.4%, respectively, (p<0.05); by the end of the intensive phase of treatment, the cessation of bacterial excretion occurred in OG in 92.0%, KG — 57.0% (p<0.001). Conclusions. The inclu-sion of drugs thioureidoiminomethylpyridinium perchlo-rate, bedaquiline, linezolid in the complex chemotherapy of tuberculosis with multi-resistant tuberculosis increases the effectiveness of the main course of treatment com-pared to the KG.

scholarly journals Safety and efficiency of the port-catheter for intensive intravenous chemotherapy in patients with multi-drug resistant tuberculosis and extensively drug-resistant tuberculosis

2018 ◽  
pp. 19-24
Author(s):  
S. O. Cherenko ◽  
N. A. Lytvynenko ◽  
O. A. Reva ◽  
O. V. Khmel ◽  
R. A. Veremeenenko ◽  
...  
Keyword(s):  
Intravenous Infusion ◽  
Control Group ◽  
Study Group ◽  
Drug Resistant ◽  
Intravenous Therapy ◽  
Port Catheter ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Sputum Conversion

PURPOSE. To study the efficacy and tolerability of the port catheter for continuous intravenous infusion in patients with MDR-TB and XDR-TB. MATERIALS AND METHODS. In a controlled study examined the effectiveness of the port catheter during an intensive 7-component anti-TB treatment with intravenous application of 3 anti-TB drugs (moxifloxacin, PAS, linezolid) in 16 patients with MDR-TB and XDR-TB. In the comparison group, which is formed by a pair of matching according to the drug resistance profile of MTB, the same intensive chemotherapy regimens in which the infusion of these drugs was carried out by daily injections of veins. In each group dominated patients with retreatment cases — 14 (87.5 %) patients. The planned duration of intravenous therapy was 2—4 months. RESULTS. Port-catheter for continuous infusion of combination of anti-tuberculosis drugs in comparison to their administration in the usual way ensures high efficiency and safety. In any case, was not observed phlebitis, no complaints of pain at the injection site, only 12.5 % cases were hematoma after setting the port in comparison to 100.0 % of patients with daily venous injections. In the study group was not a single case of interruption of intravenous infusion. In the control group, 56.2 % of patients discontinued intravenous treatment due to inability to penetrate the vein, patient’s complaints pain or phlebitis. At the end of the intensive phase of chemotherapy sputum conversion and disappearance of clinical symptoms were observed in 15 (3.7 %) patients of the study group, that was 26.7 % higher, than in control group (p>0,05). We found significant difference in terms of sputum conversion, which occurred in the study group through (2,2±0,1) months vs (3,7±0,3) months (<0,05) in control group. CONCLUSIONS. Port-catheter for long-term daily infusions of combination of anti-TB drugs compared with their usual daily injections is safe and effective method of intravenous therapy. It is not accompanied by subjective complaints of patients and the development of phlebitis, which leads to early sputum conversion. With daily injections of veins 56.2 % of patients prematurely discontinued treatment through intensive local complications or phlebitis. Application of intensive treatment with the introduction of anti-TB drugs allows for faster time to achieve sputum conversion.

scholarly journals Effect of moxifloxacin on oxidative stress, paraoxonase-1 (PON1) activity and efficacy of treatment in patients with multiple drug-resistant tuberculosis

2017 ◽  
Vol 16 (10) ◽  
pp. 2515-2520 ◽  
Author(s):  
Hongguo Yang ◽  
Yanyan Zhao ◽  
Yunbo Ma ◽  
Qiang Wen ◽  
Minghui Zhang
Keyword(s):  
Oxidative Stress ◽  
Paraoxonase 1 ◽  
Pon1 Activity ◽  
Control Group ◽  
Multiple Drug ◽  
Observation Group ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Multiple Drug Resistant ◽  
Mdr Tb

Purpose: To investigate the effect of moxifloxacin on paraoxonase-1 (PON1)  activity, and serum oxidative stress in patients with multiple drug-resistant tuberculosis (MDR-TB).Methods: A total ofof 130 MDR-TB patients who were treated with moxifloxacin from October 2014 to October 2010 in Eastern Medical District of Linyi People's Hospital of Shandong Province, China were randomly divided into an observation group (65 cases, moxifloxacin group) and control group (65 cases, non-moxifloxacin group). Total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), PON1 levels and treatment efficacy for groups were determined.Results: Compared with pre-treatment levels, TOS (23.3 ± 4.7 vs 13.9 ± 3.3 umol H2O2 Eq/L, t = 13.20, p = 0.00) and OSI (17.4 ± 4.8 vs 5.7 ± 1.4 U, t = 18.87, p = 0.00) of the observation group significantly decreased, while TAS (1.4 ± 0.5 vs 3.5 ± 0.7 umol Trolox Eq/L, t = 19.68, p = 0.00) and PON1 (15.5 ± 6.9 vs 31.1 ± 8.3 U/L, t = 11.65, p = 0.00) significantly increased. TOS (23.3 ± 4.7 vs 13.9 ± 3.3 umol H2O2 Eq/L, t = 7.73, p < 0.05) and OSI (16.9 ± 5.5 vs 7.4 ± 3.2U, t = 12.04, p = 0.05) reduced significantly in the control group. Moxifloxacin correlated positively with △TAS (r = 0.697, p = 0. 04) and △PON1 (r = 0.785, p = 0.01), but correlation with △TOS (r = -0.625, p = 0.01) was negative. Efficacy was significantly higher in the observation group than that in the control group (81.54 % vs 56.92 %, p =0.00).Conclusion: Oxidative stress injury in MDR-TB patients may be effectively managed by combination of moxifloxacin with anti-TB treatmentKeywords: Multiple drug-resistant TB, Moxifloxacin, Paraoxonase, Oxidative stress

Clinical Study on Prevalence of Multi Drug Resistant Tuberculosis in Khammam District, Telangana – An Observational Study

2017 ◽  
Vol 3 (4) ◽  
pp. 372-374
Author(s):  
Humera Ayesha Mohammad ◽  
Kavya Yeluru ◽  
Suresh Kumar P ◽  
Vijay Chowhan K
Keyword(s):  
Middle Age ◽  
Age Groups ◽  
Healthcare Personnel ◽  
Early Age ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
The People ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Background: The aim of the study is to evaluate the prevalence of multi drug resistant tuberculosis in Khammam district. The objective is to create awareness among healthcare personnel and patients regarding MDR-TB. The study was conducted over a period of six months, i.e., December 2016 – June 2017. Result: A total of 54 MDR-TB cases were studied. According to age groups 32 subjects are in the young and middle age groups which comprise a total of about 59.1 whereas in early age there are 6.8%. Many variables are considered in this study out of which alcohol was rated as highest because 59.2% subjects in the study were alcoholics. A total of 31.8% smokers was found out. Diabetes was also a variation with 27.8% subjects suffering. A total of 18.5% of subjects was suffering from TB with HIV. Conclusion: The study reveals that the subjects suffered from resistance to category-I drugs and hence they are transferred to category-IV drugs. Tuberculosis is a disease that mainly affects the people of age groups 20-40 and is more prevalent in males than that of females. Variables like alcohol consumption rated as highest risk factor, followed by smoking, diabetes and HIV respectively.

scholarly journals Hygienic assessment of the nutritional status of patients with multi-drug-resistant pulmonary tuberculosis

2019 ◽  
Vol 44 (3) ◽  
pp. 79-83
Author(s):  
S.Ch. Mamedsakhatova
Keyword(s):  
Nutritional Status ◽  
Point Of View ◽  
Control Group ◽  
Fatty Tissue ◽  
Drug Resistant ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Priority Direction ◽  
Mdr Tb ◽  
Multiple Correlation Analysis

Introduction. The priority direction of hygienic science at the present stage is the study of the nutritional status of patients with multi-drug-resistant tuberculosis (MDR-TB) of the lungs. The aim of study is to identify the basic patterns of formation of the structure of the nutritional status of patients with MDR-TBof the lungs in order to adopt a reasonable system of measures for their optimization(from a hygienic point of view). Materials and research methods. The actual nutrition of 103 patients with MDR-TBof the lungs was studied using a specially prepared standardized questionnaire, which included information on previous and yesterday nutrition. Nutritional status was determined by evaluating anthropometric indices (height, body mass, chest circumference), on the basis of which the Quetelet index was calculated. Surveyed control group included 20 relatively healthy patients. Bioimpedancemetrywas a special research method. Results and discussion. In the case of multiple correlation analysis, a high direct correlation of the total protein level with the indicator of fat mass according to bioimpedancemetry (r=0.63; p<0.01)was found in patients with MDR-TB of the lungs. Conclusion. There is a need for prevention and correction of excess fatty tissue and a lack of muscle mass, which can be achieved with the help of physical exercise, rational nutrition and nutritional support.

scholarly journals The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
María José Iglesias ◽  
◽  
Daniel Ibarz ◽  
Alberto Cebollada ◽  
Jéssica Comín ◽  
...  
Keyword(s):  
Age Groups ◽  
Public Health Problem ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
The European Union ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Epidemiological Characteristics ◽  
Over Time

AbstractMolecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson’s chi-squared or Fisher’s exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann–Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples.

scholarly journals Safety and efficiency of the port-catheter for intensive intravenous chemotherapy in patients with multi-drug resistant tuberculosis and extensively drug-resistant tuberculosis

2018 ◽  
pp. 19-24
Author(s):  
S. O. Cherenko ◽  
N. A. Lytvynenko ◽  
O. A. Reva ◽  
O. V. Khmel ◽  
R. A. Veremeenenko ◽  
...  
Keyword(s):  
Intravenous Infusion ◽  
Control Group ◽  
Study Group ◽  
Drug Resistant ◽  
Intravenous Therapy ◽  
Port Catheter ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
Sputum Conversion

PURPOSE. To study the efficacy and tolerability of the port catheter for continuous intravenous infusion in patients with MDR-TB and XDR-TB. MATERIALS AND METHODS. In a controlled study examined the effectiveness of the port catheter during an intensive 7-component anti-TB treatment with intravenous application of 3 anti-TB drugs (moxifloxacin, PAS, linezolid) in 16 patients with MDR-TB and XDR-TB. In the comparison group, which is formed by a pair of matching according to the drug resistance profile of MTB, the same intensive chemotherapy regimens in which the infusion of these drugs was carried out by daily injections of veins. In each group dominated patients with retreatment cases – 14 (87.5 %) patients. The planned duration of intravenous therapy was 2–4 months. RESULTS. Port-catheter for continuous infusion of combination of anti-tuberculosis drugs in comparison to their administration in the usual way ensures high efficiency and safety. In any case, was not observed phlebitis, no complaints of pain at the injection site, only 12.5 % cases were hematoma after setting the port in comparison to 100.0 % of patients with daily venous injections. In the study group was not a single case of interruption of intravenous infusion. In the control group, 56.2 % of patients discontinued intravenous treatment due to inability to penetrate the vein, patient’s complaints pain or phlebitis. At the end of the intensive phase of chemotherapy sputum conversion and disappearance of clinical symptoms were observed in 15 (3.7 %) patients of the study group, that was 26.7 % higher, than in control group (p>0,05). We found significant difference in terms of sputum conversion, which occurred in the study group through (2,2±0,1) months vs (3,7±0,3) months (<0,05) in control group. CONCLUSIONS. Port-catheter for long-term daily infusions of combination of anti-TB drugs compared with their usual daily injections is safe and effective method of intravenous therapy. It is not accompanied by subjective complaints of patients and the development of phlebitis, which leads to early sputum conversion. With daily injections of veins 56.2 % of patients prematurely discontinued treatment through intensive local complications or phlebitis. Application of intensive treatment with the introduction of anti-TB drugs allows for faster time to achieve sputum conversion.

scholarly journals Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018

2021 ◽  
Vol 18 (9) ◽  
pp. 4663
Author(s):  
Khasan Safaev ◽  
Nargiza Parpieva ◽  
Irina Liverko ◽  
Sharofiddin Yuldashev ◽  
Kostyantyn Dumchev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
National Level ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Loss To Follow Up ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

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