High frequency of multidrug‐resistant <i>Mycobacterium tuberculosis</i> isolates in Georgetown, Guyana

Menner, Nikolai; Günther, Ingo; Orawa, Helmut; Roth, Andreas; Rambajan, I; Wagner, Jutta; Hahn, Helmut; Persaud, S.; Ignatius, Ralf

doi:10.1111/j.1365-3156.2005.01521.x

Cited by 8 publications

(3 citation statements)

References 11 publications

(9 reference statements)

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“…This finding is in agreement with a previous study that reported resistance to at least one anti-TB drug in 22.2% of the tested Guyanese MTBC isolates and MDR-TB in 11.1% of the strains [21]. The authors attributed these high levels of resistance to inadequate monitoring and followup of patient treatment and to poor management of the TB control program.…”

Section: Discussionsupporting

confidence: 92%

A First Assessment ofMycobacterium tuberculosisGenetic Diversity and Drug-Resistance Patterns in Twelve Caribbean Territories

Millet

Baboolal

Streit

et al. 2014

BioMed Research International

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With the exception of some French-speaking islands, data on tuberculosis (TB) in the Caribbean are scarce. In this study, we report a first assessment of genetic diversity of a convenience sample of Mycobacterium tuberculosis strains received from twelve Caribbean territories by spoligotyping and describe their drug-resistance patterns. Of the 480 isolates, 40 (8.3%) isolates showed resistance to at least one anti-TB drug. The proportion of drug-resistant strains was significantly higher in The Bahamas (21.4%; P = 0.02), and Guyana (27.5%; P < 0.0001), while it was significantly lower in Jamaica (2.4%; P = 0.03) than in other countries of the present study. Regarding genetic diversity, 104 distinct spoligotype patterns were observed: 49 corresponded to clustered strains (2 to 93 strains per cluster), while 55 remained unclustered among which 16 patterns were not reported previously. Combining the study results with regional data retrieved from the international SITVIT2 database underlined a connection between frequency of certain M. tuberculosis phylogenetic lineages and the language spoken, suggesting historical (colonial) and ongoing links (trade, tourism, and migratory flows) with European countries with which they shared a common past.

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Section: Discussionsupporting

confidence: 92%

A First Assessment ofMycobacterium tuberculosisGenetic Diversity and Drug-Resistance Patterns in Twelve Caribbean Territories

Millet

Baboolal

Streit

et al. 2014

BioMed Research International

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“…This data confirms the continued existence of drug resistance in Guyana, as an earlier report by Menner et al, 2005 [40] also reported a high frequency of drug resistance in this country with 22.2% of the isolates tested showing resistance to at least one anti-tuberculosis drug and 11.1% showing resistance to INH and RIF [40]. The reason for the continued persistence of MDR-TB in Guyana according to Menner et al is the lack of human resources to adequately follow up and monitor patient treatment as well as poor management of the tuberculosis control programme [40]. In this present study similar results were seen as 20.5% of isolates tested showed resistance to at least one anti-TB drug and 14.5% showed resistance to INH and RIF (MDR-TB).…”

Section: Profiles Of Drug Susceptibility Patterns Of Mycobacterium Tusupporting

confidence: 78%

Laboratory Diagnosis of Latent and Active Tuberculosis Infections in Trinidad & Tobago and Determination of Drug Susceptibility Profile of Tuberculosis Isolates in the Caribbean

Akpaka¹,

Baboolal²

2012

Understanding Tuberculosis - Global Experiences and Innovative Approaches to the Diagnosis

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“…These omissions may result in an underestimate of the burden of resistant disease and preclude design of effective standardized regimens. 52 The foregoing summary results also mask significant variability (Table 1 [53][54][55][56][57][58][59][60][61][62][63][64] ). * In some parts of the world, like the former Soviet Union and eastern Europe, the percent of new and previously treated TB cases with Source population and sampling strategy are specified for those countries or regions for which sampling was conducted.…”

Section: Epidemiology Of Mdr-tbmentioning

confidence: 99%

Epidemiology and Treatment of Multidrug Resistant Tuberculosis

Mitnick

Appleton

Shin

2008

Semin Respir Crit Care Med

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Multidrug resistant tuberculosis is now thought to afflict between 1 and 2 million patients annually. Although significant regional variability in the distribution of disease has been recorded, surveillance data are limited by several factors. The true burden of disease is likely underestimated. Nevertheless, the estimated burden is substantial enough to warrant concerted action. A range of approaches is possible, but all appropriate interventions require scale-up of laboratories and early treatment with regimens containing a sufficient number of second-line drugs. Ambulatory treatment for most patients, and improved infection control, can facilitate scale-up with decreased risk of nosocomial transmission. Several obstacles have been considered to preclude worldwide scale-up of treatment, mostly attributable to inadequate human, drug, and financial resources. Further delays in scale-up, however, risk continued generation and transmission of resistant tuberculosis, as well as associated morbidity and mortality. KeywordsTuberculosis; drug resistance; surveillance; management; epidemiology An estimated 489,139, or nearly 5% of all new cases of tuberculosis (TB) diagnosed in 2006 were multidrug resistant (MDR), that is resistant to isoniazid and rifampicin, the two most effective anti-TB agents. This represents an increase of 12% since 2004 and 56% since 2000. 1 An additional 1 to 1.5 million prevalent cases of MDR-TB were estimated in 2006, resulting in as many as 2 million people with active disease. 2 The successful treatment of MDR-TB requires the use of second-line drugs, which historically presented an insurmountable cost barrier in resource-poor settings. To alleviate this gap, the World Health Organization (WHO) established the Green Light Committee (GLC) in 2000 to facilitate access to and strictly supervise the use of second-line agents for TB control.Even with the inception of the GLC and a significant reduction in cost of second-line drugs, drug resistant TB continues to grow and challenge the current capacity in most settings. Recognition of the magnitude of the MDR-TB problem and its associated morbidity and mortality has motivated recent calls for increased research and scaled-up treatment. 3,4 Several recent, excellent articles have reviewed the molecular mechanisms of resistance, risk factors for drug resistant TB (DR-TB), DR-TB and HIV, and global epidemiology of TB. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] This article highlights the gaps in knowledge of the global epidemiology of MDR-TB, illustrates EPIDEMIOLOGY OF MDR-TB Drug Resistance and Multidrug TherapyDR-TB is defined as tuberculosis caused by a strain of Mycobacterium tuberculosis that grows, in vitro, in the presence of one or more antimycobacterial drugs. Spontaneous mutations leading to resistance occur at random in large populations of M. tuberculosis at a rate per cell division of 10 −10 for rifampin (RIF), 10 −8 for isoniazid (INH) and streptomycin, 10 −6 to 10 −8 for fluoroquinolones, 10 −7 for etham...

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High frequency of multidrug‐resistant Mycobacterium tuberculosis isolates in Georgetown, Guyana

Cited by 8 publications

References 11 publications

A First Assessment ofMycobacterium tuberculosisGenetic Diversity and Drug-Resistance Patterns in Twelve Caribbean Territories

A First Assessment ofMycobacterium tuberculosisGenetic Diversity and Drug-Resistance Patterns in Twelve Caribbean Territories

Laboratory Diagnosis of Latent and Active Tuberculosis Infections in Trinidad & Tobago and Determination of Drug Susceptibility Profile of Tuberculosis Isolates in the Caribbean

Epidemiology and Treatment of Multidrug Resistant Tuberculosis

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