Prevalence of and risk factors for resistance to second-line drugs in people with multidrug-resistant tuberculosis in eight countries: a prospective cohort study

Dalton, Tracy; Cegielski, Peter; Akksilp, Somsak; Asencios, Luis; Caoili, Janice Campos; Cho, Sang Nae; Erokhin, V V; Ershova, Julia; Gler, Ma Tarcela; Kazennyy, Boris Y.; Kim, Hee Jin; Kliiman, Kai; Kurbatova, Ekaterina V.; Kvasnovsky, Charlotte; Leimane, Vaira; Walt, Martie van der; Via, Laura E.; Volchenkov, Grigory; Yagui, Martín; Kang, Hyungseok

doi:10.1016/s0140-6736(12)60734-x

Cited by 200 publications

(180 citation statements)

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“…If these drugs are misused, multidrug-resistant TB (MDR-TB) can develop [1]. MDR-TB is one of the most dangerous forms of TB; it is defined as tuberculosis that is resistant to at least isoniazid and rifampicin, the two most powerful first-line anti-TB treatment drugs [3]. MDR-TB takes longer to treat with second-line drugs (SLDs), which are more expensive and have more side effects.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Areeshi

Bisht

Mandal

et al. 2014

J Infect Dev Ctries

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Introduction: The prevalence of drug resistance in clinical isolates of Mycobacterium tuberculosis from the Gulf Cooperation Council (GCC; Saudi Arabia, Qatar, Bahrain, Kuwait, Oman, United Arab Emirates [UAE]) countries was appraised using reports published between January 2002 and March 2013. Methodology: A total of 11,393 tuberculosis (TB) isolates from the GCC were studied through published literature and were analyzed statistically. Results: Most of the isolates were resistant to isoniazid, followed by streptomycin, rifampin, ethambutol, and pyrazinamide. The highest prevalence rate of multidrug-resistant-TB (MDR-TB) was found in UAE (9.2%), followed by Kuwait (5.9%) and Saudi Arabia (4.3%). The overall MDR-TB prevalence rate was recorded as 4.0% in the entire GCC region. Automated linear modeling revealed that isoniazid resistance had a strong relationship with the prevalence of MDR-TB in all the GCC countries and was found to be the strongest predictor for MDR-TB. Interestingly, rifampicin resistance was significantly associated with the prevalence of MDR-TB in Oman, Kuwait, and Saudi Arabia, while isoniazid was identified for UAE. On the basis of a number of reports and isolates, the principal component analysis showed that, among all GCC member countries, the highest burden of TB was in Saudi Arabia and Kuwait, and maximum drug resistance was present in UAE. Conclusion: The study demonstrates that the prevalence of MDR-TB in GCC countries is almost equal to other developing and developed countries, and requires immediate attention for surveillance and control.

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Section: Introductionmentioning

confidence: 99%

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Areeshi

Bisht

Mandal

et al. 2014

J Infect Dev Ctries

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“…Dalton u. Mitarb. fanden in Osteuropa und im Baltikum ebenfalls über 95 % Streptomycinresistenzen, während diese in allen anderen untersuchten Regionen deutlich seltener anzufinden waren [7]. In unserer Studie zeigten die Stämme aus der Region Tschetschenien einen signifikant höheren Anteil an Resistenzen gegen Amikacin.…”

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“…In unserer Studie zeigten die Stämme aus der Region Tschetschenien einen signifikant höheren Anteil an Resistenzen gegen Amikacin. Daten der WHO [10,11] und der PETTS-Studie [7] zeigten ebenfalls relevante Unterschiede zwischen den regionalen Resistenzhäufigkeiten verschiedener Hochprävalenzregionen weltweit. Auch innerhalb Osteuropas konnten regionale Unterschiede gezeigt werden.…”

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“…Amikacin traten in Estland/Lettland/Russland in jeweils 4,4 %/15,0 %/7,0 % bzw. 23,9 %/35,0 %/16,5 % der Stämme auf [7]. In Anbetracht der Toxizität dieser Medikamentengruppe wäre die Kenntnis regional hoher Resistenzraten für die kalkulierte Therapie von besonderer Relevanz.…”

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“…Als Risikofaktoren für zusätzliche Medikamentenresistenzen bei MDR TB-Patienten sind vor allem die Vorbehandlung mit Zweitlinienmedikamenten und vorherige Krankenhausaufenthalte mit der Gefahr einer nosokomialen Übertragung beschrieben [12]. Soziale Indikatoren wie der Aufenthalt in Gefängnissen, Arbeitslosigkeit, Alkoholismus und Rauchen scheinen vor allem das Auftreten von Resistenzen gegen injizierbare Zweitlinienmedikamente zu beeinflussen [7]. In einer russischen Studie entwickelten 5 % der MDR TB-Patienten eine XDR TB im Verlauf der Therapie, 6 Monate nach Abschluss der Therapie stieg dieser Anteil sogar auf 11 % [13].…”

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Resistenzen gegen Zweitlinienmedikamente bei Migranten mit multiresistenter Tuberkulose in der Region Berlin

et al. 2014

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!The empiric therapy of multidrug-resistant (MDR) tuberculosis (TB) after rapid molecular testing is rendered difficult by an often several weeks-long period of uncertainty, because results of susceptibility testing for second-line TB drugs are pending. The analysis of regional resistance patterns could lead to a more targeted empiric treatment for migrants depending on their country of origin. The results of the susceptibility testing from 2008 to 2013 of all mycobacteria sent to the Institute of Microbiology, working with the department of Pneumology, Heckeshorn Lung Clinic, Berlin, were reanalysed and tested for regional differences. We found 39 multidrug-resistant Mycobacterium tuberculosis strains among the examined strains. More than half of these strains tested susceptible to the following second line drugs namely, linezolid (97 %), clofazimine (95 %), cycloserine (95 %), capreomycin (90 %), p-aminosalicylic acid (82 %), moxifloxacin (79 %) and amikacin (79 %). The proportion of strains susceptible to pyrazinamide (44 %), ethambutol (28 %), prothionamide (15 %), rifabutin (8 %) and streptomycin (8 %) was lower. The mycobacterial cultures of the Chechen patients (n = 14) showed significantly different susceptibilities to amikacin (57 %) and prothionamide (36 %) compared to the strains from migrants of other regions. In this study, the regional differences in mycobacterial susceptibility to second line drugs suggest that the initial MDR TB therapy of migrants should be tailored to their country of origin.Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages. Einleitung

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Precision medicine in Thailand

Shotelersuk

Tongsima

Pithukpakorn

et al. 2019

American J of Med Genetics Pt C

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Extraordinary advances in high throughput next generation sequencing (NGS) technology and bioinformatics are the main thrust that transforms the current state of healthcare into the era of precision medicine where clinical practice takes individual variability into account. Here, we summarize the current status of the infrastructure we have and the adoption of precision medicine in Thailand in four spheres: rare diseases, oncology, pharmacogenomics, and noncommunicable diseases. Moreover, we provide our perspectives to the future of precision medicine in Thailand, especially the manpower and ethical, legal, and social issues. We believe that with decreasing costs of NGS, increasing ability to interpret the genomic data, a greater number of actionable and available treatments, implementation of precision medicine at the public health level is not a matter of if but when. K E Y W O R D Snoncommunicable diseases, pharmacogenomics, precision medicine, precision oncology, rare diseases, Thailand

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Prevalence of and risk factors for resistance to second-line drugs in people with multidrug-resistant tuberculosis in eight countries: a prospective cohort study

Cited by 200 publications

References 11 publications

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Prevalence of drug resistance in clinical isolates of tuberculosis from GCC: a literature review from January 2002 to March 2013

Resistenzen gegen Zweitlinienmedikamente bei Migranten mit multiresistenter Tuberkulose in der Region Berlin

Precision medicine in Thailand

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