scholarly journals The impact of resistant strains of mycobacterium tuberculosis on relapse of tuberculosis

2006 ◽  
Vol 59 (11-12) ◽  
pp. 522-525 ◽  
Author(s):  
Jelica Videnovic-Ivanov ◽  
Violeta Vucinic-Mihailovic ◽  
Dragan Mandaric
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Medical Treatment ◽  
Extrapulmonary Tuberculosis ◽  
Previous Treatment ◽  
Huge Number ◽  
Number Of Patients ◽  
Resistant Strains ◽  
The Impact ◽  
Significant Factors

Introduction. Relapses of tuberculosis are fairly rare nowdays and they represent the onset of tuberculosis two, or more than two years after completion of previous treatment. Material and Methods. In the previous period, relapses of tuberculosis occurred in 141 patients (87 male and 54 female). Their mean age was 46.2 years. Results. Relapses of tuberculosis occurred after 11.3 years, on average. All patients presented with pulmonary tuberculosis, and two patients also had pulmonary and extrapulmonary tuberculosis(bones). Resistance was one of the statistically significant factors for relapse of tuberculosis. Resistance to one antituberculotic agent was most common - 8 patients, resistance to two drugs - 4 patients, resistance to three drugs - 4 patients, resistance to four drugs in 5 patients. Due to these findings on resistant strains of mycobacterium tuberculosis, a huge number of patients with relapses of tuberculosis had full recovery and completed the treatment. Conclusion. The importance of resistant strains of mycobacterium tuberculosis is really huge in our conditions. The findings of these resistant strains of mycobacterium tuberculosis and adequate medical treatment are obligatory nowadays. .

scholarly journals Tuberculosis in Otorhinolaryngology: Clinical Presentation and Diagnostic Challenges

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Rajiv C. Michael ◽  
Joy S. Michael
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Clinical Presentation ◽  
Extrapulmonary Tuberculosis ◽  
Common Type ◽  
The Body ◽  
Diagnostic Challenge ◽  
Cervical Adenitis ◽  
Important Form

Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80% of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) hadMycobacterium tuberculosisculture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but important form of extrapulmonary tuberculosis.

Extrapulmonary tuberculosis during the COVID-19 pandemic: features of detection and course

2021 ◽  
pp. 585-589
Author(s):  
Ekaterina V. Kulchavenia ◽  
◽  
Ekaterina V. Kulchavenia ◽  
Keyword(s):  
Negative Impact ◽  
Extrapulmonary Tuberculosis ◽  
Abdominal Tuberculosis ◽  
First Year ◽  
Large Variability ◽  
Number Of Patients ◽  
Federal Districts ◽  
Novel Coronavirus ◽  
Far Eastern ◽  
The Impact

Background. COVID-19 pandemic caused by novel coronavirus has destabilized the world's health systems, revealing flaws in the organization of work in extreme conditions. Currently, there is limited empirical data on the impact of COVID-19 on tuberculosis outcomes. Materials and methods. Non-interventional comparative retrospective cohort study of the structure of the incidence of extrapulmonary tuberculosis (EPTB) in the Siberian and Far Eastern Federal Districts for the period 1999–2020 was carried out. Data of 13 852 patients were analyzed. Results. Of all 13 852 EPTB patients who were first diagnosed during the study period, the majority of cases (973) were registered in 1999, and the smallest number (550) – in 2017. Then, for 2 years, an increase in EPTB incidence was observed again (582 cases in 2018, and 563 cases in 2019) with a natural reduction by 18.5% in 2020 (459 cases). Over the first year of the COVID-19 epidemic, the incidence of central nervous system tuberculosis decreased by almost half (by 45.9%), the incidence of peripheral lymph nodes tuberculosis remained virtually unchanged, and the number of cases of "other" localizations, mainly abdominal tuberculosis, increased by 55.3%. Overall, in the Siberian and Far Eastern Federal Districts, the detection of isolated forms of EPTB over the first year of the pandemic reduced by 18.5% (from 563 to 459 patients). A large variability of data was found across regions. Thus, in the Novosibirsk, Tomsk and Omsk regions there was a significant decrease in the number of patients diagnosed with isolated EPTB (by 30.2; 47.1 and 64.5%, respectively) while in the Kemerovo and Irkutsk regions, the number of patients with isolated EPTB increased (by 80.9 and 32.3%, respectively). Conclusion. COVID-19 has had a significant negative impact on all services of national and global healthcare, the ultimate losses we have yet to calculate. Diagnostics of any diseases, and particularly EPTB, in the first year of the pandemic was difficult due to the restriction of patient visits to medical and preventive institutions, the closure or re-profiling of some of them, as well as a decrease in the number of specialists due to their selfisolation, re-profiling and COVID-19 disease. Nevertheless, the role of EPTB is still important.

scholarly journals Mutations Associated with Rifampicin Resistance in Mycobacterium tuberculosis Isolates from Moroccan Patients: Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Rkia Eddabra ◽  
Mounsef Neffa
Keyword(s):  
Systematic Review ◽  
Mycobacterium Tuberculosis ◽  
Single Point ◽  
Rifampicin Resistance ◽  
Single Point Mutation ◽  
Target Sequence ◽  
Number Of Patients ◽  
Pubmed Database ◽  
Resistant Strains ◽  
Moroccan Patients

Background. In recent years, the treatment of tuberculosis has been threatened by the increasing number of patients with drug resistance, especially rifampicin resistance, which is the most effective first-line antibiotic against Mycobacterium tuberculosis. Methods. We performed a systematic review of the literature by searching the PubMed database for studies of rifampicin-resistant Mycobacterium tuberculosis (MTB) isolates from Moroccan patients, published between 2010 and 2020. The aim of this review was to quantify the frequency of the most common mutations associated with rifampicin resistance, to describe the frequency at which these mutations co-occur. Identified studies were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results. 6 studies met our inclusion criteria. Results show that 99.36% of MTB isolates had a single-point mutation, and the most commonly mutated codon of rpoB gene is 531 with 70.33% of phenotypically resistant strains. However, 10.38% of MTB strains phenotypically resistant to RIF did not exhibit any mutation in the rpoB gene. Conclusion. Identification of a resistance-associated mutation to rifampicin can be a good marker of drug-resistant TB, but lack of a mutation in the target sequence must be interpreted with caution.

scholarly journals Prevalence of Fluoroquinolone Resistance among Tuberculosis Patients in Shanghai, China

2009 ◽  
Vol 53 (7) ◽  
pp. 3170-3172 ◽  
Author(s):  
Peng Xu ◽  
Xia Li ◽  
Ming Zhao ◽  
Xiaohong Gui ◽  
Kathryn DeRiemer ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Molecular Marker ◽  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
Tuberculosis Treatment ◽  
Fluoroquinolone Resistance ◽  
First Line ◽  
Tuberculosis Patients ◽  
Resistant Strains ◽  
Line Drug

ABSTRACT We determined the prevalence of fluoroquinolone resistance among the isolates of Mycobacterium tuberculosis from 605 pulmonary tuberculosis patients in Shanghai, China. Mutations in gyrA were found in 81.5% of phenotypically fluoroquinolone-resistant isolates and were used as a molecular marker of fluoroquinolone resistance. gyrA mutations were detected in 1.9% of strains pan-susceptible to first-line drugs and 25.1% of multidrug-resistant strains. Fluoroquinolone resistance was independently associated with resistance to at least one first-line drug and prior tuberculosis treatment.

scholarly journals Evolutionary trajectories and transmission dynamics of multidrug-resistant Mycobacterium tuberculosis in Tibet, China

2021 ◽  
Author(s):  
Qi Jiang ◽  
Hai-can Liu ◽  
Qing-yun Liu ◽  
Jody E. Phelan ◽  
Li Shi ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Phylogenetic Trees ◽  
Multidrug Resistant ◽  
Rifampicin Resistance ◽  
Whole Genome Sequencing Data ◽  
High Burden ◽  
Increased Risk ◽  
Mdr Tb ◽  
Resistant Strains ◽  
The Impact

ABSTRACTObjectiveTibet has the highest prevalence of both tuberculosis disease and multidrug-resistant tuberculosis (MDR-TB) in China. The circulated Mycobacterium tuberculosis strains from Tibet were sequenced to investigate the underlying drivers for the high burden of MDR-TB.MethodsUsing whole-genome sequencing data of 576 M. tuberculosis strains isolated from consecutive patients in Tibet, we mapped resistance-conferring mutations onto phylogenetic trees to determine their evolution and spread. The impact of drug resistance on bacterial population growth was assessed with a Bayesian (Skyline Plot) analysis. Multivariable logistic regression was used to identify risk factors for the development of rifampicin resistance.ResultsOf the 576 isolates, 284 (49.3%), 280 (48.6%), and 236 (41.0%) were, respectively, genetically resistant to isoniazid, rifampicin, or both (MDR-TB). Among the isoniazid- and rifampicin-resistant strains, the proportions in phylogenetically-inferred clusters were 77.8% (221/284) and 62.1% (174/280), respectively. Nearly half (47.2%, 134/284) of the isoniazid-resistant strains were in six major clades, which contained between 8 and 58 strains with katG S315T, katG S315N, or fabG1 promoter −15 C>T resistance mutations. These major clades exponentially expanded after emerging with isoniazid resistance and stabilized before evolving into MDR-TB twenty years later. Isoniazid-resistant isolates showed an increased risk of accumulating rifampicin resistance compared to isoniazid-susceptible strains, with an adjusted odds ratio of 3.81 (95% confidence interval 2.47-5.95).ConclusionHistorical expansion of isoniazid-resistant strains and their increased likelihood of acquiring rifampicin resistance both contributed to the high burden of MDR-TB in Tibet, highlighting the need to detect INH-resistant strains promptly and to control their transmission.

scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Muhammad Aqeelur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
The Impact

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it. Methods New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured. Results Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase. Conclusion Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

scholarly journals Association Study of MBL2 Gene Polymorphisms and Risk of Tuberculosis in Southeast of Iran

2020 ◽  
Vol 121 (4) ◽  
pp. 236-243
Author(s):  
Mohsen Taheri ◽  
Rezvan Karimloo ◽  
Hosna Sarani ◽  
Behrouz Molashahi ◽  
Mohammad Naderi ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Gene Polymorphisms ◽  
Mbl2 Gene ◽  
Number Of Patients ◽  
Pcr Rflp ◽  
Mannose Binding ◽  
Polymerase Chain ◽  
Risk Protection ◽  
The Impact ◽  
Control Study

Mannose-binding lectin (MBL) is an acute phase protein which recognizes the pathogens through its carbohydrate recognition domain. It is an important part of human innate immunity. The aim of the current study was to evaluate the impact of MBL2 polymorphism on pulmonary tuberculosis in a number of patients from the southeast of Iran. In this case-control study, 2 MBL gene polymorphisms (rs1800450, rs7095891) were genotyped using PCR-RFLP method and polymerase chain reaction for detection of 34bp ins/del of MBL2 gene (rs777980157) polymorphism. The study included 170 patients with PTB (pulmonary tuberculosis) and 175 control subjects. The findings indicated that the GA (GA vs. GG: OR=0.172, 95% CI=0.107–0.275, P<0.001) (OR – odds ratio; CI – confidence interval) genotype as well as GA+AA (GA+AA vs. GG: OR=0.191, 95% CI=0.120–0.302, P<0.001) genotype of rs1800450 reduced the risk of PTB compared to GG genotype. The rs7095891 variant significantly decreased the risk of PTB in codominant (GA vs. GG: OR=0.118, 95% CI=0.054–0.258, P<0.001; and AA vs. GG: OR=0.029, 95% CI=0.01–0.082, P<0.001), dominant (GA+AA vs. GG: OR=0.095, 95% CI=0.044–0.207, P<0.001) and recessive (AA vs. GA+GG: OR=0.172, CI=0.081–0.365, P<0.001) inheritance models. No significant relationship was identified between the rs777980157 variant and PTB risk/protection. In conclusion, we found that the MBL2 rs1800450 and rs7095891 polymorphisms provide relative protection against PTB. Additional studies on larger populations with different ethnicities are required to verify our findings.

scholarly journals Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure

2019 ◽  
Author(s):  
Atiqa Ambreen ◽  
Muhammad Jamil ◽  
Muhammad Aqeelur Rahman ◽  
Tehmina Mustafa
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Care Hospital ◽  
Continuation Phase ◽  
Pulmonary Tb ◽  
Direct Smear ◽  
Smear Examination ◽  
End Of Treatment ◽  
The Impact

Abstract Background Pulmonary tuberculosis (TB) with detectable Mycobacterium tuberculosis in the sputum is a major source of transmission. In resource limited TB endemic settings, cure is declared through sputum smear examination for acid fast bacilli without performing culture. This may lead to erroneous treatment outcomes as viable bacteria may be missed due to the low sensitivity of direct smear method. The aim of this study was to investigate if sterilizing cure is achieved among the new pulmonary TB cases declared cured by sputum smear conversion and to evaluate the impact of addition of ethambutol in the continuation phase in achieving it. Methods New sputum smear-positive pulmonary TB patients registered at a tertiary care hospital in Pakistan from November 2013 to March 2014 were followed under standard Directly Observed Treatment Short Course strategy for six months. Half of these patients received ethambutol in addition to isoniazid and rifampicin in the continuation phase. Sputum specimens were examined on microscopy at 2 months and at the end of treatment. Sputa of patients with negative direct smear examination at the end of treatment were cultured. Results Among 5746 TB suspects, 1595 were new sputum smear positive pulmonary TB cases, and 533 were registered at our hospital. Among these, 504 converted sputum negative at 2 months and 348 converted at the end of six months of treatment and were declared cured. Sputa of 204/348 patients were cultured, and 12/204 (6%) were culture-positive. Culture positivity at 6 months was not associated with bacterial load, smoking, diabetes, presence of cavities, history of contact with TB patients, age, sex, socioeconomic status, or addition of ethambutol in the continuation phase. Conclusion Viable cultivable bacilli were detected in 6% of cured patients, which would have significant impact on the control of TB. This highlights the need for an inexpensive and accurate surrogate marker for culture as it is not feasible to perform culture in routine for monitoring treatment response in the low-resource settings. The treatment outcome did not improve by addition of ethambutol emphasizing the need to find the optimal duration of treatment for individual or carefully selected groups of patients.

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