INFLUENCE OF GENOTYPIC VARIABILITY OF M. TUBERCULOSIS ON THE COURSE OF TUBERCULOSIS WITH MULTIPLE DRUG RESISTANCE

2020 ◽  
pp. 68-71
Author(s):  
V. S. Krutko ◽  
L. H. Nikolaieva ◽  
T. V. Maistat ◽  
O. A. Oparin ◽  
Anton Viktorovych Rohozhyn
Keyword(s):  
Clinical Laboratory ◽  
Multiple Drug Resistance ◽  
Multidrug Resistant ◽  
Multiple Drug ◽  
Genotypic Variability ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Promising Area ◽  
Infection Source

Tuberculosis is infectious and socially dependent disease, being now one of the most pressing issues in practical health care. As well the usual types of tuberculosis infection, chemoresistant tuberculosis is spreading rapidly in the world. The WHO estimates that about 500,000 people on the planet are infected with M. tuberculosis, which is resistant to standard anti−tuberculosis drugs. The probability of successful treatment decreases with emergence of new genotypes of M. tuberculosis with total resistance. In the modern epidemiology of tuberculosis, it is important to identify genotypes on certain signs, allowing to address issues such as their origin, identification of the infection source, possible routes and factors of transmission, as well as to reveal cases and spread of resistance to anti−tuberculosis drugs. To evaluate the therapy efficiency of multidrug−resistant tuberculosis patients with revealed genotypic variability during treatment, 10 patients with chemoresistant pulmonary tuberculosis having M. tuberculosis genotypic variability were treated. In these patients, the clinical, laboratory and radiological dynamics of disease in intensive phase of treatment were studied. Analysis of treatment results for patients with chemoresistant tuberculosis with genotypic variability of M. tuberculosis was evaluated by the intoxication syndrome dynamics of, the timing of closure of the decay cavities and cessation of bacterial excretion. The study found that the genotypic variability of M. tuberculosis is characterized by the change of less virulent genotypes of M. tuberculosis to more virulent. Signs of intoxication have been shown to change from less virulent M. tuberculosis genotypes to M. tuberculosis Beijing genotypes. Genotypic variability of mycobacteria in hospital suggests that hospitalization in tuberculosis facilities is a risk of exogenous tuberculosis superinfection. Studying the influence of genotypic variability of M. tuberculosis on the course of multidrug−resistant tuberculosis requires more extensive research, being a very relevant and promising area in phthisiology. Key words: Mycobacterium tuberculosis, genotypic variability, VNTR−genotyping, treatment.

scholarly journals Intensive-Phase Treatment Outcomes among Hospitalized Multidrug-Resistant Tuberculosis Patients: Results from a Nationwide Cohort in Nigeria

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e94393 ◽  
Author(s):  
Olanrewaju Oladimeji ◽  
Petros Isaakidis ◽  
Olusegun J. Obasanya ◽  
Osman Eltayeb ◽  
Mohammed Khogali ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Multidrug Resistant ◽  
Intensive Phase ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

scholarly journals Treatment Compliance of Multidrug Resistant Tuberculosis in Uzbekistan: Does Practice Follow Policy?

2021 ◽  
Vol 18 (8) ◽  
pp. 4071
Author(s):  
Ruzilya Usmanova ◽  
Nargiza Parpieva ◽  
Hayk Davtyan ◽  
Olga Denisiuk ◽  
Jamshid Gadoev ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Treatment Compliance ◽  
Multidrug Resistant ◽  
Future Research ◽  
Continuation Phase ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Treatment Changes ◽  
Drug Dosages

Compliance with treatment guidelines is essential to achieve successful outcomes in tuberculosis patients. Thus, we assessed if multidrug-resistant tuberculosis treatment practices from 2012–2018 in Uzbekistan were compliant with national guidelines in terms of regimens prescribed, weight-based drug dosages used, and documentation of treatment changes (such as prolongation of intensive phase, change of drugs, and their reasons) in the treatment card and Consilium form. A total of 1481 patients were included. Of them, only 25% received standardized regimens as per guidelines and the remaining received individualized regimens. There was an increasing trend in using standardized regimens from 2% in 2012 to 44% in 2018. Compliance to recommended weight-based drug dosages was observed in 85% of the patients during the intensive phase and 84% in the continuation phase—ranged 71–91% over the years. Prolongation of the intensive phase was done in 42% of patients. The treatment was changed in 44% of patients during the intensive phase and 34% of patients during the continuation phase. The documentation of treatment changes was suboptimal (42–75%) during the initial years (2012–2014); however, it improved significantly during later years (86–100%). Future research should explore reasons for non-compliance so that the quality of patient care can be improved.

scholarly journals Factors influencing the length of hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

2020 ◽  
Author(s):  
koku Sisay Tamirat ◽  
Gashaw Andargie ◽  
Yaregal Animut Babel
Keyword(s):  
Hospital Stay ◽  
Drug Effects ◽  
Length Of Hospital Stay ◽  
Multidrug Resistant ◽  
Tuberculosis Treatment ◽  
Intensive Phase ◽  
State Hospitals ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Hospital Stays

Abstract Background: The length of hospital stay is the duration of hospitalization and reflects disease severity and resource utilization indirectly. Generally, tuberculosis considered as an ambulatory disease able to be treated at DOTs clinics, however, hospitalization remains an important component for clinical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia.Methods: An institution-based retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral from September 2010 to December 2016 (n=432). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression analysis was used to identify factors associated with longer hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stay was 62 (interquartile range 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), functional status of bedridden (AOR= 2.88, 95%CI; 1.29 to 6.43), and reported adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were significant predictors of extended hospital stays.Conclusion: The study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse drug effects.

scholarly journals Factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study

2020 ◽  
Author(s):  
koku Sisay Tamirat ◽  
Gashaw Andargie ◽  
Yaregal Animut Babel
Keyword(s):  
Hospital Stay ◽  
Drug Effects ◽  
Length Of Hospital Stay ◽  
Multidrug Resistant ◽  
Tuberculosis Treatment ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Hospital Stays

Abstract Background: The length of hospital stay is the duration of hospitalization, which reflects disease severity and resource utilization indirectly. Generally, tuberculosis is considered an ambulatory disease that could be treated at DOTs clinics; however, admission remains an essential component for patients' clinical stabilization. Hence, this study aimed to identify factors influencing hospital stay length during the intensive phase of multidrug-resistant tuberculosis treatment.Methods: A retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral hospitals from September 2010 to December 2016 (n=432). Data extracted from hospital admission/discharge logbooks and individual patient medical charts. A binary logistic regression analysis was used to identify factors associated with more extended hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stays was 62 (interquartile range from 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), bedridden functional status (AOR= 2.88, 95%CI; 1.29 to 6.43), and adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were factors associated with extended hospital stays.Conclusion: This study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of more extended hospital stays. These underscore the importance of early case detection and prompt treatment of adverse drug effects.

scholarly journals PO 8544 USE OF XPERT MTB/RIF ASSAY AND FDA MICROSCOPY RELATIVE TO MONTHLY CULTURES IN MONITORING MULTIDRUG-RESISTANT TUBERCULOSIS PATIENTS IN BAMAKO, MALI

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A51.3-A52
Author(s):  
Bassirou Diarra ◽  
B Aissata ◽  
Tom Decroo ◽  
Marie L Keita ◽  
Boureima Degoga ◽  
...  
Keyword(s):  
Vital Staining ◽  
Multidrug Resistant ◽  
Alternative Methods ◽  
Intensive Phase ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Resource Limited ◽  
Mgit Culture

IntroductionXpert MTB/RIF assay is used extensively for the detection of rifampicin-resistant TB (RR-TB). RR-TB treatment monitoring is culture-based, although, in resource-limited settings, access to TB culture is poor. Alternative methods are needed. We therefore conducted a pilot study to determine the performance of fluorescein di-acetate FDA vital staining, a microscopy-based test that shows viable bacilli, and Xpert threshold cycle value (Ct) changes when assessing culture conversion at the end of the intensive phase of RR-TB treatment.MethodsBetween December 2015 and April 2018, we prospectively followed patients with RR-TB during the 6-month intensive phase of a 21-month standardised WHO treatment regimen. Sputum was collected and tested monthly with Auramine, FDA, Xpert MTB/RIF, and culture (Manual MGIT). Culture was considered to have converted to negative when two consecutive cultures, taken at least 30 days apart, were negative, including at least one culture between 4–6 months of treatment.ResultsForty-one patients were included in this study, 80% were male and 7% were HIV-co-infected. Conversion could not be assessed in 12 (29%) patients. Among the remaining 29 patients, 9 (31%) converted, and 11 (38%) did not convert. All 9 who converted on culture had a negative FDA, and most (6) had a Ct trend that showed a reduction of excreted DNA (increasing Ct trend). Three of these were still positive on Auramine (excretion of dead bacilli?). Of 11 patients with positive cultures, 8 tested negative on FDA, 5 tested ‘MTB not detected’ on Xpert MTB/RIF, and another 2 showed a reduction of excreted DNA.ConclusionResults from culture, FDA, and Xpert MTB/RIF provide similar results among converters but contrasting results among non-converters. Longer follow-up time is needed to assess the value of these tests to predict treatment outcome.

scholarly journals Retrospective analysis of multidrug-resistant tuberculosis case notifications in Australia (1999–2018)

2020 ◽  
Vol 44 ◽  
Author(s):  
Hendrik S Camphor ◽  
Kerri Viney ◽  
Ben Polkinghorne ◽  
Kate Pennington
Keyword(s):  
Clinical Laboratory ◽  
Treatment Success ◽  
Multidrug Resistant ◽  
Current Data ◽  
Notification Rate ◽  
Tuberculosis Case ◽  
Tb Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

This study describes the epidemiology and treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) cases notified in Australia between 1999 and 2018, and investigates whether current data fields in the national tuberculosis (TB) dataset allow description and measurement of surveillance information pertaining to the diagnosis and clinical management of MDR-TB. In May 2019, de-identified demographic, clinical, laboratory, drug susceptibility, treatment, risk factor and outcome data for all MDR-TB case notifications were extracted from the Australian National Notifiable Disease Surveillance System. The dataset included ten treatment outcome categories, which were aggregated to four categorical outcomes for descriptive and inferential analyses. The majority of cases were overseas-born (91%). Absolute case numbers increased over time; however, the MDR-TB notification rate remained fairly stable during the study period. Treatment success was achieved in nearly two-thirds of cases (62.1%). Whilst timeframes between initial presentation, specimen collection, case notification and treatment commencement were calculated, current data fields in the national dataset precluded measurement and description of other parameters deemed important for MDR-TB surveillance. This study demonstrates that while Australia’s MDR-TB burden is low, cases will continue to occur until TB control improves in countries with which Australia shares cultural and migration links. Australia should continue to support national and regional TB control programmes to sustain progress towards national elimination of TB. This study’s findings support a review of data fields in the national TB dataset with potential expansion or adjustment to improve national data reporting, including the monitoring of evidence-based recommendations for the prevention and management of MDR-TB.

scholarly journals Multidrug Resistant Tuberculosis in Children in Port Harcourt – A Worrisome Trend

2019 ◽  
pp. 1-8
Author(s):  
Lucy Eberechukwu Yaguo Ide ◽  
Nsirimobu Ichendu Paul ◽  
Rosemary Ogochukwu Ugwu
Keyword(s):  
Multidrug Resistant ◽  
Drug Resistant ◽  
Second Line ◽  
Female Ratio ◽  
Intensive Phase ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Port Harcourt ◽  
Mdr Tb ◽  
Paediatric Tuberculosis

Background: Drug-resistant tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in particular represent a major threat to the fight against tuberculosis globally. MDR-TB presents with similar features and is transmitted in the same way as drug sensitive TB but its progression is rapid and its treatment, associated drug toxicity and monitoring constitute a heavy burden to the patients and the health system. MDR-TB affect people of all age groups but very little is known about the magnitude of this problem in children. Aims/Objectives: To determine the prevalence of multidrug resistant tuberculosis among children in Port Harcourt. Materials and Methods: Information on Paediatric tuberculosis was retrieved from the patients’ case notes, TB registers at the directly observed treatment short course (DOTs) clinic and the Multidrug resistant tuberculosis (MDR-TB) treatment center of the University of Port Harcourt Teaching Hospital from January 2018 to June 2019. Obtained data was analysed and presented in prose and tables.  Results: There was a total of 1,860 patients records of which 37 were Paediatrics cases giving a prevalence of Paediatric tuberculosis cases of 2.0% Out of these 37cases, four were multidrug resistant tuberculosis cases giving a prevalence of MDR-TB cases of 10.8%. There were three males and one female giving a male female ratio of 3: 1. and their ages ranged from 3months to 24months. All belonged to social class 5.  Common presentation was chronic cough, prolonged fever, weight loss and lymph node swellings. Three (75%) had no prior treatment for tuberculosis while one (25%) completed 6months of anti TB drugs. All had BCG immunization within one week of delivery. One (25%) child had extra-pulmonary TB while 3(75%) children had pulmonary tuberculosis. Xpert MTB/RIF assay for all (100%) showed MTB detected, RIF resistant detected. Three (75%) of the mothers had MDRTB and the medications for their children was based on the drug sensitivity testing (DST) of their mothers. One (25%) of the children and his mother were HIV positive and the mother had died while still on the intensive phase of second line antiTB drugs. Three (75%) had completed the intensive phase of the conventional therapy with second line antiTB drugs and are closely followed up weekly on the continuation phase while one child is still on admission. Conclusions: The prevalence of MDR-TB in children in PH is high. All childhood TB (whether drug susceptible or drug resistant) is usually traced to an adult, thus effectively diagnosing and     treating all adults as well as a high index of suspicion in presumptive cases is required to curb MDR-TB. Recommendations: We recommend strict use of the DOTs strategy in TB management to ensure drug adherence. Also, proper contact tracing, investigation and treatment of children of infected parents to reduce cases of MDR-TB is advocated. 

scholarly journals Factors influencing length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study

2020 ◽  
Author(s):  
Koku Sisay Tamirat ◽  
Gashaw Andargie ◽  
Yaregal Animut Babel
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Multidrug Resistant ◽  
Tuberculosis Treatment ◽  
Intensive Phase ◽  
Follow Up Study ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Hospital Stays

Abstract Background: Tuberculosis (TB) generally considered as an ambulatory disease. However, hospitalization remains an important component for isolation and medical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: retrospective follow up study.Methods: An institution based retrospective follow up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda and Debremarkos referral from September 2010 to December 2016 (n=465). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression was used to identify factors associated with longer hospital stays during the intensive phase of multidrug resistant tuberculosis treatment.Result: Most patients (92.5%) had a pulmonary form of multidrug resistant tuberculosis and a quarter of them HIV co-infections. The median length of hospital stay was 61 (interquartile range 34 to 101) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.20, 95% confidence interval [CI]; 1.28 to 7.96), treated at the University of Gondar (AOR= 2.11, 95%CI; 1.02 to 4.41) and Borumeda Hospital (AOR= 3.59, 95%CI; 1.67 to 7.72), functional status of ambulatory (AOR=2.25, 95% CI; 1.19 to 4.27) and bedridden (AOR= 3.39, 95%CI; 1.57 to 7.35), and reported adverse drug reactions (AOR=2.54, 95%CI; 1.60 to 4.02) were significant predictors of extended hospital stays.Conclusion: The study revealed that longer hospital stay and significant differences were observed among hospitals. Decreased functional status at admission, pulmonary form of tuberculosis and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse effects.

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