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Kumar G, Kumar M, Muni S, Kumar R, Shankar M, Kumar R, Kumari N. Study of Culture Conversion in Drug-Resistant Pulmonary Tuberculosis on All-Oral Longer Regimen at IGIMS, Patna. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1549-S1553. [PMID: 38882839 PMCID: PMC11174214 DOI: 10.4103/jpbs.jpbs_407_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 06/18/2024] Open
Abstract
Background Multidrug-resistant tuberculosis (MDR-TB) refers to tuberculosis that resists at least two primary drugs, namely isoniazid and rifampicin. To assess the management of MDR-TB, sputum culture conversion is performed. This study aimed to determine the culture conversion status of MDR-TB patients undergoing an all-oral longer regimen. Methods This research constitutes an observational and prospective study conducted within a hospital setting. The study was done at the Department of Microbiology, IGIMS, Patna, from October 2020 to March 2022. Culture conversion in multidrug resistance pulmonary tuberculosis on all-oral longer regimens took one spot and one morning sample of sputum as per standard protocol after completing two months of all-oral longer regimens and culturing it in liquid broth using Mycobacterium Growth Indicator Tube (MGIT) 960 System at two, four then six months till we got a negative result. Results Maximum number of the cases, 77 (74.8%), belonged to 19-35 years of age group. Males were 68 (66.1%) and females were 35 (33.9%), respectively, with male to female ratio of 1.9:1. After 2 months of oral longer regimen treatment, out of 103 cases, we found 98 (95.1%) patients had sputum for culture positive and only five (4.2%) patients had sputum for culture negative. After 6 months of oral longer regimen treatment, out of 101 cases, we found 16 (15.8%) patients had sputum for culture positive and 85 (85.2%) patients had sputum for culture negative. Conclusion In patients with multidrug-resistant pulmonary tuberculosis (MDR-TB) who received an all-oral longer regimen, the introduction of bedaquiline led to positive outcomes as evidenced by a greater number of negative sputum cultures, a decrease in culture reversions, and a reduced risk of developing a more resistant form of MDR-TB.
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Affiliation(s)
- Gudesh Kumar
- Department of Microbiology, IGIMS, Patna, Bihar, India
| | - Manish Kumar
- Department of Microbiology, IGIMS, Patna, Bihar, India
| | - Sweta Muni
- Department of Microbiology, IGIMS, Patna, Bihar, India
| | - Rakesh Kumar
- Department of Microbiology, IGIMS, Patna, Bihar, India
| | - Manish Shankar
- Department of Pulmonary Medicine, IGIMS, Patna, Bihar, India
| | - Randhir Kumar
- Department of Microbiology, IGIMS, Patna, Bihar, India
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Purkan P, Hadi S, Retnowati W, Sumarsih S, Wahyuni DK, Piluharto B, Panjaitan TM, Ifada C, Nadila A, Nabilah BA. Exploring of pyrazinamidase recombinant activity from PZA-sensitive and resistant Mycobacterium tuberculosis expressed in Escherichia coli BL21 (DE3). BRAZ J BIOL 2024; 84:e278911. [PMID: 38422295 DOI: 10.1590/1519-6984.278911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/15/2024] [Indexed: 03/02/2024] Open
Abstract
The mutations of pncA gene encoding pyrazinamidase/PZase in Mycobacterium tuberculosis are often associated with pyrazinamide/PZA resistance. The H and R1 isolates showed significant phenotypic differences to PZA. The H isolate was PZA sensitive, but R1 was PZA resistant up to 100 ug/ml. The paper reports the pncA profile for both isolates and the activity of their protein expressed in Escherichia coli BL21(DE3). The 0.6 kb of each pncA genes have been subcloned successfully into the 5.4 kb pET30a vector and formed the pET30a-pncA recombinant with a size of 6.0 kb. The pncAR1 profile exhibited base mutations, but not for pncAH against to pncA from the PZA-sensitive M. tuberculosis H37RV published in Genbank ID: 888260. Three mutations were found in pncAR1, ie T41C, G419A, and A535G that subsequently changed amino acids of Cys14Arg, Arg140His and Ser179Gly in its protein level. The mutant PZase R1 that expressed as a 21 kDa protein in E. coli Bl21(DE3) lost 32% of its performance in activating PZA drug to pyrazinoic acid/POA compared to the wild-type PZase H. The mutation in the pncAR1 gene that followed by the decreasing of its PZase activity underlies the emergence of pyrazinamide resistance in the clinical isolate. Structural studies for the R1 mutant PZase protein should be further developed to reveal more precise drug resistance mechanisms and design more effective TB drugs.
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Affiliation(s)
- P Purkan
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - S Hadi
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - W Retnowati
- Airlangga University, Faculty of Medicine, Department of Microbiology, Surabaya, Indonesia
| | - S Sumarsih
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - D K Wahyuni
- Airlangga University, Faculty of Science and Technology, Department of Biology, Surabaya, Indonesia
| | - B Piluharto
- Jember University, Faculty of Mathematic and Natural Sciences, Department of Chemistry, Jember, Indonesia
| | - T M Panjaitan
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - C Ifada
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - A Nadila
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
| | - B A Nabilah
- Airlangga University, Faculty of Science and Technology, Department of Chemistry, Surabaya, Indonesia
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Mohamed MA, Ali OA, Osman AM, Abatcha MG, Ahmed AA, Ali AM, Dirie AA, de Oliveira CJB, Osman AY, Wang SH, Vieira RFC. Assessment of drug-susceptible and multidrug-resistant tuberculosis (MDR-TB) in the Central Region of Somalia: A 3-year retrospective study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002319. [PMID: 37676848 PMCID: PMC10484424 DOI: 10.1371/journal.pgph.0002319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) remains a public health emergency and a threat globally. Although increasing MDR-TB cases have been recently reported in Somalia, limited information is known. This study aims to determine the prevalence of drug-susceptible and MDR-TB in suspected patients referred to the TB Department in Mudug Hospital, Galkayo, Somalia, and identify potential factors associated with MDR-TB. METHODS A 3-year hospital laboratory-based retrospective study was conducted by manually reviewing laboratory records of Mycobacterium tuberculosis specimens and GeneXpert MTB/RIF results from January 2019 to December 2021 at the reference mycobacteria laboratory department in Mudug Hospital. RESULTS A total of 714 positive GeneXpert-MTB results were identified: 619 (86.7%) were drug susceptible (no Rifampin resistance [RR] detected) and 95 (13.3%) with RR detected or defined as MDR-TB. Most of the MDR-TB patients were males (71.6%, 68/95) and between the ages of 15 to 24 (31.6%, 30/95). Most isolates were collected in 2021 (43.2%, 41/95). Multivariate analyses show no significant difference between patients having MDR-TB and/or drug-susceptible TB for all variables. CONCLUSION This study showed an alarming frequency of MDR-TB cases among M. tuberculosis-positive patients at a regional TB reference laboratory in central Somalia.
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Affiliation(s)
- Mohamed Abdelrahman Mohamed
- Somali National Institutes of Health, Ministry of Health, Mogadishu, Somalia
- Faculty of Veterinary Medicine and Animal Husbandry, Somali National University, Mogadishu, Somalia
| | | | - Aamir Muse Osman
- Somali One Health Centre, Abrar University, Mogadishu, Somalia
- Vector-Borne Diseases Laboratory, Department of Veterinary Medicine, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
- College of Veterinary Medicine, Abrar University, Mogadishu, Somalia
| | - Mustapha Goni Abatcha
- Veterinary Service Department, Ministry of Agriculture and Natural Resources, Damaturu, Yobe State, Nigeria
| | | | - Ali Mohamed Ali
- Food and Agriculture Organization of the United Nations, Mogadishu, Somalia
| | | | - Celso José Bruno de Oliveira
- Department of Animal Science, College of Agricultural Sciences, Federal University of Paraíba, Areia, Paraiba, Brazil
- Global One Health Initiative, The Ohio State University, Columbus, Ohio, United States of America
| | - Abdinasir Yusuf Osman
- Somali National Institutes of Health, Ministry of Health, Mogadishu, Somalia
- The Royal Veterinary College, University of London, Hatfield, United Kingdom
| | - Shu-Hua Wang
- Global One Health Initiative, The Ohio State University, Columbus, Ohio, United States of America
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Rafael F. C. Vieira
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
- Center for Computational Intelligence to Predict Health and Environmental Risks, University of North Carolina at Charlotte, Charlotte, North Carolina, United States of America
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Li A, Yuan SY, Li QG, Li JX, Yin XY, Liu NN. Prevalence and risk factors of malnutrition in patients with pulmonary tuberculosis: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1173619. [PMID: 37636566 PMCID: PMC10448260 DOI: 10.3389/fmed.2023.1173619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/30/2023] [Indexed: 08/29/2023] Open
Abstract
Background Malnutrition is prevalent in patients with pulmonary tuberculosis (PTB) and is associated with a poor prognosis. Objective This study aims to assess the prevalence and risk factors of malnutrition in patients with PTB. Methods Studies related to the prevalence and risk factors of malnutrition in patients with PTB were searched through PubMed, Embase, Web of Science, and Cochrane Library databases from January 1990 to August 2022, and two researchers screened the literature, evaluated the quality, and extracted data independently. A random-effects model was used to pool the effect sizes and 95% confidence intervals. Subgroup analysis, meta-regression analysis, and sensitivity analysis were further performed to identify sources of heterogeneity and evaluate the stability of the results. Publication bias was assessed by Doi plot, Luis Furuya-Kanamori (LFK) asymmetry index, funnel plot, and Egger's tests. Results A total of 53 studies involving 48, 598 participants were identified in this study. The prevalence of malnutrition was 48.0% (95% CI, 40.9-55.2%). Subgroup analysis revealed that malnutrition was more common among male gender (52.3%), bacterial positivity (55.9%), family size over 4 (54.5%), drug resistance (44.1%), residing in rural areas (51.2%), HIV infection (51.5%), Asian (51.5%), and African (54.5%) background. The prevalence of mild, moderate, and severe malnutrition was 21.4%, 14.0%, and 29.4%, respectively. Bacterial positivity (OR = 2.08, 95% CI 1.26-3.41), low income (OR = 1.44, 95% CI 1.11-1.86), and residing in rural areas (OR = 1.51, 95% CI 1.20-1.89) were risk factors of malnutrition in patients with PTB. However, male (OR = 1.04, 95% CI 0.85-1.26) and drinking (OR = 1.17, 95% CI 0.81-1.69) were not risk factors for malnutrition in patients with PTB. Due to the instability of sensitivity analysis, HIV infection, age, family size, smoking, and pulmonary cavity need to be reevaluated. Meta-regression suggested that sample size was a source of heterogeneity of prevalence. The Doi plot and LFK asymmetry index (LFK = 3.87) indicated the presence of publication bias for prevalence, and the funnel plot and Egger's test showed no publication bias for risk factors. Conclusion This meta-analysis indicated that malnutrition was prevalent in patients with PTB, and bacterial positivity, low income, and those residing in rural areas were risk factors for malnutrition. Therefore, clinical workers should pay attention to screening the nutritional status of patients with PTB and identifying the risk factors to reduce the incidence of malnutrition and provide nutritional interventions early to improve the prognosis in patients with PTB.
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Affiliation(s)
| | | | | | | | | | - Na-na Liu
- Department of Respiratory Critical Care Medicine, The Second People's Hospital of Weifang, Weifang, Shandong, China
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Duga AL, Salvo F, Kay A, Figueras A. Safety Profile of Medicines Used for the Treatment of Drug-Resistant Tuberculosis: A Descriptive Study Based on the WHO Database (VigiBase ®). Antibiotics (Basel) 2023; 12:antibiotics12050811. [PMID: 37237714 DOI: 10.3390/antibiotics12050811] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The introduction of new drugs that increase the usage of repurposed medicines for managing drug-resistant tuberculosis (DR-TB) comes with challenges of understanding, properly managing, and predicting adverse drug reactions (ADRs). In addition to the health consequences of ADRs for the individual, ADRs can reduce treatment adherence, thus contributing to resistance. This study aimed to describe the magnitude and characteristics of DR-TB-related ADRs through an analysis of ADRs reported to the WHO database (VigiBase) in the period from January 2018 to December 2020. METHODS A descriptive analysis was performed on selected reports from VigiBase on the basis of medicine-potential ADR pairs. The ADRs were stratified by sex, age group, reporting country, seriousness, outcome of the reaction, and dechallenge and rechallenge. RESULTS In total, 25 medicines reported to be suspected individual medicines or as a fixed-dose combination in the study period were included the study. Pyrazinamide (n = 836; 11.2%) was the most commonly reported medicine associated with ADRs, followed by ethionamide (n = 783; 10.5%) and cycloserine (n = 696; 9.3%). From the report included in this analysis, 2334 (31.2%) required complete withdrawal of the suspected medicine(s), followed by reduction of the dose (77; 1.0%) and an increased dose (4; 0.1%). Almost half of the reports were serious ADRs mainly caused by bedaquiline, delamanid, clofazimine, linezolid, and cycloserine that are the backbone of the DR-TB treatment currently in use. CONCLUSIONS A third of the reports required medication withdrawal, which impacts treatment adherence and ultimately leads to drug resistance. Additionally, more than 40% of the reports indicated that ADRs appeared two months after the commencement of treatment, thus it's important to remain alert for the potential ADRs for the entire duration of the treatment.
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Affiliation(s)
- Alemayehu Lelisa Duga
- Doctoral School Societies, Politics, Public Health, Pharmacoepidemiology and Pharmacovigilance, University of Bordeaux, 33300 Bordeaux, France
- National Pharmacovigilance Center, Eswatini Ministry of Health, Mbabane H100, Eswatini
- Baylor College of Medicine Children's Foundation-Eswatini, Mbabane H100, Eswatini
| | - Francesco Salvo
- Doctoral School Societies, Politics, Public Health, Pharmacoepidemiology and Pharmacovigilance, University of Bordeaux, 33300 Bordeaux, France
| | - Alexander Kay
- Baylor College of Medicine Children's Foundation-Eswatini, Mbabane H100, Eswatini
- Baylor College of Medicine, Houston, TX 77030, USA
| | - Albert Figueras
- Doctoral School Societies, Politics, Public Health, Pharmacoepidemiology and Pharmacovigilance, University of Bordeaux, 33300 Bordeaux, France
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Muacevic A, Adler JR. Multidrug-Resistant TB (MDR-TB) and Extensively Drug-Resistant TB (XDR-TB) Among Children: Where We Stand Now. Cureus 2023; 15:e35154. [PMID: 36819973 PMCID: PMC9938784 DOI: 10.7759/cureus.35154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 02/20/2023] Open
Abstract
Drug-resistant tuberculosis (DR-TB) has continued to be a global health cataclysm. It is an arduous condition to tackle but is curable with the proper choice of drug and adherence to the drug therapy. WHO has introduced newer drugs with all-oral shorter regimens, but the COVID-19 pandemic has disrupted the achievements and raised the severity. The COVID-19 controlling mechanism is based on social distancing, using face masks, personal protective equipment, medical glove, head shoe cover, face shield, goggles, hand hygiene, and many more. Around the globe, national and international health authorities impose lockdown and movement control orders to ensure social distancing and prevent transmission of COVID-19 infection. Therefore, WHO proposed a TB control program impaired during a pandemic. Children, the most vulnerable group, suffer more from the drug-resistant form and act as the storehouse of future fatal cases. It has dire effects on physical health and hampers their mental health and academic career. Treatment of drug-resistant cases has more success stories in children than adults, but enrollment for treatment has been persistently low in this age group. Despite that, drug-resistant childhood tuberculosis has been neglected, and proper surveillance has not yet been achieved. Insufficient reporting, lack of appropriate screening tools for children, less accessibility to the treatment facility, inadequate awareness, and reduced funding for TB have worsened the situation. All these have resulted in jeopardizing our dream to terminate this deadly condition. So, it is high time to focus on this issue to achieve our Sustainable Development Goals (SDGs), the goal of ending TB by 2030, as planned by WHO. This review explores childhood TB's current position and areas to improve. This review utilized electronic-based data searched through PubMed, Google Scholar, Google Search Engine, Science Direct, and Embase.
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The effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis: a systematic review and meta-analysis. Int J Infect Dis 2023; 127:93-105. [PMID: 36481489 DOI: 10.1016/j.ijid.2022.11.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis (MDR-TB). METHODS We searched for publications in the Medline, Embase, Scopus, and Web of Science databases. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Hazard ratio (HR) for sputum culture conversion and odds ratio (OR) for end-of-treatment outcomes, with 95% CI, were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger's tests. RESULTS Of the 2358 records screened, 63 studies comprising a total of 31,583 people with MDR-TB were included. Undernutrition was significantly associated with a longer time to sputum culture conversion (HR 0.7, 95% CI 0.6-0.9, I2 = 67·1%), and a higher rate of mortality (OR 2.8, 95% CI 2.1-3.6, I2 = 21%) and unsuccessful treatment outcomes (OR 1.8, 95% CI 1.5-2.1, I2 = 70%). There was no significant publication bias in the included studies. CONCLUSION Undernutrition was significantly associated with unsuccessful treatment outcomes, including mortality and longer time to sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardized TB drugs.
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Inbaraj LR, Daniel J, Rajendran P, Bhaskar A, Srinivasalu VA, Narayanan MKS, Shewade HD, Kirubakaran R, Scandrett K, Malaisamy M, Takwoingi Y, Padmapriyadarsini C. Truenat MTB assays for pulmonary tuberculosis and rifampicin resistance in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2023; 2023:CD015543. [PMCID: PMC9837843 DOI: 10.1002/14651858.cd015543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the diagnostic accuracy of Truenat assays (MTB, MTB Plus, and MTB RIF Dx) for detecting pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis.
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Affiliation(s)
| | - Leeberk Raja Inbaraj
- Department of Clinical ResearchICMR – National Institute for Research in TuberculosisChennaiIndia
| | - Jefferson Daniel
- Department of Pulmonary MedicineChristian Medical CollegeVelloreIndia
| | - Priya Rajendran
- Department of BacteriologyICMR – National Institute for Research in TuberculosisChennaiIndia
| | - Adhin Bhaskar
- Department of BiostatisticsICMR – National Institute for Research in TuberculosisChennaiIndia
| | - Vignes Anand Srinivasalu
- Department of Clinical ResearchICMR - National Institute for Research in TuberculosisChennaiIndia
| | - Mukesh KS Narayanan
- Department of EpidemiologyICMR – National Institute for Research in TuberculosisChennaiIndia
| | - Hemant D Shewade
- Division of Health System ResearchICMR – National Institute of EpidemiologyChennaiIndia
| | - Richard Kirubakaran
- Prof. BV Moses Center for Evidence-Informed Health Care and Health PolicyChristian Medical CollegeVelloreIndia
| | - Katie Scandrett
- Test Evaluation Research Group, Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
| | - Muniyandi Malaisamy
- Department of Health EconomicsICMR – National Institute for Research in TuberculosisChennaiIndia
| | - Yemisi Takwoingi
- Test Evaluation Research Group, Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
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Li S, Liang Y, Hu X. Risk factors for multidrug resistance in tuberculosis patients with diabetes mellitus. BMC Infect Dis 2022; 22:835. [PMID: 36369020 PMCID: PMC9650799 DOI: 10.1186/s12879-022-07831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To study the risk factors and prediction models of multidrug resistance in patients with tuberculosis and diabetes and those with a history of tuberculosis treatment. Methods A total of 256 tuberculosis patients with diabetes who were registered in Luoyang city, Henan Province, from January 2018 to December 2021. Logistic regression analysis was performed to analyse the risk factors for multidrug resistance. ROC curves were used to analyse the predictive model for multidrug resistance. Results Age < 65 years old, HbA1c, and a history of tuberculosis treatment were independent risk factors for multidrug resistance in patients with tuberculosis and diabetes (P < 0.05). The area under the ROC curve of predictive model for MDR was 0.878 (95% CI (0.824, 0.932)). Age < 65 years old and HbA1c were independent risk factors for MDR in patients with TB and diabetes with a history of TB treatment. The area under the ROC curve of predictive model for MDR was 0.920 [95% CI (0.831, 0.999)]. Conclusion The predictive model had certain prediction value for the risk of multidrug resistance in patients with tuberculosis and diabetes.
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The Characteristics and Patterns of Drug-Resistant Pulmonary Tuberculosis in Eastern India. Trop Med Infect Dis 2022; 7:tropicalmed7090244. [PMID: 36136655 PMCID: PMC9502428 DOI: 10.3390/tropicalmed7090244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Drug-resistant tuberculosis is a major public health problem throughout the world and accounts for substantial morbidity and mortality rates in India, too. Early diagnosis is the corner stone of tuberculosis treatment. State-level and cluster-wise variations in drug resistance is a possibility and should be regularly checked in from time to time. Materials and Methods: The present prospective cohort study (January 2019 to May 2022) was conducted in Darbhanga Medical College and Hospital on drug-resistant pulmonary tuberculosis patients. Sputum specimens were collected from designated centers. Rapid molecular drug-resistance testing (genotypic tests) and growth-based drug-susceptibility testing (DST) (phenotypic tests) were performed in the National Tuberculosis Elimination Program certified Laboratory. Results: A total of 268 patients with drug-resistant pulmonary tuberculosis were included in the study group. The treatment outcomes revealed as cured in 100 (37.31%); treatment completed in 43 (16.04%); died in 56 (20.89%); treatment failed in 22 (8.21%); loss of follow up in 34 (12.69%); and transferred out in 13 (4.85%) drug-resistant pulmonary tuberculosis patients. Adverse events were recorded in 199 (74.25%) of the drug-resistant pulmonary tuberculosis patients. Conclusions: Drug-resistant pulmonary tuberculosis patients are a matter of concern and need to be addressed.
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Zhang X, Zhang Y, Yin Z, Xia W, Mao H, Bao L, Liu Y, Cao M. Relationship between vitamin D receptor gene polymorphisms and second acid-fast bacilli smear-positive during treatment for tuberculosis patients. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 103:105324. [PMID: 35777530 DOI: 10.1016/j.meegid.2022.105324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/01/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Tuberculosis (TB) treatment is associated with Vitamin D. This study aimed to explore the relationship between Vitamin D receptor (VDR) gene polymorphisms and second acid-fast bacilli (AFB) smear-positive during treatment for TB patients. METHODS This was a cross-sectional study. Seven hundred and thirty-one TB patients whose single nucleotide polymorphism site (SNPs) of VDR gene were detected from December 2019 to December 2020 in XinJiang of China. The genotypic distributions in each group were tested separately for Hardy-Weinberg equilibrium. The tetragram test was used to construct haplotypes to evaluate the association between each haplotype and second AFB smear-positive occurrence. RESULTS No significant deviations were observed with all the four polymorphism sites in the genotypic distributions (P>0.05). Linkage disequilibrium (LD) analysis showed that there was LD between SNPs of VDR gene (r2=0.74, D`>0.9). Each haplotype was not considered to be the influencing factor of second AFB smear-positive. CONCLUSIONS There is no association between VDR gene polymorphism (ApaI, BsmI, FokI and TaqI) and second AFB smear-positive.
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Affiliation(s)
- Xiaoxu Zhang
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yan Zhang
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Zhe Yin
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Wenjun Xia
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Hongkai Mao
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Liangliang Bao
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yajie Liu
- Medical record room, Xinjiang Medical University Affiliated Third Hospital, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Mingqin Cao
- Department of epidemiology and health statistics, School of public health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
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Puspitasari IM, Sinuraya RK, Aminudin AN, Kamilah RR. Knowledge, Attitudes, and Preventative Behavior Toward Tuberculosis in University Students in Indonesia. Infect Drug Resist 2022; 15:4721-4733. [PMID: 36034171 PMCID: PMC9416452 DOI: 10.2147/idr.s365852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to assess the knowledge, attitudes, and preventative behaviors of university students in Indonesia toward Tuberculosis (TB). Patients and Methods Participants included students from a university in West Java, Indonesia, who were aged ≥18 years, had access to electronic communication devices and the internet, and agreed to participate in this study. This cross-sectional study invited participants to fill an online questionnaire on Google Forms, and the study was conducted from February to March 2021. Descriptive statistics was used to describe the demographic characteristics of participants. Differences in participants’ knowledge, attitudes, and preventative behavior were analyzed using t-test. Spearman correlation coefficient was used to determine the relationships between variables. Characteristics of participants that influenced preventative behavior toward TB were analyzed using linear multiple regression analysis. Results This study included 524 students. The average knowledge scores out of a possible 11 points of health and non-health students were 7.03 ± 2.36 (out of 11) and 4.98 ± 2.20, respectively. The attitude was 45.40 ± 4.17 (out of 52), 43.75 ± 4.09 respectively, and their average scores out of 44 for preventative behaviors toward TB were 33.08 ± 4.49 and 33.16 ± 4.40, respectively. Female students and students from health faculties demonstrated greater knowledge and better attitudes. Students with a postgraduate academic degree had better knowledge and attitudes and engaged in more preventative behavior. Students who did not smoke had greater knowledge than those who did, and students who had received information about TB engaged in more preventative behavior. Conclusion Faculty, knowledge of symptoms, preventative examinations, and attitudes toward preventative examinations, treatment, and preventative education, were found to affect TB prevention behavior. These variables should be emphasized in the development of university TB socialization and education programs. The internet and social media should be used in TB education for students.
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Affiliation(s)
- Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
| | - Rano Kurnia Sinuraya
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia.,Unit of Global Health, Department of Health Sciences, University of Groningen/University Medical Center Groningen, Groningen, the Netherlands
| | - Arini Nurhaqiqi Aminudin
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Rika Rahmi Kamilah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
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13
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Purnami N, Palandeng RW, - S, Arifianto D, Moon IS. Validity of automated audiometry for hearing examination in patients with multidrug-resistant tuberculosis. F1000Res 2022; 10:1277. [PMID: 36127887 PMCID: PMC9468620 DOI: 10.12688/f1000research.75090.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The objective of this study was to test the validity of automated audiometry as a method of hearing examination in patients with multidrug-resistant tuberculosis.
Methods: This was a cross-sectional comparative study with a retrospective approach, using patient medical records. Patients with multidrug-resistant tuberculosis (MDR-TB) were recruited based-on medical records that met the inclusion and exclusion criteria at the Pulmonology outpatient unit, then referred to the Otorhinolaryngology outpatient unit of the Dr. Soetomo Academic Medical Center. The subjects’ hearing function was measured with two different devices (automated audiometer and conventional audiometer) before being given anti-tuberculosis drug therapy (aminoglycoside injection) as ototoxicity monitoring from July to December 2019 period. Sensitivity and specificity analysis was used to assess the validity of the test. Results: A total of 36 patients (72 ears) were included. The comparison test results using the Mann-Whitney test showed that there were significant differences between automated audiometry and conventional audiometry in both ears. Analysis values were: sensitivity 80-97%, specificity 37-96%, positive predictive value 74-98%, and negative predictive value 59-96%. Conclusions: Automated audiometry is valid for use as a method of hearing examination and monitoring in patients with multidrug-resistant tuberculosis.
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Affiliation(s)
- Nyilo Purnami
- Departement of Otorhinolaryngology Head and Neck Surgery, Airlangga University, Surabaya, Indonesia, -, Indonesia
| | - Rian W. Palandeng
- Departement of Otorhinolaryngology Head and Neck Surgery, Airlangga University, Surabaya, Indonesia, -, Indonesia
| | - Soedarsono -
- Department of Pulmonology and Respiratory Medicine, Airlangga University, Surabaya, Indonesia, -, Indonesia
| | - Dhany Arifianto
- Departement of Engineering Physics, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia, -, Indonesia
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University, Seoul, South Korea
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14
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Kadri A, Machmud R, Putra A, Indrapriyatna AS. Factors Associated of Multidrug-Resistance Tuberculosis among Minangkabau Ethnicity in Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Past tuberculosis therapy has been linked to an increased chance of developing multidrug-resistant tuberculosis (MDR-TB). Indonesia is placed 8th among the 27 nations with "high-burden" MDR-TB.
AIM: The purpose of this study was to determine the risk factors associated of multidrug-resistance tuberculosis among minangkabau ethnicity in Indonesia.
METHODS: The authors conducted a case control study. Data were gathered in Dr. M Djamil General Hospital Padang, Lubuk Alung Hospital Pariaman and Primary Health Care in Padang Pariaman District from December 2019-March 2020. In this study, there were 73 cases (MDR-TB) and 219 controls (Tuberculosis) who were matched by age and sex. The sampling technique in this research was convenience sampling. Data were gathered from medical records. Bivariate and multivariate analysis were investigated using chi-square and logistic binary regression test. The data were analyzed using STATA version 14.2.
Results: The risk factors for MDR-TB, cavitary pulmonary had the highest odds ratio (OR = 113.54 [95% CI 15.02-858.54]), followed by TB outside the lung (OR = 38,68 [95% CI 4.89-305.43]), nutritional status (OR = 10.92 [95% CI 5.79-20.56]), alcohol consumption (OR = 6.45 [95% CI 1.57-26.48]), working status (OR = 4.08 [95% CI 2.33-7.17]), level of education (OR = 2.79 [95% CI 1.61-4.85]), history of close contact to patients with MDR-TB and TB (OR = 2.35 [95% CI 1.30-4.22]) and diabetes mellitus (OR = 2.12 [95% CI 1.15-3.91]). Multivariate analysis found that patients with a cavitary pulmonary was significant dominant factors for MDR-TB.
Conclusion: MDR-TB was predicted by previous tuberculosis therapy and cavitary pulmonary disease.
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Pan Y, Yu Y, Lu J, Yi Y, Dou X, Zhou L. Drug Resistance Patterns and Trends in Patients with Suspected Drug-Resistant Tuberculosis in Dalian, China: A Retrospective Study. Infect Drug Resist 2022; 15:4137-4147. [PMID: 35937782 PMCID: PMC9348136 DOI: 10.2147/idr.s373125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/13/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose The emergence of drug-resistant tuberculosis (DR-TB) represents a threat to the control of tuberculosis. This study aimed to estimate the patterns and trends of DR-TB in patients with suspected DR-TB. In addition, risk factors for multidrug-resistant tuberculosis (MDR-TB) were identified among suspected DR-TB patients in Dalian, China. Patients and Methods A total of 5661 patients with suspected DR-TB from Jan 1, 2013 to Dec 31, 2020 were included in the final analysis. The resistance pattern of all resistant strains was determined by drug susceptibility testing (DST) using the conventional Lowenstein-Jensen Proportion Method (LJ). DR-TB trends were estimated from 2013 to 2020. During the research period, the chi-square test was employed to analyze the significance of linear drug-resistance trends across time. Bivariate and multivariate logistic regression were performed to assess factors associated with MDR-TB. Results From 2013 to 2020, the resistance rates of rifampicin (RFP) and isoniazid (INH) decreased significantly, whereas the resistance rates of ethambutol (EMB) and streptomycin (SM) increased in patients with suspected DR-TB. From 2013 to 2020, the prevalence of DR-TB decreased in all patients from 34.71% to 28.01% with an average annual decrease of 3.02%. Among new cases, from 2013 to 2020, the prevalence of DR-TB (from 26.67% to 24.75%), RFP-resistant TB (RR-TB) (from 15.09% to 3.00%) and MDR-TB (from 6.08% to 2.62%) showed a significant downward trend. Among patients with a previous treatment history, DR-TB (from 54.70% to 37.50%), RR-TB (from 44.16% to 11.49%) and MDR-TB (from 26.90% to 10.34%) showed a significant downward trend from 2013 to 2020. Males (AOR 1.28, 95% CI 1.035–1.585), patients 45 to 64 years of age (AOR 1.75, 95% CI 1.342–2.284), patients 65 years and older (AOR 1.65, 95% CI 1.293–2.104), rural residents (AOR 1.24, 95% CI 1.014–1.519) and a previous treatment history (AOR 3.94, 95% CI 3.275–4.741) were risk factors for MDR-TB. Conclusion The prevalence of DR-TB, RR-TB and MDR-TB was significantly reduced from 2013 to 2020. Considerable progress has been made in the prevention and treatment of DR-TB during this period. However, the increasing rate of drug resistance in EMB and SM should be taken seriously. Suspected DR-TB patients who are male, older than 45 years of age, live in rural areas, and have a history of TB treatment should be given priority by health care providers.
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Affiliation(s)
- Yuanping Pan
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
| | - Yingying Yu
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
| | - Jiachen Lu
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
| | - Yaohui Yi
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian, 116000, People’s Republic of China
- Correspondence: Ling Zhou, School of Public Health, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, People’s Republic of China, Tel +86 411 8611 0368, Email
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Zhang X, Zhang Y, Xia W, Liu Y, Mao H, Bao L, Cao M. The relationship between vitamin D level and second acid-fast bacilli (AFB) smear-positive during treatment for TB patients was inferred by Bayesian network. PLoS One 2022; 17:e0267917. [PMID: 35507601 PMCID: PMC9067663 DOI: 10.1371/journal.pone.0267917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitamin D is related to human immunity, so we used Bayesian network model to analyze and infer the relationship between vitamin D level and the acid-fast bacilli (AFB) smear-positive after two months treatment among pulmonary tuberculosis (TB) patients. METHODS This is a cross-sectional study. 731 TB patients whose vitamin D level were detected and medical records were collected from December 2019 to December 2020 in XinJiang of China. Logistic regression was used to analyze the influencing factors of second AFB smear-positive. Bayesian network was used to further analyze the causal relationship among vitamin D level and the second AFB smear-positive. RESULTS Baseline AFB smear-positive (OR = 6.481, 95%CI: 1.604~26.184), combined cavity (OR = 3.204, 95%CI: 1.586~6.472), full supervision (OR = 8.173, 95%CI:1.536~43.492) and full management (OR = 6.231, 95%CI:1.031~37.636) were not only the risk factors and can also be considered as the reasons for second AFB smear-positive in TB patients (Ensemnle > 0.5). There was no causal relationship between vitamin D level and second AFB smear-positive (Ensemnle = 0.0709). CONCLUSIONS The risk factors of second AFB smear-positive were baseline AFB smear-positive, combined cavity, full supervision and full management. The vitamin D level in TB patients was not considered as one of the reasons for the AFB smear-positive.
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Affiliation(s)
- Xiaoxu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Wenjun Xia
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yajie Liu
- Medical Record Room, Third Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Hongkai Mao
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Liangliang Bao
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - MingQin Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China
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Putra ON, Nur Hidayatullah AY. Factors associated with treatment outcomes in drug-resistant tuberculosis. Int J Mycobacteriol 2022; 11:226-227. [PMID: 35775563 DOI: 10.4103/ijmy.ijmy_64_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Oki Nugraha Putra
- Department of Clinical Pharmacy, Study Program of Pharmacy, Hang Tuah University, Surabaya, Indonesia
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18
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Soeroto AY, Nurhayati RD, Purwiga A, Lestari BW, Pratiwi C, Santoso P, Kulsum ID, Suryadinata H, Ferdian F. Factors associated with treatment outcome of MDR/RR-TB patients treated with shorter injectable based regimen in West Java Indonesia. PLoS One 2022; 17:e0263304. [PMID: 35089981 PMCID: PMC8797248 DOI: 10.1371/journal.pone.0263304] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Background and aims Multi drug or rifampicin resistant tuberculosis (MDR/RR-TB) is a major burden to TB prevention and eradication globally. Since 2016, WHO guidelines have included options for treating MDR/RR-TB with a standard regimen of 9 to 11 months duration (the ’shorter regimen’) rather than an individual regimen of at least 20 months. This regimen has been introduced in Indonesia since September 2017. Therefore, we aimed to determine the success rate and factors associated with the treatment outcome of shorter injectable based regimen in West Java province, Indonesia. Methods This was a retrospective cohort study of MDR/RR-TB patients aged over 18 years old who received the shorter injectable based regimen between September 2017 and December 2020. We defined successful outcomes as the combined proportion of patients who were cured or had complete treatment. While, unsuccessful outcomes were defined as the combined proportion of patients who died from any causes, failure, and loss to follow-up (LTFU). Results A total of 315 patients were included in this study. The success rate was 64.5%. Multivariate analysis showed male gender (aRR = 1.18, 95% CI 1.04 to 1.34) increased the chance of successful outcome, while malnutrition (aRR = 0.78, 95% CI 0.68 to 0.89), history of previous TB treatment (aRR = 0.80%CI 0.68 to 0.94), and time of culture conversion >2 months (aRR = 0.72 (95% CI 0.59 to 0.87) decreased the chance of successful outcome. Conclusion History of previous TB treatment, time of culture conversion >2 months, and malnutrition were independent factors that decrease the chance for success rate, while male gender increase the likelihood for success rate of patients treated by the shorter injectable based regimen.
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Affiliation(s)
- Arto Yuwono Soeroto
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Raden Desy Nurhayati
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Department of Internal Medicine, Rotinsulu Pulmonary Hospital, Bandung, West Java, Indonesia
| | - Aga Purwiga
- Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Bony Wiem Lestari
- Faculty of MedicineDepartment of Public Health, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, TB-HIV Research Center, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Chica Pratiwi
- Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Department of Internal Medicine, Cimacan Hospital, Cianjur, West Java, Indonesia
| | - Prayudi Santoso
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Iceu Dimas Kulsum
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Hendarsyah Suryadinata
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Ferdy Ferdian
- Faculty of Medicine, Division of Respirology and Critical Care Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia.,Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, West Java, Indonesia
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Sidamo T, Shibeshi W, Yimer G, Aklillu E, Engidawork E. Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study. Infect Drug Resist 2022; 14:5473-5489. [PMID: 34984005 PMCID: PMC8703047 DOI: 10.2147/idr.s342964] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose/Background Although Ethiopia is among the thirty high multi-drug resistant tuberculosis (MDR-TB) burden countries in the world, comparative therapeutic efficacy of moxifloxacin and levofloxacin has not been explored, particularly in MDR-TB patients. We therefore aimed to prospectively compare clinical outcomes and determine potential predictors of the outcomes among patients on moxifloxacin or levofloxacin-based MDR-TB drug regimens. Methods We analyzed clinical parameters and laboratory data of eighty MDR-TB patients on moxifloxacin- or levofloxacin-based regimens. The clinical outcomes were compared using the Kaplan–Meier survival functions and the outcome definitions of the 2013 World Health Organization. Monthly sputum culture conversions and a molecular line probe assay results were also assessed. Observed outcomes and patient-related variables between the two groups were compared using chi-square, Wilcoxon Rank and Fisher exact tests. We also determined the potential predictors influencing treatment outcomes of moxifloxacin and levofloxacin using Cox proportional hazard model. Results The levofloxacin-based treatment group had a lower failure rate and adverse drug events as well as better treatment success than the moxifloxacin-based group. Overall treatment success was 65%. Disaggregating the data revealed that 53.8% were cured, 11.2% completed treatment, 10.0% died, 11.2% failed, and 13.8% were lost-to-follow-up. The line probe assay result showed that 11.3% of the clinical isolates were resistant to fluoroquinolones and 3.8% were resistant to both fluoroquinolones and injectable anti-TB agents. Treatment regimen type, culture conversion rate, alcohol use, cavity lesion, serum levels of creatinine and alanine aminotransferase were independent predictors of treatment outcome. Conclusion The levofloxacin-based regimen group has a better overall treatment success than the moxifloxacin-based group among MDR-TB patients. Clinical parameters and substance use history of the patients influenced treatment outcomes. We recommend further broader clinical studies to substantiate our findings as an input to review MDR-TB treatment guidelines.
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Affiliation(s)
- Temesgen Sidamo
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workineh Shibeshi
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Yimer
- Global One Health Initiative, Office of International Affairs, The Ohio State University, Columbus, OH, USA
| | - Eleni Aklillu
- Department of Laboratory of Medicine Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, C-168 141 86, Sweden
| | - Ephrem Engidawork
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Indarti H, Kristin E, Soedarsono S, Endarti D. Cohort analysistreatment outcomes of multidrug-resistant tuberculosis patients in East Java, Indonesia: A retrospective. Int J Mycobacteriol 2022; 11:261-267. [DOI: 10.4103/ijmy.ijmy_86_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Kusmiati T, Mertaniasih NM, Eko Putranto JN, Suprapti B, Soedarsono, Luthfah N, Koesoemoprodjo W, Sari AP. The role of C-Reactive protein as an inflammatory marker to predict prolonged QTc interval in rifampicin-resistant tuberculosis patients: A case-control study. Ann Med Surg (Lond) 2021; 70:102899. [PMID: 34691435 PMCID: PMC8519798 DOI: 10.1016/j.amsu.2021.102899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 01/08/2023] Open
Abstract
Background long-term use of anti-tuberculosis drugs (ATD) increases the risk of QTc prolongation, while C-reactive protein (CRP) can be used as an inflammatory marker of Mycobacterium tuberculosis infection. Objective: correlation of CRP on the QTc interval in Rifampicin-resistant tuberculosis (RR-TB) patients with the short regimen. Methods An observational study was conducted in Rifampicin-resistant tuberculosis (RR-TB) patients from 2 groups, patients on intensive phase and patients on continuation phase. CRP levels were measured from blood samples and measured automatically using the immunoturbidimetric assay. QTc interval was calculated using electrocardiography. Levels of CRP levels and QTc interval between the 2 groups were analyzed. The statistical analysis used includes the independent t-test, Mann Whitney test, and Rank Spearman test with p = 0.05. Results Forty-five eligible RR-TB patients were included in this study. CRP levels and QTc intervals between 2 groups (intensive and continuation phase) showed significant difference with p < 0.001 but found no significant correlation of CRP levels and QTc interval in both intensive and continuation phase with p = 0.226 and 0.805, respectively. A higher level of CRP strongly indicated the inflammation caused by RR-TB infection at the early phase of the disease, but not correlated with QTc interval in RR-TB patients. Conclusion Levels of CRP and QTc interval do not correlate in RR-TB patients and can not be used to be the marker of QTc prolongation in RR-TB Patients. CRP levels are markers used for diagnosis and monitoring in RR-TB patients. Decrease CRP levels in RR-TB patients are don't a marker of QTc prolongation. The significant between intensive and continuation phase of CRP and QTc interval in RR-TB patients.
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Affiliation(s)
- Tutik Kusmiati
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ni Made Mertaniasih
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Johanes Nugroho Eko Putranto
- Department of Vascular and Cardiology Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Budi Suprapti
- Faculty of Pharmacy, Universitas Airlangga - Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Soedarsono
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Nadya Luthfah
- Department of Vascular and Cardiology Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Winariani Koesoemoprodjo
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Aryani Prawita Sari
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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22
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Putra ON, Yuniar N H A. Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis: Concern to Bedaquiline. Tuberc Respir Dis (Seoul) 2021; 84:338-339. [PMID: 34343423 PMCID: PMC8497772 DOI: 10.4046/trd.2021.0115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/01/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Oki Nugraha Putra
- Department of Clinical Pharmacy, Program Study of Pharmacy, Hang Tuah University - Arief Rahman Hakim 150, Surabaya, East Java - Indonesia
| | - Affan Yuniar N H
- Department of Clinical Pharmacy, Program Study of Pharmacy, Hang Tuah University - Arief Rahman Hakim 150, Surabaya, East Java - Indonesia
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