Epidemiology of antituberculosis drug resistance 2002–07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance

Wright, Abigail; Zignol, Matteo; Deun, Armand Van; Falzon, Dennis; Gerdes, Sabine Ruesch; Feldman, Knut; Hoffner, Sven; Drobniewski, Francis; Barrera, Lucía; Soolingen, Dick van; Boulabhal, Fadila; Cn, Paramasivan; Kam, Kai Man; Mitarai, Satoshi; Nunn, Paul; Raviglione, Mario

doi:10.1016/s0140-6736(09)60331-7

Cited by 339 publications

(268 citation statements)

References 6 publications

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“…In addition, 2 other esx proteins, esxS and esxG, share 96% homology; therefore, esxS will represent what we have designated the TB9.8 subfamily. The proteins where chosen on the basis that they met one or more of the following criteria: 1 known efficacy to reduce the bacterial load of Mtb in rodent models 2,12,26,60 putatively secreted antigens; 12,133 antigens known to be immunogenic in humans or cattle, 12 and 4 antigens known to be absent in BCG. 34 The remaining 8 esx genes have little homology to each other and, in order to target the entire family, were also incorporated ( Table S1).…”

Section: Esx Antigen Selection For Constructsmentioning

confidence: 99%

“…1 The increased co-morbidity of TB and HIV, along with the emergence of multidrug resistant strains, facilitates the TB epidemic, a pressing public health threat. 1,2 The only available TB vaccine is the liveattenuated BCG vaccine, which was developed over 90 y ago. While the BCG vaccine has been demonstrated to be effective at reducing the risk of acute disseminated forms of TB, including TB meningitis, developed in exposed infants, its ability to prevent against adult and adolescent pulmonary TB, which accounts for most TB disease worldwide, remains unproven.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multivalent TB vaccines targeting the esx gene family generate potent and broad cell-mediated immune responses superior to BCG

Villarreal¹,

Walters

Laddy

et al. 2014

Human Vaccines & Immunotherapeutics

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Section: Esx Antigen Selection For Constructsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multivalent TB vaccines targeting the esx gene family generate potent and broad cell-mediated immune responses superior to BCG

Villarreal¹,

Walters

Laddy

et al. 2014

Human Vaccines & Immunotherapeutics

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“…The World Health Organization (WHO) estimates current MDRTB rates in new and previously treated cases globally to be 2.9 and 15.3%, respectively (50).…”

mentioning

confidence: 99%

Evaluation of Two Molecular Assays for Rapid Detection of Mycobacterium tuberculosis Resistance to Fluoroquinolones in High-Tuberculosis and -Multidrug-Resistance Settings

et al. 2011

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The Russian Federation is a high-tuberculosis (TB)-burden country with high rates of drug resistance, including multidrug and extensive drug resistance to TB (M/XDRTB). Rapid diagnosis of resistance to fluoroquinolones (FQs) using molecular assays is essential for the implementation of appropriate drug regimens and prevention of the transmission of XDR strains. A total of 51 individual MDRTB strains were tested by pyrosequencing of the quinolone resistance determining region of the gyrA gene and the GenoType MTBDRsl assay (Hain Lifescience, GmbH, Nehren, Germany), and the results were evaluated against those obtained by phenotypic drug susceptibility testing (DST). Mutations were detected in 25 (78.1%) FQ-resistant strains, with the majority of mutations (n ‫؍‬ 19 [73.0%]) found in codon 94 of the gyrA gene; the novel mutation 1457 C3⌻ was found in the gyrB gene. Three mixed allelic variants were detected, which is a well-known phenomenon in areas with high TB and drug-resistant TB rates. The sensitivity and specificity of pyrosequencing (86.2 and 100%, respectively) and MTBDRsl (86.2 and 100%, respectively) were high; however, the results for 5.9% of the analyzed strains were unreadable when MTBDRsl was used. The MTBDRsl and pyrosequencing assays offer a rapid and accurate means for diagnosing resistance to FQs in high-TB-burden areas.Tuberculosis (TB) remains a major threat to public health worldwide and in the developing world in particular, causing almost 2 million deaths annually. The real magnitude of drug resistance is not yet known, although the Indian subcontinent, China, and Russia are believed to account for the majority of cases globally (48).Multidrug-resistant TB (MDRTB), caused by TB bacilli resistant to both isoniazid (INH) and rifampin (RIF), poses difficulties in diagnosis and treatment, with lower survival rates (especially in HIV-infected persons) and the associated high costs of TB control programs. The World Health Organization (WHO) estimates current MDRTB rates in new and previously treated cases globally to be 2.9 and 15.3%, respectively (50).The Russian Federation is a high-TB-burden country with high rates of TB drug resistance, dominated by TB strains of the Beijing family reported to be associated with MDRTB (7, 42). The Samara Oblast (Central Russia) is a hot spot for both TB and HIV epidemics; ca. 20% of new TB cases are MDR, with rates even higher in previously treated cases and in the prison sector (8). Converging TB, drug-resistant TB, and HIV epidemics pose a serious problem for low-and middle-income countries such as Russia where access to second-and third-line drug therapy is limited (2, 8).The rate of extensively drug-resistant TB (XDRTB) (which is caused by MDRTB bacilli with additional resistance to a fluoroquinolone [FQ] and one or more injectable drugs) has been increasing in Russia (36) due to multiple incomplete treatment regimens and poor infection control practice. Cases of XDRTB show a high rate of treatment failure and mortality especially in XDRTB patients with c...

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“…1,2 Mutations in genes encoding drug targets and other mechanisms such as enzymes activating the drug and overexpression of the targets, lead to the evolution of drug resistance particularly in cases with incomplete or inadequate treatment. 3 Sequential accumulations of mutations in target genes generally lead to resistance of multiple drugs.…”

Section: Introductionmentioning

confidence: 99%

First Insight Into the Fluoroquinolone and Aminoglycoside Resistance of Multidrug-Resistant Mycobacterium tuberculosis in Saudi Arabia

Varghese

Al‐Hajoj

2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In Saudi Arabia, there were no nationwide screening studies conducted so far to determine the aminoglycoside and fluoroquinolone resistance among multidrug-resistant tuberculosis (MDR-TB) isolates. Therefore, as the first attempt in the country, a retrospective analysis has been conducted on a nationwide collection of 2,956 M. tuberculosis clinical isolates screened with phenotypic drug susceptibility testing to define MDR-TB. Enrolled MDR-TB isolates were subjected to second-line drug susceptibility testing, detection of mutations conferring resistance to aminoglycosides and fluoroquinolone, followed by 24-loci mycobacterial interspersed repetitive unitvariable number of tandem repeat typing and spoligotyping. Overall, 83 isolates were identified as MDR-TB, and 13 (15.7%) isolates showed resistance to second-line drugs. Moxifloxacin (low level) showed higher resistant rates (10.8%) followed by ofloxacin (7.2%), capreomycin (3.6%), kanamycin (3.6%), and amikacin (2.4%). Overall fluoroquinolone resistance was 12%, whereas aminoglycoside resistance was 7.2%. Predominant mutations conferring resistance to fluoroquinolone were found in gyrA A90V and D94G, whereas aminoglycoside resistance was observed only with rrs gene A1401G mutation. The corresponding strain lineages predominated with Indo-Oceanic and EastAfrican Indian origin. Interestingly, none of the isolates with second-line drug resistance was defined as extensively drug-resistant TB (XDR-TB). Surprisingly, many isolates (50.6%) were panresistant to first-line drugs. Saudi Arabia faces considerable burden of fluoroquinolone-and aminoglycoside-resistant MDR-TB. Higher incidence of panresistant MDR-TB reveals a threat for the emergence of XDR-TB strains in the near future.

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Epidemiology of antituberculosis drug resistance 2002–07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance

Cited by 339 publications

References 6 publications

Multivalent TB vaccines targeting the esx gene family generate potent and broad cell-mediated immune responses superior to BCG

Multivalent TB vaccines targeting the esx gene family generate potent and broad cell-mediated immune responses superior to BCG

Evaluation of Two Molecular Assays for Rapid Detection of Mycobacterium tuberculosis Resistance to Fluoroquinolones in High-Tuberculosis and -Multidrug-Resistance Settings

First Insight Into the Fluoroquinolone and Aminoglycoside Resistance of Multidrug-Resistant Mycobacterium tuberculosis in Saudi Arabia

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