Emergence of New Forms of Totally Drug-Resistant Tuberculosis Bacilli

Velayati, Ali Akbar; Masjedi, Mohammad Reza; Farnia, Parissa; Tabarsi, Payam; Ghanavi, Jalaledin; ZiaZarifi, Abol Hassan; Hoffner, Sven

doi:10.1378/chest.08-2427

Cited by 495 publications

(161 citation statements)

References 12 publications

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“…A limited number of isolates were also resistant to para -aminosalicylic acid. This suggests that the atypical Beijing genotype clone is evolving toward total drug resistance (defined as in vitro resistance to all first-line drugs, as well as aminoglycosides, cyclic polypeptides, fluoroquinolones, thioamides, serine analogs, and salicylic acid derivatives [ 30 ]) with acknowledgment of WHO’s concern over the definition ( 31 ). Our molecular-based results are in accordance with a recent study from the Eastern Cape, which documented extremely poor treatment outcomes for XDR TB case-patients ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Klopper¹,

Warren²,

Hayes³

et al. 2013

Emerg. Infect. Dis.

209

162

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Factors driving the increase in drug-resistant tuberculosis (TB) in the Eastern Cape Province, South Africa, are not understood. A convenience sample of 309 drug-susceptible and 342 multidrug-resistant (MDR) TB isolates, collected July 2008-July 2009, were characterized by spoligotyping, DNA fingerprinting, insertion site mapping, and targeted DNA sequencing. Analysis of molecularbased data showed diverse genetic backgrounds among drug-sensitive and MDR TB sensu stricto isolates in contrast to restricted genetic backgrounds among pre-extensively drug-resistant (pre-XDR) TB and XDR TB isolates. Second-line drug resistance was significantly associated with the atypical Beijing genotype. DNA fingerprinting and sequencing demonstrated that the pre-XDR and XDR atypical Beijing isolates evolved from a common progenitor; 85% and 92%, respectively, were clustered, indicating transmission. Ninety-three percent of atypical XDR Beijing isolates had mutations that confer resistance to 10 anti-TB drugs, and some isolates also were resistant to para-aminosalicylic acid. These findings suggest the emergence of totally drug-resistant TB.

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Section: Discussionmentioning

confidence: 99%

Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Klopper¹,

Warren²,

Hayes³

et al. 2013

Emerg. Infect. Dis.

209

162

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“…The recent reports of TDR TB from Iran, India, and Italy represent the tip of an iceberg as antitubercular susceptibility testing occurs in only 5% of TB cases worldwide. The emergence of tuberculosis as the world's largest killer amongst infectious diseases surpassing HIV in 2014 -15 reflects the scourge of tuberculosis upon the future of health systems worldwide (34)(35)(36)(37). The DOTS (Directly observed Treatment Short course) program for developing countries has been challenged by the emergence of XDR TB and TDR TB.…”

Section: Evolution Of Antimicrobial Resistancementioning

confidence: 99%

Emerging Antimicrobial Resistance and Evolving Healthcare: Dangerous Crossroads for the Community and the Military

Khan¹,

Gupta

Sen

et al. 2017

J Arch Mil Med

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Modern diagnostic and therapeutic procedures including advanced surgeries, organ transplants, and immunotherapy are pillared by antimicrobial therapy. Parallel to the rising incidence of infectious diseases, the menace of antimicrobial resistance (AMR) emerged worldwide. Developing countries are facing the brunt in epidemic proportions due to huge population, substandard housing, overcrowding, rapid unplanned urbanization, deterioration in water and waste management systems, strained public health infrastructure, and limited resource allocation to healthcare. Simultaneously, AMR has adversely affected the outcome of military injuries. The rising problem of AMR is discouraging the development of newer antimicrobials by the pharmaceutical industry. There has been a considerable impetus towards concept development; however, the magnitude of the problem overshadows the progress made towards the control of AMR worldwide. There is a dire need to identify this threat, develop concerted multipronged strategy, develop infrastructure, foster expertise, and take coordinated and urgent steps to tackle the serious public health challenge. An intensified commitment needs to be taken up on a war footing at individual, local, national, regional, and international levels. This article discusses the overall concept for developing countries.

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“…Drug resistant TB adversely affects patient outcome and public health in the developing world. The past two decades have seen the global appearance of MultidrugResistant Tuberculosis (MDR-TB) (Frieden et al, 1993;Robert et al, 2003), followed by Extensively Drug-Resistant Tuberculosis (XDR-TB) (Shah et al, 2007) and of late strains those are resistant to all antituberculosis drugs (Velyati et al, 2009). Data from the published literature are insufficient to indicate whether the incidence of Multidrug-Resistant (MDR) TB is rising or falling globally as many national programs are failing to diagnose MDR tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

“…Globally, only 30, 000 cases of MDR-TB were reported to World Health Organization (WHO) in 2008, compared to the estimate of 440,000 cases (7% of the estimated total). The WHO/IUALTD Global project on Anti-tuberculosis Drug Resistance Surveillance recorded considerable variation in the prevalence of drug resistance among 35 countries in 5 different continents (Velyati et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Drug Susceptibility Pattern of <i>M.Tuberculosis</i> Isolated from Patients Attending a Private Hospital

Roger¹

2011

American Journal of Infectious Diseases

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Problem statement: Drug resistance in Tuberculosis (TB) is an emerging problem that adversely affects patient outcome and public health in the developing world. Although much of tuberculosis care is provided by the private sector in India, the magnitude of drug resistance in TB in the private sector is not well described. The present study was carried out to determine the resistance pattern of tuberculosis in patients attending a large tertiary care hospital in South India. Approach: Anti-tuberculosis resistance patterns of all Mycobacterium tuberculosis (M.tb) isolates in a tertiary care referral hospital from January 2010 to December 2010 were studied retrospectively. Isolates were grown in MB/BacT automated liquid culture system. Sensitivities to various anti-tuberculosis drugs were done by the proportion method on Lowenstein-Jensen (L-J) media. Results: During the study period, sensitivity reports for 50 Mycobacterium isolates were available.14 (28%) of the isolates were multi-drug resistant isolates (resistant to both isoniazid and rifampicin). Isolated resistance to isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin were 42, 32, 28, 48.28 and 44% respectively. Moxifloxacin was tested against only 12 tuberculosis isolates and was uniformly sensitive against all isolates tested. Conclusion: Nearly one third of M.tb isolates in a private sector tertiary care hospital were multi-drug resistant. Isolated resistance to ethambutol was the lowest among the first line antituberculosis drugs and resistance to moxifloxacin was not seen in this study. Even allowing for referral bias, our results suggest that tertiary care hospitals which see complicated tuberculosis patients should routinely ask for susceptibility tests whenever M.tb is cultured.

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Emergence of New Forms of Totally Drug-Resistant Tuberculosis Bacilli

Cited by 495 publications

References 12 publications

Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Emerging Antimicrobial Resistance and Evolving Healthcare: Dangerous Crossroads for the Community and the Military

Drug Susceptibility Pattern of <i>M.Tuberculosis</i> Isolated from Patients Attending a Private Hospital

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