Extensively Drug-Resistant Tuberculosis

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D. Van Soolingen - One of the best experts on this subject based on the ideXlab platform.

  • Individualizing management of Extensively Drug-Resistant Tuberculosis: diagnostics, treatment, and biomarkers
    Expert review of anti-infective therapy, 2016
    Co-Authors: Jan-willem C. Alffenaar, Martin P. Grobusch, Scott K. Heysell, Onno W. Akkerman, Richard M. Anthony, Simon Tiberi, Frank Cobelens, D. Van Soolingen
    Abstract:

    ABSTRACTIntroduction: Success rates for treatment of Extensively drug resistant Tuberculosis (XDR-TB) are low due to limited treatment options, delayed diagnosis and inadequate health care infrastructure.Areas covered: This review analyses existing programmes of prevention, diagnosis and treatment of XDR-TB. Improved diagnostic procedures and rapid molecular tests help to select appropriate drugs and dosages. Drugs dosages can be further tailored to the specific conditions of the patient based on quantitative susceptibility testing of the M. Tuberculosis isolate and use of therapeutic drug monitoring. Pharmacovigilance is important for preserving activity of the novel drugs bedaquiline and delamanid. Furthermore, biomarkers of treatment response must be developed and validated to guide therapeutic decisions.Expert commentary: Given the currently poor treatment outcomes and the association of XDR-TB with HIV in endemic regions, a more patient oriented approach regarding diagnostics, drug selection and tail...

  • Characterization of Extensively Drug-Resistant Tuberculosis cases from Valle del Cauca, Colombia.
    Journal of Clinical Microbiology, 2012
    Co-Authors: Luisa María Nieto, Beatriz E. Ferro, Sonia L. Villegas, Carolina Mehaffy, Liliana Forero, Nalin Rastogi, Cesar Moreira, D. Van Soolingen
    Abstract:

    Extensively drug resistant Tuberculosis (XDR-TB), which is TB resistant to isoniazid and rifampin plus one fluoroquinolone and a second-line injectable drug, represents an obstacle for the treatment and control of TB. This paper presents data on molecular characterization of XDR-TB cases from Valle del Cauca, Colombia.

  • Characterization of Extensively Drug-Resistant Tuberculosis Cases from Valle del Cauca, Colombia
    Journal of clinical microbiology, 2012
    Co-Authors: Luisa María Nieto, Beatriz E. Ferro, Sonia L. Villegas, Carolina Mehaffy, Liliana Forero, César A. Moreira, Nalin Rastogi, D. Van Soolingen
    Abstract:

    Extensively Drug-Resistant Tuberculosis (XDR-TB), which is TB resistant to isoniazid and rifampin plus one fluoroquinolone and a second-line injectable drug, represents an obstacle for the treatment and control of TB. Previously, we reported four XDR-TB cases and a high proportion of the Beijing

Nesri Padayatchi - One of the best experts on this subject based on the ideXlab platform.

  • Adherence in the treatment of patients with Extensively Drug-Resistant Tuberculosis and HIV in South Africa: a prospective cohort study.
    Journal of acquired immune deficiency syndromes (1999), 2014
    Co-Authors: Max Roe Oʼdonnell, Lise. Werner, Allison Wolf, C. Robert Horsburgh, Nesri Padayatchi
    Abstract:

    Objective Extensively Drug-Resistant Tuberculosis (XDR-TB)/HIV co-infection is difficult to treat with frequent adverse drug reactions, and high mortality. Adherence to antiretroviral therapy (ARV) and second-line TB medications may reduce mortality, prevent amplification of drug-resistance, and improve outcomes.

  • Treatment Outcomes for Extensively Drug-Resistant Tuberculosis and HIV Co-infection
    Emerging infectious diseases, 2013
    Co-Authors: Max R. O'donnell, Nesri Padayatchi, Lise. Werner, Iqbal Master, Charlotte Kvasnovsky, C. Robert Horsburgh
    Abstract:

    High mortality rates have been reported for patients co-infected with Extensively Drug-Resistant Tuberculosis (XDR-TB) and HIV, but treatment outcomes have not been reported. We report treatment outcomes for adult XDR TB patients in KwaZulu-Natal Province, South Africa. Initial data were obtained retrospectively, and outcomes were obtained prospectively during 24 months of treatment. A total of 114 XDR TB patients were treated (median 6 drugs, range 3–9 drugs); 82 (73%) were HIV positive and 50 (61%) were receiving antiretroviral therapy. After receiving treatment for 24 months, 48 (42%) of 114 patients died, 25 (22%) were cured or successfully completed treatment, 19 (17%) withdrew from the study, and 22 (19%) showed treatment failure. A higher number of deaths occurred among HIVpositive patients not receiving antiretroviral therapy and among patients who did not show sputum culture conversion. Culture conversion was a major predictor of survival but was poorly predictive (51%) of successful treatment outcome.

  • Pulmonary Resection for Extensively Drug Resistant Tuberculosis in Kwazulu-Natal, South Africa
    The Annals of thoracic surgery, 2012
    Co-Authors: Adam Iddriss, Nesri Padayatchi, Darshan Reddy, Anu Reddi
    Abstract:

    Background Extensively drug resistant Tuberculosis (XDR-TB) has been reported in 58 countries around the world and has emerged as a major public health challenge. Our objective was to determine the impact of pulmonary resection on XDR-TB treatment outcomes in a resource-constrained setting. Methods We conducted a retrospective case review of 11 patients with XDR-TB who were referred for pulmonary resection between January 2007 and June 2010 at a tertiary care referral hospital in South Africa. Two pneumonectomies and three upper lobectomies were performed. Occurrence of surgical complications and TB treatment outcome were assessed. Results No perioperative mortality or major morbidity was noted. All patients achieved sputum conversion, with 4 regarded as "cured." One patient defaulted on treatment, but subsequently returned and is regarded as a probable cure. Conclusions We describe pulmonary resection for XDR-TB management in Africa. Although the initial cohort of XDR-TB patients from Tugela Ferry demonstrated nearly complete mortality, our results demonstrate the potential of adjuvant surgical methods in XDR-TB treatment. With appropriate chemotherapy and timely adjuvant surgery, patients with XDR-TB localized to lobe or lung may achieve a "cure" with low morbidity and mortality. Consequently, this approach may be the most cost effective treatment for patients suitable for lung resection.

  • High Incidence of Hospital Admissions With MultiDrug-Resistant and Extensively Drug-Resistant Tuberculosis Among South African Health Care Workers
    Annals of internal medicine, 2010
    Co-Authors: Max R. O'donnell, Nesri Padayatchi, Julie Jarand, Marian Loveday, Jennifer Zelnick, Lise. Werner, K Naidoo, Iqbal Master, Garth Osburn, Charlotte Kvasnovsky
    Abstract:

    The rates of multiDrug-Resistant Tuberculosis (MDR-TB) and Extensively Drug-Resistant Tuberculosis (XDR-TB) are high in South Africa, but the risks for these diseases among health care workers have...

  • Managing multiple and Extensively Drug-Resistant Tuberculosis and HIV
    Expert opinion on pharmacotherapy, 2007
    Co-Authors: Nesri Padayatchi, Gerald Friedland
    Abstract:

    Global increases in multi-Drug-Resistant and Extensively Drug-Resistant Tuberculosis (TB), are threatening both TB and HIV treatment programs worldwide. Together, they raise concerns of a global epidemic of untreatable TB. In the developing world, the directly observed treatment, short course (DOTS) strategy is proving ineffective as available resources are being outstripped by the large number of patients needing treatment. Thus, TB treatment and outcomes are sub-optimal, and multi-drug resistant and Extensively Drug-Resistant TB are on the rise.

Salmaan Keshavjee - One of the best experts on this subject based on the ideXlab platform.

  • treatment of Extensively drug resistant Tuberculosis in tomsk russia a retrospective cohort study
    The Lancet, 2008
    Co-Authors: I Y Gelmanova, Sergey P Mishustin, A K Strelis, Salmaan Keshavjee, Paul Farmer, Yevgeny G Andreev
    Abstract:

    Summary Background Mycobacterium Tuberculosis strains that cause untreatable Drug-Resistant disease are a threat worldwide. We describe the treatment, management, and outcomes of patients with Extensively Drug-Resistant Tuberculosis in Tomsk, Russia. Methods We undertook a retrospective cohort study of 608 patients with multidrug resistant Tuberculosis who had treatment in civilian or prison services, between Sept 10, 2000, and Nov 1, 2004, according to the treatment strategy recommended by WHO. Clinical characteristics, management practices, and treatment outcomes of patients with Extensively Drug-Resistant (XDR) Tuberculosis and non-Extensively Drug-Resistant (non-XDR) Tuberculosis are described. The main outcome was the frequency of poor and favourable outcomes at the end of treatment. Findings Of 608 patients with multidrug resistant Tuberculosis, 29 (4·8%) patients had baseline XDR Tuberculosis. Treatment failure was more common in patients with XDR Tuberculosis than in those with non-XDR Tuberculosis (31% vs 8·5%, p=0·0008). 48·3% of patients with XDR Tuberculosis and 66·7% of patients with non-XDR Tuberculosis had treatment cure or completion (p=0·04). The frequency and management of adverse events did not differ between patients with XDR and non-XDR Tuberculosis. Interpretation The chronic features of Tuberculosis in these patients suggest that Extensively Drug-Resistant Tuberculosis may be acquired through previous treatments that include second-line drugs. Aggressive management of this infectious disease is feasible and can prevent high mortality rates and further transmission of Drug-Resistant strains of Mycobacterium Tuberculosis . Funding Bill & Melinda Gates Foundation, Eli Lilly Foundation, The Open Society Institute, Frank Hatch Fellowships in Global Health Equity at the Brigham & Women's Hospital, Infectious Disease Society of America, the Heiser Foundation, the United States National Institutes of Health, and the John D and Catherine T MacArthur Foundation.

  • Treatment of Extensively Drug-Resistant Tuberculosis in Tomsk, Russia : a retrospective cohort study. Commentary
    The Lancet, 2008
    Co-Authors: Helen Cox, Sergey P Mishustin, A K Strelis, Yevgeny G Andreev, Salmaan Keshavjee, Paul Farmer, Cheryl Mcdermid, Sidney Atwood
    Abstract:

    Background Mycobacterium Tuberculosis strains that cause untreatable Drug-Resistant disease are a threat worldwide. We describe the treatment, management, and outcomes of patients with Extensively Drug-Resistant Tuberculosis in Tomsk, Russia. Methods We undertook a retrospective cohort study of 608 patients with multidrug resistant Tuberculosis who had treatment in civilian or prison services, between Sept 10, 2000, and Nov 1, 2004, according to the treatment strategy recommended by WHO. Clinical characteristics, management practices, and treatment outcomes of patients with Extensively Drug-Resistant (XDR) Tuberculosis and non-Extensively Drug-Resistant (non-XDR) Tuberculosis are described. The main outcome was the frequency of poor and favourable outcomes at the end of treatment. Findings Of 608 patients with multidrug resistant Tuberculosis, 29 (4-8%) patients had baseline XDR Tuberculosis. Treatment failure was more common in patients with XDR Tuberculosis than in those with non-XDR Tuberculosis (31% vs 8·5%, p=0·0008). 48·3% of patients with XDR Tuberculosis and 66-7% of patients with non-XDR Tuberculosis had treatment cure or completion (p=0·04). The frequency and management of adverse events did not differ between patients with XDR and non-XDR Tuberculosis. Interpretation The chronic features of Tuberculosis in these patients suggest that Extensively Drug-Resistant Tuberculosis may be acquired through previous treatments that include second-line drugs. Aggressive management of this infectious disease is feasible and can prevent high mortality rates and further transmission of Drug-Resistant strains of Mycobacterium Tuberculosis. Funding Bill & Melinda Gates Foundation, Eli Lilly Foundation, The Open Society Institute, Frank Hatch Fellowships in Global Health Equity at the Brigham & Women's Hospital, Infectious Disease Society of America, the Heiser Foundation, the United States National Institutes of Health, and the John D and Catherine T MacArthur Foundation.

Michel Drancourt - One of the best experts on this subject based on the ideXlab platform.

  • Old antibiotics for emerging multiDrug-Resistant/Extensively Drug-Resistant Tuberculosis (MDR/XDR-TB)
    International Journal of Antimicrobial Agents, 2017
    Co-Authors: Philippe Brouqui, Fanny Quenard, Michel Drancourt
    Abstract:

    Recently, multiDrug-Resistant Tuberculosis (MDR-TB) has become a therapeutic challenge. In addition to drug resistance, drug adverse events, intravenous delivery, cost and availability of some antibiotics in low-income countries have led to a look back to old drugs, especially those efficient against closely related organisms such as Mycobacterium leprae. Here we review the available drugs that respect the conditions above and could be upgraded to first-line therapy for treating MDR-TB and Extensively Drug-Resistant Tuberculosis (XDR-TB). (C) 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  • Old antibiotics for emerging multiDrug-Resistant/Extensively Drug-Resistant Tuberculosis (MDR/XDR-TB).
    International journal of antimicrobial agents, 2017
    Co-Authors: Philippe Brouqui, Fanny Quenard, Michel Drancourt
    Abstract:

    Recently, multiDrug-Resistant Tuberculosis (MDR-TB) has become a therapeutic challenge. In addition to drug resistance, drug adverse events, intravenous delivery, cost and availability of some antibiotics in low-income countries have led to a look back to old drugs, especially those efficient against closely related organisms such as Mycobacterium leprae. Here we review the available drugs that respect the conditions above and could be upgraded to first-line therapy for treating MDR-TB and Extensively Drug-Resistant Tuberculosis (XDR-TB).

Luisa María Nieto - One of the best experts on this subject based on the ideXlab platform.

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