Impact of pyrazinamide resistance on multidrug-resistant tuberculosis in Karakalpakstan, Uzbekistan

Kuhlin, Johanna; Smith, Chris; Khaemraev, Atadjan; Tigay, Zinaida; Parpieva, Nargiza; Tillyashaykhov, Mirzagaleb; Achar, Jay; Hájek, Jan; Greig, Jane; Cros, Philipp du; Moore, David

doi:10.5588/ijtld.17.0483

Cited by 8 publications

(3 citation statements)

References 22 publications

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“…[ 30 , 31 ] Our study reaffirms a previous study that showed Hangzhou as having a higher MDR-TB treatment success rate (73.7%) than other areas of China. [ 22 ] This study's success rate is higher than rates seen in most resource-limited countries [ 15 , 32 – 34 ] but lower than success rates of resource-rich counties. [ 11 , 35 , 36 ] When compared to cure rates from other countries, we should note that the successful treatment rate in our study included both cure and completion of treatment according to Chinese guidelines; the successful treatment rate (75.6%) was slightly higher than the cure rate (71.4%).…”

Section: Discussionmentioning

confidence: 94%

“…Treatment success rates range from 34.5% to 81% globally, [ 10 – 14 ] and factors associated with failure of treatment included higher prevalence of XDR-TB, HIV co-infection, use of standardized treatment regimens rather than individualized ones, and incomplete or non-adherent treatment. [ 10 , 12 , 15 – 18 ] There is limited Chinese research on the outcomes of MDR-TB treatment. [ 19 – 22 ] In this study, we aimed to evaluate the trend of treatment success across time and to identify factors associated with unsuccessful treatment outcomes in a cohort of MDR/XDR-TB patients in Hangzhou, China.…”

Section: Introductionmentioning

confidence: 99%

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Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Shi

Lü

et al. 2020

Medicine

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Treatment of multidrug-resistant tuberculosis (MDR-TB) is challenging. More research is needed to understand treatment outcomes and associated factors. A retrospective cohort study was conducted to assess trends and predictors of treatment success among 398 MDR-TB and extensively drug resistant TB patients who started treatment in 2011 to 2015 in Hangzhou, China. Sociodemographic and clinical characteristic data were obtained from the national reporting database. Chi-square test for trend was used to evaluate changes in treatment success rates over the study years, and Cox regression analysis was used to identify predictors for poor treatment outcomes. The treatment success rate was 76% (301/398) for all participants, 77% (298/387) for MDR-TB cases and 27% (3/11) for extensively drug-resistant tuberculosis -TB cases. Treatment success increased significantly from 66% among patients who started treatment in 2011 to 85% in 2015 ( P < .01). Of the 97 (24.4%) patients with unsuccessful treatment outcomes, 10 (2.5%) died, 64 (16.1%) failed treatment, and 23 (5.8%) were lost to follow-up. Patients who started treatment in 2013 to 2015 were less likely to have unsuccessful outcomes than those who started in 2011–2012 (adjusted odds ratio [AOR] 0.4, 95% confidence interval [CI] 0.3–0.6), patients ≥25 years were more likely to have unsuccessful outcomes than younger patients (AOR 1.6, 95% CI 1.3–2.1), and cases with kanamycin resistance was associated with three times the odds of having unsuccessful outcomes than kanamycin-susceptible cases (AOR 3.0, 95% CI 1.5–5.8). With proper case management of MDR-TB, patients can achieve a high treatment success rate. Hangzhou's program offers clinical evidence that can be used to inform MDR-TB programs elsewhere in China and abroad.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Shi

Lü

et al. 2020

Medicine

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“…PZA was always controversial in the treatment of MDR-TB and XDR-TB, some studies showed that PZA resistant or not did not impact its anti-microbial activity (21,26,27), however, the high resistant rate of PZA had been considered its application in the future (28). In the present study, we tested PZA resistance by MIC value, the resistance rate was 50.9%.…”

Section: Discussionmentioning

confidence: 83%

An inexpensive, efficient and safe regimen containing Pasiniazid for MDR-TB in high Tuberculosis epidemic areas – A prospective study in China

Sun

Tang

Wang

et al. 2020

Preprint

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Background: MDR-TB（multidrug-resistant tuberculosis） remains the challenge with low success rate of treatment. Pasiniazid had been applied in China for two decades, but relevant clinical studies are rare. To verify the efficacy and safety of a regimen containing pasiniazid on MDR-TB, a prospective clinical study was conducted in China. Methods: Patients with MDR-TB satisfied with inclusion criteria were prospectively enrolled into the study from 2017 June to 2018 Dec, given the regimen and followed up, observed the treatment outcome and adverse effect of drugs made up the regimen.Results: A total of 114 patients diagnosed as MDR Pulmonary tuberculosis(MDR-PTB) were enrolled into the study and given the regimen with six months of Capremycin(Cm), Levofloxacin(Lfx), Cycloserine(Cs), Protionamide(Pto), Pyrazinamide(Z) and Pasiniazid（Pa）, followed by 12 months of LfxCsPtoZPa. The overall treatment success rate in all enrolled patients was 79.8% (91/114) while it was significantly higher in newly treated MDR-PTB (91.7%, 33/36) than that in retreated MDR-PTB(74.4%，58/78, p value was 0.03); Patients infected with strains resistant to fluoroquinolones impacted the treatment outcome (P<0.05) while other drugs did not (P >0.05). Pasiniazid was taken safely without adverse reaction during the course of treatment.Conclusions: The long term of anti-MDR-PTB regimen containing Pasiniazid was proved to be effective, safe and inexpensive although it contained injectable agents. This regimen is suited to be applied in areas with poor resource and high TB burden.

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Genetic surveillance and outcomes of pyrazinamide and fluoroquinolones-resistant tuberculosis in Taiwan

Huang,

Lin,

Chan

et al. 2023

Journal of Microbiology, Immunology and Infection

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Impact of pyrazinamide resistance on multidrug-resistant tuberculosis in Karakalpakstan, Uzbekistan

Abstract: Treatment of MDR-TB with a standard PZA regimen does not appear to improve treatment outcomes, regardless of PZA susceptibility or duration of treatment.

Cited by 8 publications

References 22 publications

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015

An inexpensive, efficient and safe regimen containing Pasiniazid for MDR-TB in high Tuberculosis epidemic areas – A prospective study in China

Genetic surveillance and outcomes of pyrazinamide and fluoroquinolones-resistant tuberculosis in Taiwan

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