scholarly journals Association of Dietary Micronutrient Intake with Pulmonary Tuberculosis Treatment Failure Rate: ACohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2491
Author(s):  
Ke Xiong ◽  
Jinyu Wang ◽  
Jianwen Zhang ◽  
Haibo Hao ◽  
Qiuzhen Wang ◽  
...  

Malnutrition is associated with an increased risk of pulmonary tuberculosis (PTB) treatment failure. Currently, there is no effective adjunctive nutritional therapy. The current objective is to investigate the association of dietary micronutrient intake with PTB treatment outcome.A cohort study including 1834 PTB patients was conducted in Linyi, China. The dietary micronutrient intake was assessed through a three-day 24 h dietary recall questionnaire. The treatment outcome was assessed by combinations of sputum smear and computerized tomography results. A multivariate binary regression model was used to assess the associations. The final model was adjusted for potential confounding factors. A low intake of vitamin C (adjusted OR (95% CI): 1.80 (1.07, 3.04), Ptrend = 0.02) and Zn (adjusted OR (95% CI): 2.52 (1.25, 5.08), Ptrend = 0.02) was associated with a high treatment failure rate. In addition, a low intake of vitamin C and Mn was associated with a severe tuberculosis symptom, as indicated by a high TB score. A supplementation of vitamin C and Zn may be beneficial in PTB treatment. Previous meta-analysis of randomized controlled trials (RCTs) reported a null effect of Zn supplementation on PTB treatment. The effect of vitamin C supplementation should be investigated by RCTs.

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Y. B. Jibrin ◽  
A. B. Ali ◽  
S. T. Saad ◽  
P. M. Kolo

Treatment failure in patients with pulmonary tuberculosis poses a great danger to the global effort in control of tuberculosis. This study evaluated prevalence of treatment failure among pulmonary tuberculosis patients at Federal Medical Centre (FMC) Gombe, Nigeria. Consecutive patients managed between August 2008 and August 2009 at the Directly Observed Therapy (Tuberculosis) Unit of our hospital were enrolled for the study. Sputum specimens were collected from each patient at entry for Acid Fast Bacilli and repeated at the end of 2nd, 5th and 7th month of treatment. Of the 247 patients recruited, 200 patients consisting of 118 (59%) males and 82 (41%) females aged 15–78 years with a mean of 36.8 ± 12.4 years completed the study. One hundred and fifteen (57.5%) of the patients were sputum smear positive at entry while 85 (42%) were negative. Among 115 smear positive patients at baseline, 80 patients (69.6%), 26 (22.6%) and 24 (20.9%) remained positive after 2nd, 5th and 7th month of treatment respectively. In conclusion, there is a high treatment failure rate (22.6%) among our TB patients; and this poses a great danger to healthcare personnel and close contacts in the community.


Author(s):  
Farnaz Mohammadzadeh ◽  
Mahrokh Dolatian Ph.D. ◽  
Masoumeh Jorjani ◽  
Pharm D. ◽  
Maryam Afrakhteh ◽  
...  

Background: Chlamydia Trachomatis is one of the most common pathogens transmitted through the genital tract in humans that leads to urogenital infection. Objective: Given the high prevalence of chlamydia infection and its adverse effects on the health of women and men, the present meta-analysis was conducted to determine the rate of treatment failure with azithromycin. Materials and Methods: Databases including MEDLINE, ISI - Web of Science, PubMed, EMBASE, Scopus, ProQuest, and Science Direct were searched for articles published between 1991 and 2018. The quality of the selected articles was assessed using the Cochrane risk of bias assessment tool. Heterogeneity was determined using the I2 and Cochrane Q-Test. Subgroup analysis and meta-regression were used to compare the prevalence rates on different levels of the variables. Results: A total of 21 articles that met the inclusion criteria were ultimately assessed. The pooled estimate of azithromycin failure rate was 11.23% (CI 95%: 8.23%-14.24%). Also, the azithromycin failure rate was 15.87% (CI 95%: 10.20%-21.54%) for the treatment of urethritis, 7.41% (CI 95%: 0.60%-14.22%) for cervicitis, and 7.14% (CI 95%: 10.90%-3.39%) for genital chlamydia. The pooled estimate of failure rate difference was 2.37% (CI 95%: 0.68%-4.06%), which shows that azithromycin has a higher failure rate in the treatment of chlamydia compared to doxycycline and other examined medications. The meta-regression results showed that the patient’s age contributes significantly to the heterogeneity for azithromycin treatment failure rate (β = 0.826; p = 0.017). Conclusion: Azithromycin has a higher failure rate than doxycycline and other studied medications in treating urogenital chlamydia infections. Key words: Azithromycin, Chlamydia trachomatis, Urogenital, Treatment failure, Meta-analysis.


2020 ◽  
Author(s):  
Bruno Alves Rudelli ◽  
Pedro Nogueira Giglio ◽  
Vladimir Cordeiro Carvalho ◽  
Jose Ricardo Pecora ◽  
Henrique Melo Campos Gurgel ◽  
...  

Abstract BACKGROUND: debridement, antibiotics and implant retention (DAIR) with the exchange of modular components is the most widely used option for the treatment of acute periprosthetic joint infections. The objective of this study is to evaluate the effect of bacteria drug resistance profile on the success rates of DAIR. METHODS: All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics.RESULTS: Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistant Staphylococcus aureus (MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p<0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p=0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p<0.05).CONCLUSION: DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.


2020 ◽  
Vol 26 (5) ◽  
pp. 398-402
Author(s):  
Haibo Ge ◽  
Shi Chen ◽  
Jia Zhu

This meta-analysis was conducted to assess the consistency and strength of the relationship between polymorphism of IL-2 -330T/G and susceptibility to pulmonary tuberculosis (TB). PubMed, Web of Knowledge and CNKI were searched to find eligible studies about the relationship between IL-2 -330T/G polymorphism and susceptibility to pulmonary TB. A total of eight studies comprising 971 cases and 1519 controls were grouped together for the purpose of elucidating the relationship between polymorphism of IL-2 -330T/G and pulmonary TB susceptibility. The allele model (G vs. T: odds ratio (OR) = 1.34; 95% confidence interval (CI) 1.05–1.71, Phet = 0.001) and the recessive model (GG+GT vs. TT: OR = 1.60; 95% CI 1.08–2.38, Phet = 0.0001) showed an increased risk of development of pulmonary TB. However, the homozygous model (GG vs. TT: OR = 1.74; 95% CI 0.98–3.09, Phet = 0.0005) and the dominant model (GG vs. TT + TG: OR = 1.30; 95% CI = 0.80-2.14, Phet =  0.001) failed to show an increased incidence of pulmonary TB. When analysis was stratified by ethnicity, no obvious associations were identified in the Caucasian subgroup under all four genetic models. Additionally, heterogeneity disappeared in the analysis of Caucasian subgroup. Our combined data suggested that there was no association between IL-2 -330T/G polymorphism and pulmonary TB among Caucasians.


1987 ◽  
Vol 7 (1) ◽  
pp. 31-33 ◽  
Author(s):  
David Bennett-Jones ◽  
Val Wass Penny ◽  
Mawson David Taube ◽  
Guy Neild Chisholm ◽  
Ogg J Stewart Cameron ◽  
...  

Eighty patients with CAPD peritonitis were randomised to receive either intraperitoneal (IP) vancomycin and tobramycin, or intravenous (IV) van-comycin and tobramycin followed by oral antibiotics, depending on the results of culture and sensitivity. Five patients were withdrawn, and, of the remaining patients, 39 were in the IP group and 36 in the IV group. When all episodes of bacterial peritonitis are considered, the treatment failure rate was higher in the IV group (34.1%), than in the IP group (10.3%) (p < 0.02). This was also the case when gram-positive organisms resistant to tobramycin were considered separately (p < 0.05), but not for vancoinycin-resistant organisms. We conclude that vancomycin should be administered by the intraperitoneal route: the case for intraperitoneal tobramycin is “not proven”.


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