Culture conversion at six months in patients receiving bedaquiline- and delamanid-containing regimens for the treatment of multidrug-resistant tuberculosis

Maretbayeva, Shynar M.; Ракишева, А.С.; Adenov, M.; Yeraliyeva, Lyazzat; Algozhin, Yerkebulan Zh.; Stambekova, Assel; Berikova, Elmira; Yedilbayev, Askar; Rich, Michael; Seung, Kwonjune J.; Issayeva, A

doi:10.1016/j.ijid.2021.03.075

Cited by 9 publications

(6 citation statements)

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“…Ninety seven patients (27.3%) were culture negative at second month of treatment, 155 (43.6%) at 4th and 188 (53.0%) at 6th month. The proportion of culture negative patients within first 6 months of treatment (53%) was higher than that reported from India (43.7%) [ 5 ], but lower than the range (83–89%) reported elsewhere [ 28 – 30 ].…”

Section: Discussioncontrasting

confidence: 57%

Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study

et al. 2022

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Background There was a lack of information about prognostic accuracy of time to sputum culture conversion (SCC) in forecasting cure among extensively drug-resistant tuberculosis (XDR-TB) patients. Therefore, this study evaluated the prognostic accuracy of SCC at various time points in forecasting cure among XDR-TB patients. Methods This retrospective observational study included 355 eligible pulmonary XDR-TB patients treated at 27 centers in Pakistan between 01-05-2010 and 30-06-2017. The baseline and follow-up information of patients from treatment initiation until the end of treatment were retrieved from electronic nominal recording and reporting system. Time to SCC was analyzed by Kaplan–Meier method, and differences between groups were compared through log-rank test. Predictors of time to SCC and cure were respectively evaluated by multivariate Cox proportional hazards and binary logistic regression analyses. A p-value < 0.05 was considered statistically significant. Results A total of 226 (63.6%) and 146 (41.1%) patients respectively achieved SCC and cure. Median time to SCC was significantly shorter in patients who achieved cure, 3 months (95% confidence interval [CI]: 2.47–3.53), than those who did not (median: 10 months, 95% CI: 5.24–14.76) (p-value < 0.001, Log-rank test). Patient’s age > 40 years (hazards ratio [HR] = 0.632, p-value = 0.004), baseline sputum grading of scanty, + 1 (HR = 0.511, p-value = 0.002), + 2, + 3 (HR = 0.523, p-value = 0.001) and use of high dose isoniazid (HR = 0.463, p-value = 0.004) were significantly associated with early SCC. Only SCC at 6 month of treatment had statistically significant association with cure (odds ratio = 15.603, p-value < 0.001). In predicting cure, the sensitivities of SCC at 2, 4 and 6 months were respectively 41.8% (95%CI: 33.7–50.2), 69.9% (95%CI: 61.7–77.2) and 84.9% (95%CI: 78.1–90.3), specificities were respectively, 82.8% (95%CI: 76.9–87.6), 74.6% (95%CI: 68.2–80.4) and 69.4% (95%CI: 62.6–75.5) and prognostic accuracies were respectively 65.9% (95%CI: 60.7–70.8), 72.7% (95%CI: 67.7–77.2) and 75.8% (95%CI: 71.0–80.1). Conclusion In forecasting cure, SCC at month 6 of treatment performed better than SCC at 2 and 4 months. However, it would be too long for clinicians to wait for 6 months to decide about the regimen efficacy. Therefore, with somewhat comparable prognostic accuracy to that SCC at 6 month, using SCC at 4 month of treatment as a prognostic marker in predicting cure among XDR-TB patients can decrease the clinicians waiting time to decide about the regimen efficacy.

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Section: Discussioncontrasting

confidence: 57%

Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study

et al. 2022

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“…The administration of bedaquiline and or delamanid as part of an all-oral regimen improve success treatment (culture conversion) and minimize side effects, such as hearing loss, hearing disorders, and renal dysfunction, related to the second line injectable drugs (Yang et al, 2017). Several studies have reported that adding bedaquiline and or delamanid to DR-TB regimens effectively increase a culture conversion rate at 6 months or after treatment completion (Kempker et al, 2020;Maretbayeva et al, 2021) Regimens containing bedaquiline to treat DR-TB is relatively safe with no cases of QTc interval more than 500 ms during six months of treatment as reported by Primadana et al (Primadana et al, 2022). On the other hand, beyond its bactericidal activity, delamanid alter the function of host immune cell.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Lee et al, reported patients with pre-XDR and XDR-TB had more lung cavities and bilateral lung disease than those with MDR-TB. The lung cavity facilitates the development of antituberculosis drug resistance due to high TB bacillary load, active bacterial replication, and potentially lower drug concentrations in the lung tissue (Lee et al, 2019) A recent study by Maretbayeva et al, stated that among DR-TB patients who did not experience sputum culture conversion after six months, 80% of them were XDR-TB and had lung cavities (Maretbayeva et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Unsuccessful Treatment of Bedaquiline and or Delamanid Based Regimens in Multidrug-Resistant Tuberculosis: A Review

Nugraha Putra,

Faizah,

Wijayanti D.N

2023

JPS

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Background: Multidrug-resistant tuberculosis (MDR-TB) is a serious health concern that is difficult to treat, requiring long and complex treatment with highly effective drugs. An all-oral regimen, bedaquiline and or delamanid have already shown low unsuccessful treatment in patients with MDR-TB. Method: We comprehensively reviewed factors associated with unsuccessful treatment (death, treatment failure, and loss to follow-up) related to all oral regimen containing bedaquiline and or delamanid in patients with MDR-TB. We conducted a scoping review under the PRISMA guideline for scoping review. Results: We included seven observational studies that met the inclusion criteria. Four studies reported the concomitant use of bedaquiline and delamanid. Unsuccessful treatment ranged from 7.8% to 36.6% in regimens containing bedaquiline, delamanid, or both at six months or after treatment completion. Low rates of treatment failure and loss to follow-up were reported in the included studies. Elderly, being underweight (BMI < 18.5 kg/m2), and hepatitis C coinfection among MDR-TB patients were associated with unsuccessful treatment in most studies. None studies reported pre-XDR and XDR-TB as risk factors for unsuccessful treatment. Conclusion: In MDR-TB patients receiving regimens containing bedaquiline and delamanid, age, BMI, and hepatitis C coinfection were associated with unsuccessful treatment.

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“…TB is a dangerous disease that is easily transmitted, so in each hospital there is a special room for TB patients so as to reduce the risk of further transmission [2]. To avoid the transmission of the TB virus, nurses are required to follow standard procedure to minimize the risk of transmission of TB bacteria [3] [4] [5]. this review underscores the critical importance of point-of-care (POC) testing in the realm of infectious diseases, which pose significant threats to public health and the economy.…”

Section: Introductionmentioning

confidence: 99%

Non-contact Respiration Monitoring Using Bio- Radar Sensor Based on Linear Regression Classifier

Y.,

Syaifudin,

Irianto

et al. 2024

j.teknokes

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Tuberculosis (TB) is an infectious disease that mainly attacks the lungs, caused by the bacterium Mycobacterium tuberculosis. To reduce its spread, hospitals use special rooms for TB patients and health workers follow strict Standard Operating Procedures (SOP). Recent advances in medical technology have led to the development of contactless respiratory monitoring techniques, such as bio-radar sensors that utilize the Doppler principle to detect lung movement. This research aims to explore the application of bio-radar sensors for contactless respiratory rate monitoring and then combine it with machine learning methods, specifically using linear regression algorithms, to translate bio-radar output into measurable respiratory rate values. By training a regression model using a processed raw data set to identify inspiration and expiration, where 1 is inspiration and 0 is expiration. To test the performance of the contactless breathing module, it was compared to a patient monitor. The module and comparison tool were run simultaneously with 10 measurement distance points for 10 patients or respondents with each distance point taken three times. The data that has been obtained from the results of comparisons between modules and comparison tools is entered into machine learning data analysis techniques, namely accuracy, precision and recall. The accuracy results were 74.9%, precision 71.4% and recall 83.3%. This research has proven that bio radar can be used to detect lung movement.

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Culture conversion at six months in patients receiving bedaquiline- and delamanid-containing regimens for the treatment of multidrug-resistant tuberculosis

Cited by 9 publications

References 4 publications

Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study

Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study

Factors Associated with Unsuccessful Treatment of Bedaquiline and or Delamanid Based Regimens in Multidrug-Resistant Tuberculosis: A Review

Non-contact Respiration Monitoring Using Bio- Radar Sensor Based on Linear Regression Classifier

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