Second-line drug resistance patterns among patients with multidrug-resistant tuberculosis of Gujarat, western India

Author(s):  
Sachin Patel ◽  
Mitesh Patel ◽  
Sumeeta Soni ◽  
Mahendra Vegad
2020 ◽  
Vol 5 (1) ◽  
pp. 43
Author(s):  
Le T. N. Anh ◽  
Ajay M. V. Kumar ◽  
Gomathi Ramaswamy ◽  
Thurain Htun ◽  
Thuy Thanh Hoang Thi ◽  
...  

Vietnam has been using a levofloxacin-based shorter treatment regimen (STR) for rifampicin resistant/multidrug-resistant tuberculosis (RR/MDR-TB) patients since 2016 on a pilot basis. This regimen lasts for 9–11 months and is provided to RR/MDR-TB patients without second-line drug resistance. We report the treatment outcomes and factors associated with unsuccessful outcomes. We conducted a cohort study involving secondary analysis of data extracted from electronic patient records maintained by the national TB program (NTP). Of the 302 patients enrolled from April 2016 to June 2018, 259 (85.8%) patients were successfully treated (246 cured and 13 ‘treatment completed’). Unsuccessful outcomes included: treatment failure (16, 5.3%), loss to follow-up (14, 4.6%) and death (13, 4.3%). HIV-positive TB patients, those aged ≥65 years and patients culture-positive at baseline had a higher risk of unsuccessful outcomes. In a sub-group of patients enrolled in 2016 (n = 99) and assessed at 12 months after treatment completion, no cases of relapse were identified. These findings vindicate the decision of the Vietnam NTP to use a levofloxacin-based STR in RR/MDR-TB patients without second-line drug resistance. This regimen may be considered for nationwide scale-up after a detailed assessment of adverse drug events.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Tichaona Sagonda ◽  
Lucy Mupfumi ◽  
Rumbidzai Manzou ◽  
Beauty Makamure ◽  
Mqondisi Tshabalala ◽  
...  

We conducted a cross-sectional study of second line drug resistance patterns and genetic diversity of MDR-TB isolates archived at the BRTI-TB Laboratory, Harare, between January 2007 and December 2011. DSTs were performed for second line antituberculosis drugs. XDR-TB strains were defined as MDR-TB strains with resistance to either kanamycin and ofloxacin or capreomycin and ofloxacin. Strain types were identified by spoligotyping. No resistance to any second line drugs was shown in 73% of the isolates, with 23% resistant to one or two drugs but not meeting the definition of XDR-TB. A total of 26 shared types were identified, and 18 (69%) matched preexisting shared types in the current published spoligotype databases. Of the 11 out of 18 clustered SITs, 4 predominant (>6 isolates per shared type) were identified. The most and least abundant types were SIT 1468 (LAM 11-ZWE) with 12 (18%) isolates and SIT 53 (T1) with 6 (9%) isolates, respectively. XDR-TB strains are rare in Zimbabwe, but the high proportion of “pre-XDR-TB” strains and treatment failure cases is of concern. The genetic diversity of the MDR-TB strains showed no significant association between SITs and drug resistance.


2014 ◽  
Vol 18 (8) ◽  
pp. 961-963 ◽  
Author(s):  
A. Chaiprasert ◽  
S. Srimuang ◽  
N. Tingtoy ◽  
N. Makhao ◽  
P. Sirirudeeporn ◽  
...  

2020 ◽  
Vol 98 (4) ◽  
pp. 32-39
Author(s):  
O. A. Pasechnik ◽  
E. A. Vilms ◽  
D. V. Turchaninov ◽  
I. V. Yarusova ◽  
T. L. Batischeva ◽  
...  

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders.


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