A model of transboundary migration effect in highly endemic foci of drug-resistant pulmonary tuberculosis

ObjectiveThis study was designed to identify the risk factors for drug-resistant tuberculosis (DR-TB) and the association between comorbidity and drug resistance among retreated pulmonary tuberculosis (PTB).DesignA retrospective study was conducted among all the 36 monitoring sites in Shandong, China, over a 16-year period. Baseline characteristics were collected from the TB Surveillance System. Categorical variables were compared by Fisher’s exact or Pearson’s χ2 test. The risk factors for drug resistance were identified using univariable analysis and multivariable logistic models. The influence of comorbidity on different types of drug resistance was evaluated by performing multivariable logistic models with the covariates adjusted by age, sex, body mass index, drinking/smoking history and cavity.ResultsA total of 10 975 patients with PTB were recorded during 2004–2019, and of these 1924 retreated PTB were finally included. Among retreated PTB, 26.2% were DR-TB and 12.5% had comorbidity. Smoking (adjusted OR (aOR): 1.69, 95% CI 1.19 to 2.39), cavity (aOR: 1.55, 95% CI 1.22 to 1.97) and comorbidity (aOR: 1.44, 95% CI 1.02 to 2.02) were risk factors for DR-TB. Of 504 DR-TB, 9.5% had diabetes mellitus, followed by hypertension (2.0%) and chronic obstructive pulmonary disease (1.8%). Patients with retreated PTB with comorbidity were more likely to be older, have more bad habits (smoking, alcohol abuse) and have clinical symptoms (expectoration, haemoptysis, weight loss). Comorbidity was significantly associated with DR-TB (aOR: 1.44, 95% CI 1.02 to 2.02), overall rifampin resistance (aOR: 2.17, 95% CI 1.41 to 3.36), overall streptomycin resistance (aOR: 1.51, 95% CI 1.00 to 2.27) and multidrug resistance (aOR: 1.96, 95% CI 1.17 to 3.27) compared with pan-susceptible patients (p<0.05).ConclusionSmoking, cavity and comorbidity lead to an increased risk of drug resistance among retreated PTB. Strategies to improve the host’s health, including smoking cessation, screening and treatment of comorbidity, might contribute to the control of tuberculosis, especially DR-TB, in China.

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Drug-induced optic neuropathy in a case of extensively drug-resistant pulmonary tuberculosis

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2018-0007 ◽

2018 ◽

Vol 30 (1) ◽

pp. 139-140 ◽

Cited By ~ 1

Author(s):

Proteesh Rana ◽

Vandana Roy ◽

Jamshed Ahmad

Keyword(s):

Pulmonary Tuberculosis ◽

Optic Neuritis ◽

Male Patient ◽

Optic Neuropathy ◽

High Dose ◽

Drug Resistant ◽

Drug Reactions ◽

Drug Induced ◽

Toxic Optic Neuropathy ◽

Extensively Drug Resistant

Abstract We report a 26-year-old male patient diagnosed with extensively drug-resistant pulmonary tuberculosis presenting with reversible bilateral toxic optic neuropathy induced by the use of linezolid along with high-dose isoniazid. The case emphasizes the importance of recognizing toxic optic neuritis in patients on antitubercular therapy. Prompt recognition and treatment of such adverse drug reactions will reduce the associated morbidity.

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Biological microchips for detection of multiple drug resistant M. tuberculosis strains isolated in Kyrgyz Republic

Russian Pulmonology ◽

10.18093/0869-0189-2008-0-3-64-66 ◽

2008 ◽

pp. 64-66

Author(s):

J. T. Isakova ◽

Z. K. Goncharova ◽

A. A. Aldashev

Keyword(s):

Drug Resistance ◽

Pulmonary Tuberculosis ◽

Gene Mutations ◽

Rpob Gene ◽

Multiple Drug ◽

Drug Resistant ◽

Kyrgyz Republic ◽

Newly Diagnosed ◽

Single Drug ◽

Multiple Drug Resistant

The aim of the study was to estimate spread of primary and secondary multiple drug resistant Mycobacterium tuberculosis (MBT) and to characterize rpoB, katG, inhA, and ahpC gene mutations of rifampicin (RIF) and isoniazid (INH) resistant MBT strains isolated from tuberculosis patients in Kyrgyz. We obtained 493 specimens from patients with pulmonary tuberculosis which were diagnosed based on clinical, X-ray, and bacteriological examination. Among them, newly diagnosed pulmonary tuberculosis was in 445 patients (90.2 %), and 48 of the patients (9.8 %) have already been treated for tuberculosis. Mutations of rpoB, KatG, inhA, and ahpC genes associated with RIF and INH resistance were detected by biological chip test. Sensitive MBT strains were detected in 47 % and resistant strains were in 53 % of the newly diagnosed patients. Single-drug resistance to RIF only was detected in 3 % of cases; resistance to INH was found in 20 %, resistance to both the drugs was detected in 30 % of the patients. In pre-treated patients single-drug resistance to RIF was defined in 4 % of cases, resistance to INH was in 8 %, resistance to both the drugs was estimated in 75 % of the patients. Therefore, we suppose that there is a high prevalence of multi-drug resistant MBT in Kyrgyz Republic: 30 % among newly diagnosed patients and 75 % among pre-treated patients. The main cause of RIF-resistance of MBT is Ser531→Leu mutation of rpoB gene, and the main cause of INHresistance is Ser315→Thr mutation of katG gene.

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The relevance of the use of electroencephalography and audiometry for the diagnosis of drug-related nervous system complications in patients with multi-drug resistant pulmonary tuberculosis during the main course of chemotherapy

Infusion & Chemotherapy ◽

10.32902/2663-0338-2018-18-1-25-29 ◽

2018 ◽

pp. 25-29

Author(s):

V.I. Ignatieva ◽

T.M. Martsinyuk ◽

V.A. Svyatnenko ◽

G.L. Gumeniuk

Keyword(s):

Nervous System ◽

Pulmonary Tuberculosis ◽

Evoked Potentials ◽

Differential Diagnostics ◽

Drug Resistant ◽

Objective Data ◽

Treatment Practice ◽

Tb Treatment ◽

Timely Treatment

PURPOSE. To analyze the relevance of introduction of modern diagnostics methods for the evaluation of drug-related complications that affect the nervous system in TB treatment practice. MATERIALS AND METHODS. We have analyzed the literature data regarding the problem of diagnosing drug-related complications that affect the nervous system in patients with multi-drug resistant pulmonary tuberculosis during the main course of chemotherapy. RESULTS. According to the results of the analysis, it was revealed that today in the TB practice there is over- or under-diagnosing of drug-related complications from the part of nervous system in patients with multi-drug resistant pulmonary tuberculosis during the main course of chemotherapy, which is due to the lack of technical possibilities of control and the need to get conclusions from specialists with narrow expertise – otolaryngologists, ophthalmologists and neuropathologists. CONCLUSIONS. The lack of data on the prevalence of drug-related nervous system complications is due to the possibility of their detection only with the help of specific technical means of control and on the basis of the conclusions of narrow specialists. The wide introduction of electroencephalography using evoked potentials and audiometry in TB practice will allow obtaining objective data on prevalence, carrying out clear differential diagnostics, monitoring the development of such complications, as well as providing timely treatment within the required amount.

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CATT polymorphism in MIF gene promoter is closely related to human pulmonary tuberculosis in a southwestern China population

International Journal of Immunopathology and Pharmacology ◽

10.1177/2058738418777108 ◽

2018 ◽

Vol 32 ◽

pp. 205873841877710 ◽

Cited By ~ 2

Author(s):

Aihua Liu ◽

Fukai Bao ◽

Supayang P Voravuthikunchai

Keyword(s):

Pulmonary Tuberculosis ◽

Proinflammatory Cytokine ◽

Promoter Region ◽

Macrophage Migration Inhibitory Factor ◽

Gene Promoter ◽

Macrophage Migration ◽

Drug Resistant ◽

Gene Promoter Region ◽

Short Tandem ◽

Str Polymorphism

Macrophage migration inhibitory factor (MIF) is deemed as an immunoregulatory and proinflammatory cytokine related to the progression of tuberculosis. A CATT short tandem repeat (STR) polymorphism at position −794 in the MIF gene promoter region is associated with the susceptibility to tuberculosis (TB). To investigate whether macrophage MIF gene mif CATT variants are associated with susceptibility to retreatment cases of TB and drug-resistant TB prevalence, genotyping of MIF −794 CATT polymorphism and quantifying of serum MIF were performed to associate MIF−794 CATT polymorphism with new patients and retreatment cases. Significant increases in MIF −794 CATT genotypes 7/8 and allele CATT 8 were observed in TB patients. Significant differences in the genotypic frequencies of MIF −794 CATT (5/X + 6/X vs 7/7 + 7/8) were demonstrated upon comparing the total cases and the new cases of TB with the controls. Significant differences in the allelic frequencies of MIF −794 CATT (5 + 6 vs 7 + 8) were observed in the total cases and new cases of TB. No differences in the genotypic frequencies of the MIF −794 CATT (5/X + 6/X vs 7/7 + 7/8) were observed between the retreatment cases and the controls or between the new cases and retreatment cases. In conclusion, the MIF −794 CATT genotypes 7/8 and allele CATT 8 were highly associated with TB; no differences in the genotypic frequencies of the MIF −794 CATT (5/X + 6/X vs 7/7 + 7/8) were observed between the new cases and retreatment cases.

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