scholarly journals Discordance of the Repeat GeneXpert MTB/RIF test for Rifampicin resistance detection among patients Initiating MDR-TB treatment in Uganda

2021 ◽  
Author(s):  
Willy Ssengooba ◽  
Jean de Dieu Iragena ◽  
Kevin Komakech ◽  
Iginitius Okello ◽  
Joanitah Nalunjogi ◽  
...  
Keyword(s):  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Resistance Rate ◽  
Rifampicin Resistance ◽  
P Value ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Mdr Tb

Abstract Background The Global Laboratory Initiative (GLI) guidelines recommend to repeat GeneXpertMTB/RIF (XpertMTB/RIF) in patients with a low-pretest probability of rifampicin-resistance (RR). Design/Methods In a cross-sectional study using results of sputum specimens collected from participants screened for the STREAM 2 trial. We recruited all patients with XpertMTB/RIF RR-TB detected who were referred for RR/MDR-TB treatment initiation at Mulago National Referral Hospital, Kampala, between September 2017 and October 2019. At baseline, smear microscopy, repeat XpertMTB/RIF, Xpert Ultra and MTBDRplus assays were done on sputum specimens. Culture-based drug-susceptibility testing (DST) were done on discordant specimens. We analysed the prevalence and factors associated with discordance between initial and repeat XpertMTB/RIF RR and false XpertMTB/RIF RR. False XpertMTB/RIF RR was defined as no RR detected by any of Xpert Ultra, LPA or culture DST (reference comparator). Results A total of 126/130 patients had repeat XpertMTB/RIF results of which, 97 (77.0%) had M. tuberculosis detected of whom, 81 (83.5%) had RR detected, and 1 (1.0%) had RR indeterminate. The prevalence of discordant XpertMTB/RIF RR was 15/96 (15.6%) whereas false XpertMTB/RIF RR prevalence was 10/96 (10.4%). Low bacillary load sputum specimens were more likely to have discordant XpertMTB/RIF RR and false XpertMTB/RIF RR results, aOR (p-value: 95%CI), 0.04 (0.01; 0.00-0.37) and 0.02 (0.01; 0.01-0.35) respectively. Conclusion Our findings show a high false-positive rifampicin resistance rate in low TB burden patients, which calls for repeat testing in order to prevent unnecessary prescription of anti MDR-TB therapy.

scholarly journals Molecular Epidemiology of Pulmonary Tuberculosis in Southern Ethiopia

2020 ◽  
Author(s):  
Yared Merid ◽  
Elena Hailu ◽  
Getnet Habtamu ◽  
Melaku Tilahun ◽  
Markos Abebe ◽  
...  
Keyword(s):  
Rural Areas ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Southern Ethiopia ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
Cross Sectional

Abstract Background Understanding the epidemiology of tuberculosis (TB) is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing (DST) patterns and genetic diversity of M. tuberculosis (Mtb) isolates in Southern Ethiopia. Methodology A cross-sectional study was conducted among newly diagnosed sputum smear positive patients with TB visiting nine health facilities in southern Ethiopia from June 2015 to May 2016. Three consecutive sputum samples (spot-morning-spot) per patient were examined using acid-fast bacilli (AFB) smear microscopy with all smear positive specimens having AFB cultures performed. Mtb isolates had DST performed using indirect proportion method and were genotyped with RD9 deletion typing and spoligotyping. Spoligotyping International Types (SIT) and sub-lineages (clades) were assigned according to the SITVITWEB data base. Results Among 250 newly diagnosed patients with TB, 154 (52%) were male and 143 (57%) from rural areas. The prevalence of HIV co-infection was 4%. Of the 250 AFB positive sputum samples, 230 (92%) were culture positive. All 230 isolates were M. tuberculosis strains belonging to three lineages: Euro-American, 187 (81%); East-African-Indian, 31 (14%); and Lineage 7 (Ethiopian lineage), 8 (4%). The 230 isolates could be categorized into 65 different spoligotype patterns, of which 84% fell into 29 clusters. The dominant spoligotypes were SIT149 (21%), SIT53 (19%) and new strains (16%). Mtb strains were clustered by districts. DST revealed that 14% of Mtb isolates were resistant to > 1 first line anti-TB drugs including 11% to isoniazid. SIT 149 was the most prevalent genotype among drug resistant isolates (20%). Conclusion The study revealed several clusters including lineage 7 strains circulating in southern Ethiopia. SIT 149 (T3-ETH) was the most dominant circulating strain in the study area including among drug-resistant cases.

scholarly journals Discordance of the Repeat GeneXpert MTB/RIF test for Rifampicin Resistance Detection among Patients Initiating MDR-TB Treatment in Uganda

2020 ◽  
Author(s):  
Willy Ssengooba ◽  
Jean Iragena ◽  
Kevin Komakech ◽  
Iginitius Okello ◽  
Joanitah Nalunjogi ◽  
...  
Keyword(s):  
Treatment Initiation ◽  
Sputum Sample ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Smear Microscopy ◽  
First Line ◽  
Tb Treatment ◽  
Mulago National Referral Hospital ◽  
Mdr Tb ◽  
National Referral Hospital

Abstract We recruited all patients with Xpert Rifampicin-Resistant (RR)-TB detected, referred to the MDR-TB ward at Mulago National Referral Hospital, Kampala, Uganda for MDR-TB treatment initiation between September 2017 and October 2019. Using baseline samples collected for patients screened for STREAM 2 trial, smear microscopy, repeat Xpert test and first-line MTBDRplus assay were done. Culture-based drug-susceptibility testing was done on discordant samples. We analysed for factors associated with discordant results and false RR as determined as no RR detected by at least two of the methods used (reference standard). Of 126/130 patients who had results of repeat Xpert, 97 (77.0%) had M. tuberculosis detected of which 81 (83.5%) had RR-detected, 1 (1.0%) indeterminate. A total of 10/96 (10.4%) patients were rifampicin susceptible by at least two of the methods. Having false Xpert RR was associated with low bacillary load measured by high cycle threshold (Ct) value i.e. low (Ct 22–28) and very low (Ct > 28) of the initial Xpert test 0.09 (0.05; 0.01–1.08) and 0.02 (0.01; 0.01–0.35) respectively. Our results show that a repeat Xpert test on another sputum sample for patients with initial low M. tuberculosis detected RR-detected, would exclude 10% of the TB patients from unnecessary MDR-TB treatment initiation.

scholarly journals Drug Susceptibility Profile of Mycobacterium tuberculosis Isolated from Patients Visiting National Tuberculosis Centre, Nepal

2018 ◽  
Vol 5 ◽  
pp. 63-68
Author(s):  
S. Dahal ◽  
M.R. Banjara ◽  
D. Khadka ◽  
G. Ghimire ◽  
S. Sharma
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Mdr Tb ◽  
Lowenstein Jensen

Objectives: The objective of this study was to assess drug susceptibility pattern of Mycobacterium tuberculosis (MTB). Methods: This cross-sectional study was carried out among 145 clinically suspected and previously treated pulmonary tuberculosis patients visiting National Tuberculosis Centre, Bhaktapur, Nepal. After obtaining written informed consent, questionnaire was administered and sputum samples were collected from each patient. Each sample was subjected to Ziehl-Neelsen (ZN) staining and cultured on Lowenstein Jensen (LJ) medium at 37ºC for 8 weeks. MTB isolates were identified by growth rate and colony morphology, confirmed by biochemical tests and drug susceptibility testing (DST) of identified isolates was performed by proportion method. Results: A total of 49.7% (n=72) sputum samples were positive for MTB by culture and 46.9% (n=68) were positive by ZN staining. Among culture positive isolates of MTB (n= 72), 25% (n=18) were resistant to at least one drug. The prevalence of multi drug resistant tuberculosis (MDR-TB) was 15.3% (n=11) of which 5.56% (n=4) were resistant to rifampicin (RIF) only, 1.39% (n= 1) were resistant to isoniazid (INH) only. Out of 18 resistant isolates, 61.1% (n=11) were resistant to both RIF and INH, 21.43% (n=3) resistant to INH were susceptible to RIF and 26.67% (n=4) resistant to RIF were susceptible to INH. Smoking (P=0.001) and coughing (P=0.009) were statistically significant with isolation of MTB. Conclusion: Since the prevalence of MDR-TB was high, MDR-TB strains should be identified in order to initiate second line treatment.

scholarly journals Patterns of Drug Resistance Among Tuberculosis Patients in West and Northwestern Iran

2016 ◽  
Vol 10 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Leyla Sahebi ◽  
Khalil Ansarin ◽  
Parviz Mohajeri ◽  
Majid Khalili ◽  
Amir Monfaredan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Drug Susceptibility Testing ◽  
Effective Control ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Mdr Tb ◽  
History Of ◽  
Hiv Negative

Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases. Objective: The goal of this cross-sectional study (2011-2013;2013) was to examine the patterns of TB drug resistance among HIV-negative pulmonary TB patients in regions near the Iranian border. Method: To this end, MTB isolates were harvested from 300 HIV-negative, pulmonary smear-positive TB patients from the northwest and west Iranian border provinces. Isolates were subjected to first and second-line drug susceptibility testing by the 1% proportion method. Demographic and clinical data were provided using a questionnaire and information from patient records. Results were analyzed using SPSS-18. Results: The mean age of the patients was 52.03 years and 54.3% were male. The prevalence of resistance to any TB drug was 13.6% (38 cases). Eleven percent of the new treatment TB group (28 patients) and 40.7% of the retreatment TB group (11 patients) were resistant to all TB drugs. Twelve (4.3%) patients had multidrug-resistant tuberculosis (MDR-TB) (2.38% in the new TB treatment group and 23.1% in the retreatment group). One patient had extensively drug-resistant tuberculosis (XDR-TB). There was a statistically significant relationship between TB drug resistance and smoking (p=0.02) and a history of migration from village to city (p=0.04), also between TB drug resistance and recurrence of TB in patients that had previously received treatment (p<0.001). Conclusion: Knowledge of drug resistance patterns for new and previously treated cases is critical for effective control of MDR-TB in different regions of the country. The burden of MDR-TB in retreatment cases was high. Previous TB treatment was one of the most important mokers and those who had a history of rural to urban migration were at high risk for the occurrence of TB drug resistance.

scholarly journals Comparative study of different methods of microscopy followed by a culture method in the detection of mycobacterium tuberculosis in clinically and radiologically suspected cases of pulmonary tuberculosis

2021 ◽  
Vol 7 (2) ◽  
pp. 108-115
Author(s):  
Aarthi Sridhar ◽  
Anjana Gopi ◽  
Abhilasha Dalal ◽  
Divya Ravi
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Culture Method ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Cross Sectional ◽  
Indicator Tube ◽  
Resistant Tuberculosis ◽  
Mdr Tb

To compare the sensitivity of 2 microscopic methods for the diagnosis of Mycobacterium tuberculosis (M.tb) along with culture and drug susceptibility testing to first line drugs.: The cross-sectional study comprises 200 suspected cases of pulmonary tuberculosis both clinically and radiologically in KIMS, Bangalore over a period of 2 years. Samples (sputum/BAL fluid) were collected, processed and stained by Ziehl Neelson (ZN) and Fluorescent methods. Culture and drug susceptibilty testing was done for Streptomycin, Isoniazid, Rifampicin and Ethambutol by Mycobacterium growth indicator tube (MGIT) method after decontamination.Fischer’s test : 1. Out of 200 samples: 1.120 were male and 80 were female; 2. 18 were positive by Ziehl Neelson, 21 by Fluorescent and 28 by culture; 3. Majority of the patients belonged to age group 41-50 years (23%); 4. InMGIT, 26 were M.tb and 2 were Non-tubercular mycobacteria; 5. Out of 26 M.tb isolates, 4 were resistant to streptomycin, 6 to isoniazid, 2 to rifampicin and 9 to ethambutol.1. The sensitivity of Fluorescent staining (64.28%) is higher than that of Ziehl-Neelson (51.7%); 2. In MGIT, 26 were M.tb and 2 were Non tubercular mycobacteria; 3. 2 were Multi-drug resistant- tuberculosis (MDR-TB) This study made us aware of the need for prompt detection, identification and appropriate treatment of Tuberculosis due to the rising incidence of MDR-TB.

scholarly journals Drug Resistance among Pulmonary Tuberculosis Patients in Calabar, Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Akaninyene Otu ◽  
Victor Umoh ◽  
Abdulrazak Habib ◽  
Soter Ameh ◽  
Lovett Lawson ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
High Prevalence ◽  
Mdr Tb ◽  
Lowenstein Jensen ◽  
Proportion Method

Background. This study aimed to determine the pattern of drug susceptibility to first-line drugs among pulmonary TB patients in two hospitals in Calabar, Nigeria.Methods. This was a descriptive cross-sectional study carried out between February 2011 and April 2012. Sputum samples from consecutive TB patients in Calabar were subjected to culture on Lowenstein-Jensen (LJ) slopes followed by drug susceptibility testing (DST). The DST was performed on LJ medium by the proportion method.Results. Forty-two of the 100Mycobacterium tuberculosisstrains were found to be resistant to at least one drug. Resistance to only one drug (monoresistance) was found in 17 patients. No strains with monoresistance to rifampicin were found. Resistance to two drugs was found in 22 patients, while one patient was resistant to both three and four drugs. MDR TB was seen in 4% (4/100). The independent variables of HIV serology and sex were not significantly associated with resistance (P>0.05).Conclusion. There was a high prevalence of anti-TB drug resistance in Calabar.

scholarly journals Faktor risiko kejadian multi drug resistant tuberculosis di RSUP Dr. Sardjito

2017 ◽  
Vol 33 (7) ◽  
pp. 325
Author(s):  
Erma Nurjanah Widiastuti ◽  
Yanri Wijayanti Subronto ◽  
Dibyo Promono
Keyword(s):  
Risk Factors ◽  
Secondary Data ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Mdr Tb ◽  
Hiv Aids

PurposeThe purpose of this study was to identify the determinants of multidrug resistant events in patients with tuberculosis in Dr. Sardjito Hospital in Yogyakarta.MethodsA cross-sectional study was conducted involving 122 patients with suspected MDR TB consisting of 61 cases of MDR TB and 61 non MDR TB cases. The data collected were secondary data from MDR TB.06 registers, medical records, MDR TB.03 registers, and MDR TB patients' baseline data forms at Dr. Sardjito Hospital Yogyakarta from January 2012 until September 2016. Data were analyzed to determine the correlation between independent variables and dependent variable using Chi-Square tests, and to know the most dominant risk factors using multiple logistic regression tests.Results MDR TB patients’ characteristics showed there were more males (63.93%), age >45 years (52.46%), previously TB treatment (96.72%), never smoking (75.41%), no contacts with MDR TB patients (86.89%), and never examined for HIV-AIDS (59.02%). The analysis showed there was no significant association between age, sex, previous TB treatment, smoking, contact with MDR TB patients, and HIV-AIDS status with MDR TB incidence in Dr. Sardjito Hospital Yogyakarta (p value >0.05).Conclusion The variables of age, sex, previous TB treatment, smoking, contacts with MDR TB patients, and HIV-AIDS status were not risk factors for MDR TB incidence in Dr. Sardjito Hospital in Yogyakarta.

scholarly journals A Retrospective Cross-Sectional Study of the Utility of Cartridge-Based Nucleic Acid Amplification Test in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis in People Living with HIV in Second Highest HIV Prevalent State in India

2021 ◽  
Author(s):  
Tade Bagbi ◽  
Ningthoukhongjam Reema ◽  
S. Bhagyabati Devi ◽  
Thangjam Gautam Singh ◽  
Mohammad Jaleel ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Cross Sectional Study ◽  
Nucleic Acid Amplification Test ◽  
Nucleic Acid Amplification ◽  
Rifampicin Resistance ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Smear Negative

Abstract Introduction Tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV) is difficult to diagnose due to fewer organisms in sputum and extrapulmonary samples. Sputum culture takes 4 to 8 weeks for growth of the mycobacteria. Delayed treatment for TB in PLHIV leads to increased mortality. This study evaluated cartridge-based nucleic acid amplification test (CBNAAT) as a diagnostic tool for diagnosis of pulmonary TB (PTB) and extrapulmonary TB (EPTB) in PLHIV in the second most HIV prevalent state in India and for comparing its efficacy between Ziehl–Neelsen (ZN) staining sputum smear–positive and sputum smear–negative TB. Methods This cross-sectional study was conducted in RIMS, Imphal, with 167 PLHIV patients, age 15 years or older, having signs and symptoms of TB. Appropriate samples for sputum microscopy and CBNAAT were sent. Conclusion The overall sensitivity of sputum smear for acid-fast bacillus (AFB) was found to be 30.71% and that of CBNAAT was 38.57%. Sensitivity of CBNAAT for sputum smear–positive and sputum smear–negative TB was 100 and 11.3%, respectively. Sensitivity of ZN smear for AFB of EPTB sample was 48.1% and that of CBNAAT was 59.25%. In both PTB and EPTB, CBNAAT showed an increase in diagnosis of microbiologically confirmed PTB cases by 7.8 and 11.1%, respectively, over and above the cases diagnosed by ZN smear microscopy. Rifampicin resistance was detected in five patients. We conclude that CBNAAT is a rapid test with better sensitivity in diagnosis of PTB and EPTB in PLHIV, compared with ZN smear microscopy. It detects rifampicin resistance for multidrug-resistant TB and helps in early treatment intervention.

scholarly journals Prevalence and Determinant of Depression among Multi-Drug Resistance Tuberculosis: Study in Dr. Kariadi General Hospital

2020 ◽  
Vol 40 (2) ◽  
pp. 88-96
Author(s):  
Mahalul Azam ◽  
Arulita Ika Fibriana ◽  
Fitri Indrawati ◽  
Indah Septiani
Keyword(s):  
Drug Resistance ◽  
General Hospital ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Multi Drug Resistance ◽  
P Value ◽  
Cross Sectional ◽  
Depression Status ◽  
Prevalence Of Depression ◽  
Mdr Tb

Backgrouds: Multi-drug resistance tuberculosis (MDR-TB) adds the burden of tuberculosis (TB). Depression is a common comorbidity in TB patients. Prevalence of depression among MDR-TB patients was higher, i.e. 11-70%. Prevalence of depression among TB patients in Dr. Kariadi General Hospital was 51.9%. Previous study reported the determinants related to the depression in MDR-TB patients. This study explored the prevalence of depression in MDR-TB patients and its determinants. Methods: This study was a cross-sectional study conducted from July-August 2019. Data consisted of primary and secondary data from Dr. Kariadi General Hospital patients. Sample in this study involved 72 respondents, over 16 years old from 151 registered MDR-TB patients. Depression status was determined using Depression Anxiety Stress Scales obtained from the medical record. Subjects’ characteristics and determinants were collected from primary as well as secondary data. Descriptive data were presented in proportion. Chi-square test continued by Binary logistic regression was performed to determine the association between depression status and its determinants. A P-value

scholarly journals Peer reviewed abstract submitted to the College of Health Sciences, Osun State University Annual Scientific Conference, June 15-19, 2020

2020 ◽  
Vol 8 (2) ◽  
pp. 146-151
Author(s):  
C.A. Akinleye ◽  
A. Onabule ◽  
A.O. Oyekale ◽  
M.O. Akindele ◽  
O.J. Babalola ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Scientific Conference ◽  
Clinical Predictors ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Total Respondent ◽  
Mdr Tb ◽  
Multistage Sampling ◽  
Level Of Significance

Introduction: MDR-TB poses a significant challenge to global management of TB. Laboratories in many countries among which include Nigeria are unable to evaluate drug resistance, and clinical predictors of MDR-TB might help target suspected patients.Method: The study was a cross sectional study design. Multistage sampling technique was employed in the selection of 403 tuberculosis patients. Data were analyzed using SPSS version 25. Level of significance was set at P<0.05.Results: Fifty three 53 (13.2%) of the total respondent had MDR-TB compare to national prevalence of 8% which is steeper among males 36(67.9%) (p>0.05). Education and Occupation shows a significant association with MDR-TB, (÷2=24.640, p = 0.007) and (÷2=14.416, p=0.006) respectively, smoking (r=0.074, p<0.05) and alcohol consumption (r=0.083, p>0.05) show no significant association with occurrence MDR-TB.Conclusion: Previous TB treatment and Adherence with treatment regimen were found to be the major risk factor for MDR-TB. Targeted educational intervention for patients and their contacts may minimize the non-adherence with prescribed TB treatment and lessen MDR-TB magnitude. Key words: TB Patients, MDR-TB, tuberculosis, risk factors.

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