scholarly journals Prevalence, risk and genetic characteristics of drug-resistant tuberculosis in a tertiary care tuberculosis hospital in China

2019 ◽  
Vol Volume 12 ◽  
pp. 2457-2465
Author(s):  
Li-li Zhao ◽  
Ming-xiang Huang ◽  
Tong-yang Xiao ◽  
Hai-can Liu ◽  
Ma-chao Li ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Genetic Characteristics ◽  
Resistant Tuberculosis

Multi-drug-resistant tuberculosis: the experience of an urban tertiary care hospital in South India using automated BACTEC 460 TB

2011 ◽  
Vol 42 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Baijayanti Mishra ◽  
Smitha Mary Rockey ◽  
Soham Gupta ◽  
Hiresave Srinivasa ◽  
Sethumadhavan Muralidharan
Keyword(s):  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis

Epidemiological and behavioural correlates of drug-resistant tuberculosis in a Tertiary Care Centre, Delhi, India

2019 ◽  
Vol 66 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Kevisetuo A. Dzeyie ◽  
Saurav Basu ◽  
Tanzin Dikid ◽  
Anuj K. Bhatnagar ◽  
L.S. Chauhan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Drug Resistant ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis

scholarly journals 1363. Does Genotypic Testing Improve Treatment Outcomes in Drug-Resistant Tuberculosis?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S493-S494
Author(s):  
Anupa Thampy ◽  
Marilyn Ninan ◽  
Joy Sarojini Michael ◽  
Priscilla Rupali
Keyword(s):  
Treatment Outcomes ◽  
Care Center ◽  
Tertiary Care ◽  
Small Sample ◽  
Adverse Outcomes ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Good Outcome ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

Abstract Background Treatment of drug-resistant tuberculosis (DR-TB) requires toxic and complex drug regimens. Dismal outcomes occur due to a delay in the report of susceptibility results. WHO endorses genotypic tests like line probe assay (Mtbdrsl) for an early diagnosis enabling start of robust treatment regimens. Data correlating Mtbdrsl and specific mutations with outcome are rare. Methods A concurrent cohort study was conducted on all patients diagnosed to have DR-TB between January 2016 and June 2017 in the departments of Pulmonary Medicine and Infectious Diseases at a tertiary care center in India. Patients aged >18 years with a positive Mtbdrsl (done on culture) or Mycobacterial culture were prospectively followed up till completion of therapy for assessment of outcomes. Patients were divided into 2 groups based on diagnostic method used: culture group and Mtbdrsl group. Risk factors for adverse outcomes were assessed. Results Total of 82 patients, of which 62.2% were males with a mean age of 32 years were included; 50 in the Mtbdrsl group and 32 in the culture group. Among these, 40.2% were multi-drug-resistant Tuberculosis (MDR-TB), 53.7% were Pre–XDR (pre-extensively drug resistant i.e, quinolone-resistant tuberculosis) and 6.1% were XDR (extensively drug-resistant TB). Isolated pulmonary involvement (46.3%) was common followed by disseminated TB (29.3%). Overall good outcome was seen in 39/82 (14.6% cured and 32.9% completed treatment) and bad outcome in 43/82 (41.5% lost to follow up, 7.3% treatment failure and 3.7% died). Good outcome was noted in Mtbdrsl group was 22/50 (44%) vs. 17/32 (53.1%) in the culture group. Mtbdrsl group had 140 days mean decrease in time to initiation of appropriate therapy but the odds of having a better outcome was 0.693 (CI: 0.284–1.690, P = 0.499). Among the 15 different types of mutations, FQ mutations gyrA 94Gly and gyrA 90Val comprised 15% each with gyrA 94Gly noted to have a poorer outcome [OR 2.5 (CI 0.471–13.265)]. All 5 patients with XDR TB (50 % had rrs 1401Gly mutation) had a poor outcome. Conclusion Contrary to what is expected, Mtbdrsl did not significantly contribute to better treatment outcomes. High-risk mutation gyrA 94Gly was prevalent and associated with poorer outcomes. Small sample size and a wide variety of mutations preclude generalizability of our results. Disclosures All authors: No reported disclosures.

scholarly journals The study of adverse drug reactions in indoor patients of tuberculosis taking standardized antitubercular therapy (directly observed treatment short-course and programmatic management of drug resistant tuberculosis) in a tertiary care hospital at Surat

2021 ◽  
Vol 10 (5) ◽  
pp. 507
Author(s):  
Payal P. Naik ◽  
Arvindsingh Panwar ◽  
Swati Patel
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Short Course ◽  
Directly Observed Treatment

Background: Tuberculosis is a serious public health issue in India. The treatment regimen followed is Directly observed treatment short-course (DOTS) and Programmatic Management of Drug resistant Tuberculosis (PMDT) approach. In a long period of treatment adverse drug reactions (ADRs) can be an important programmatic issue. Thus, study was undertaken to assess the ADRs caused by antitubercular therapy in indoor patients in a tertiary care hospital at Surat.Methods: The Observational, prospective study was carried out for one year period. The causality was determined by WHO UMC scale and severity was determined by Modified Hartwig and Siegel scale. Chi square test was applied for statistical analysis.Results: Among 255 tuberculosis patients, 85 (33.3%) patients developed ADRs. Occurrence of ADRs was more among females (46.6%). The commonly involved systems are gastrointestinal (40.6%) followed by haematological (17.9%). The most common ADRs observed were nausea and vomiting (21.7%). High percentage of ADRs causing drugs were isoniazid (30.6%) followed by rifampicin (26.1%). Causality assessment showed 60.4% ADRs were possible, 37.7% ADRs were probable and 1.9% ADRs was certain. Severity assessment scale showed 81.1% of moderate, 12.3% of mild and 6.6% of severe grading. Occurrence of ADRs was more among PMDT (60%) in comparison to DOTS therapy (31.06%) [p value = 0.0084 (significant p value < 0.05)].Conclusions: Antitubercular treatment is safer but early detection, management and reporting of ADRs is required to prevent it at initial stage and helps to decrease default rate.

scholarly journals AN EPIDEMIOLOGICAL STUDY OF DRUG RESISTANT TUBERCULOSIS CASES REGISTERED UNDER DOTS PLUS CENTER IN A RURAL BASED TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Manish Kumar Munda ◽  
Dr. Niranjan Kumar Sit ◽  
Dr. Rupam Kumar Ta ◽  
Dr Santanu Ghosh
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Previous History ◽  
Lower Class ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Number Of Patients ◽  
Almost All

Background: Drug resistance in tuberculosis is a global problem and India is no exception to this. However, this rise is mainly among the previously treated cases as previous antituberculosis therapy is the single most important risk factor for the development of drug resistance. The worldwide prevalence of drug resistant tuberculosis is on the rise and multiple studies give varying data regarding the epidemiology of drug resistant tuberculosis. This study was taken up to determine the demographic profile of a patient, previous history of anti tubercular drug intake and pattern of drug resistant. Design: Prospective observational study. Methods and Materials: Patient who are Sputum positive, diagnosed drug resistant tuberculosis and fulfill the inclusion and exclusion criteria, admitted from March 2015 February 2016 in DOTS PLUS centre, BMCH, Burdwan. To accomplish the objectives, information was collected by personal interviews using pre-designed, pre-tested proforma. Data, so collected, was analyzed and tabulated using appropriate statistical software. Results: More than 2/3rd were males and majority were in age group 18-55 years, educated up to primary level, living in overcrowded and ill-ventilated houses belongs to upper lower and lower class (IV & V) on Kuppuswamy‘s SES 2014. Initially almost all had pulmonary TB. At the start of category II, maximum number of patients was relapse cases. The prime cause being financial crunch and lack of knowledge. Resistance to both rifampicin and isoniazide (MDR) was found in more than 2/3rd of cases. 3 patients (3%) were reactive for HIV in the study. Conclusion: In general even after considering so many diversified variables it could be stated that most of the patients perceived some degree of improvement in their condition following treatment.

scholarly journals A study of adverse drug reactions in patients receiving treatment for multi-drug resistant tuberculosis

2017 ◽  
Vol 6 (2) ◽  
pp. 354
Author(s):  
Mayur P. Shinde ◽  
Nimish R. Halasawadekar ◽  
Sunita J. Ramanand ◽  
Shraddha M. Pore ◽  
Jayprakash B. Ramanand ◽  
...  
Keyword(s):  
Early Detection ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Resistant ◽  
Drug Reactions ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Mdr Tb

Background: A high frequency of adverse drug reactions (ADRs) is one of the major challenges in the treatment of Multi-drug resistant tuberculosis (MDR-TB). Patients may refuse to continue treatment if ADRs are not properly addressed, drugs may be stopped unnecessarily and treatment may be terminated prematurely by inexperienced health workers, resulting in a high proportion of failure.Methods: Patients diagnosed for MDR-TB and registered in Drug Resistant TB centre (DR-TB) of tertiary care hospital during period of July 2014 to June 2015 were enrolled in the study. Data of patients hospitalized for the complaints of ADR in DR-TB centre during study period was collected.Results: Out of 468 patients, 60 (12.82%) patients developed at least one adverse reaction and were hospitalised for the same. Among 109 reported ADRs, Gastrointestinal upset was the most common ADR reported (5.98%) followed by psychosis (4.91%) and ototoxicity (2.99%).Conclusions: The health providers, the patients and their relatives should be sensitised about these ADRs for early detection and treatment. It can also be suggested that the setup of DR-TB centre should be integrated with psychiatry and ENT specialities, with all the provisions of early detection of ADR and treatment.

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