Extensively Drug-Resistant Tuberculosis Treatment Disappointing Outcomes for Global Public Health

2013 ◽  
Vol 8 (4) ◽  
Author(s):  
Masoud Mardani
Keyword(s):  
Public Health ◽  
Tuberculosis Treatment ◽  
Drug Resistant ◽  
Global Public Health ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

scholarly journals Pre-detection history of extensively drug-resistant tuberculosis in KwaZulu-Natal, South Africa

2019 ◽  
Vol 116 (46) ◽  
pp. 23284-23291 ◽  
Author(s):  
Tyler S. Brown ◽  
Lavanya Challagundla ◽  
Evan H. Baugh ◽  
Shaheed Vally Omar ◽  
Arkady Mustaev ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Whole Genome ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Kwazulu Natal ◽  
History Of

Antimicrobial-resistant (AMR) infections pose a major threat to global public health. Similar to other AMR pathogens, both historical and ongoing drug-resistant tuberculosis (TB) epidemics are characterized by transmission of a limited number of predominant Mycobacterium tuberculosis (Mtb) strains. Understanding how these predominant strains achieve sustained transmission, particularly during the critical period before they are detected via clinical or public health surveillance, can inform strategies for prevention and containment. In this study, we employ whole-genome sequence (WGS) data from TB clinical isolates collected in KwaZulu-Natal, South Africa to examine the pre-detection history of a successful strain of extensively drug-resistant (XDR) TB known as LAM4/KZN, first identified in a widely reported cluster of cases in 2005. We identify marked expansion of this strain concurrent with the onset of the generalized HIV epidemic 12 y prior to 2005, localize its geographic origin to a location in northeastern KwaZulu-Natal ∼400 km away from the site of the 2005 outbreak, and use protein structural modeling to propose a mechanism for how strain-specific rpoB mutations offset fitness costs associated with rifampin resistance in LAM4/KZN. Our findings highlight the importance of HIV coinfection, high preexisting rates of drug-resistant TB, human migration, and pathoadaptive evolution in the emergence and dispersal of this critical public health threat. We propose that integrating whole-genome sequencing into routine public health surveillance can enable the early detection and local containment of AMR pathogens before they achieve widespread dispersal.

scholarly journals Emergence of Low-level Delamanid and Bedaquiline Resistance During Extremely Drug-resistant Tuberculosis Treatment

2019 ◽  
Vol 69 (7) ◽  
pp. 1229-1231 ◽  
Author(s):  
Silke Polsfuss ◽  
Sabine Hofmann-Thiel ◽  
Matthias Merker ◽  
David Krieger ◽  
Stefan Niemann ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
New Drugs ◽  
Tuberculosis Treatment ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Low Level ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

Abstract Two new drugs, delamanid and bedaquiline, have recently been approved for treatment of multidrug-resistant and extensively drug-resistant (XDR) tuberculosis. Here, we report a case of clofazimine, bedaquiline, and low-level delamanid resistances acquired during treatment of a patient with XDR tuberculosis.

scholarly journals Translating basic science insight into public health action for multidrug- and extensively drug-resistant tuberculosis

Respirology ◽  
2012 ◽  
Vol 17 (5) ◽  
pp. 772-791 ◽  
Author(s):  
NICHOLAS D. WALTER ◽  
MICHAEL STRONG ◽  
ROBERT BELKNAP ◽  
DIANE J. ORDWAY ◽  
CHARLES L. DALEY ◽  
...  
Keyword(s):  
Public Health ◽  
Basic Science ◽  
Drug Resistant ◽  
Public Health Action ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Health Action ◽  
Insight Into

scholarly journals Managing an extensively drug-resistant tuberculosis outbreak: the public health face of the medal

2014 ◽  
Vol 45 (1) ◽  
pp. 292-294 ◽  
Author(s):  
Luigi R. Codecasa ◽  
Giorgio Ciconali ◽  
Ester Mazzola ◽  
Maurizio Ferrarese ◽  
Daniela Cirillo ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
The Public ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant
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