Respiratory Review of 2014: Tuberculosis and Nontuberculous Mycobacterial Pulmonary Disease

Abstract

Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.

Prevalência De Notificação Dos Casos De Tuberculose Nas Estratégias De Saúde Da Família No Município De Santa Cruz Do Sul, Rs

“…[28][29][30] Outros estudos ainda mostram que a prevalência de infecção é 2,5 vezes maior nos contatos do que na população em geral, reiterando a importância da busca ativa realizada pelas ESF. 31,32 Com a metodologia empregada no presente estudo, não há como afirmar se a busca ativa dos contatos próximos do paciente foi realizada, mas essa hipótese ganha força ao observar-se a distribuição da doença nas populações analisadas em que, em vários locais, há apenas 1 caso notificado, corroborando com a proposta de busca ativa dos vulneráveis diminuindo a prevalência da doença. Entretanto, em estudo realizado no município, entre 2000 e 2010, observou-se que a maior prevalência de notificação foi encontrada em bairros de baixa condição socioeconômica.…”

Serum concentrations of clarithromycin and rifampicin in pulmonary Mycobacterium avium complex disease: long-term changes due to drug interactions and their association with clinical outcomes

“…Currently, the bacilli negative conversion rates of the standard treatment for pulmonary MAC disease have been reported to be approximately 60–80 % [ 21 – 25 ], with relapse occurring in 48 % of patients after completion of treatment [ 26 ]. Therefore, this disease is often difficult to treat.…”

Identification and application of ssDNA aptamers against H37Rv in the detection of Mycobacterium tuberculosis

“…drugs (Park and Kwon 2014). Thus, it is essential to develop a species-specific detective method to increase the specificity of identifying MTB by microscopic observation.…”