Clinical implications of the global multidrug-resistant tuberculosis epidemic

Abstract

Multidrug-resistant tuberculosis (MDR TB) IntroductionThe significant threat of the global multidrug-resistant tuberculosis (MDR TB) epidemic has been described as a crisis in the World Health Organization's (WHO's) End TB strategy .1 MDR TB is defined as tuberculosis (TB) caused by Mycobacterium tuberculosis isolates that are resistant to at least both rifampicin and isoniazid.2 The WHO's Global tuberculosis report supplement in 2014 estimated that MDR TB accounts for 3.5% (95% confidence interval (CI) 2.2-4.7%) of all new cases of TB and 20.5% (95% CI 13.6-27.5%) of TB cases among individuals previously treated for the disease. 3 There were approximately 480,000 new cases of MDR TB globally in 2013, with an estimated 210,000 deaths attributable to MDR TB. The highest levels of MDR TB are in Eastern European and Asian countries, with more than half the global burden of MDR TB being located in India, China and Russia. 4 Additional cause for concern is the emergence of extensively drug-resistant TB (XDR TB), which is defined as tuberculosis caused by M tuberculosis isolates that are resistant to rifampicin, isoniazid, any ABSTRACT fluoroquinolones and at least one of the second-line injectable drugs (capreomycin, kanamycin and amikacin). Here we provide an overview of the importance of MDR TB, its epidemiology, clinical implications, potential ways of addressing the disease and prospects for new diagnostics and treatment. EpidemiologyGlobal epidemiology of TB

A simple-to-use nomogram for the individualized prediction of multidrug-resistant tuberculosis among individuals with previous tuberculosis history

“…To decrease the risk of MDR-TB, it is vital that standardized TRs are implemented by re-treatment TB patients. Some researchers found a highly significant association between the contact with MDR-TB patient and incident MDR-TB [6,14,30]. Our study also suggested that a history of direct contact was one of the strongest independent predictors for incident MDR-TB in individuals with PTBH.…”

“…To date, in the research field of MDR-TB control, though some variables, such as sociodemographic, clinical, and microbiological predictors [12][13][14], have been well recognized as determinants of incident MDR-TB risk in TB patients, few studies focused on the status of incident MDR-TB among individuals with PTBH, let alone integrated them so as to comprehensively assess a patient's specific risk of incident MDR-TB. It is now well established from a variety of studies, that the nomogram model is an algorithm with integrating predictors and has been identified as a practical tool of preventive interventions [15].…”

Some New Hydrazone Derivatives Bearing the 1,2,4-Triazole Moiety as Potential Antimycobacterial Agents

“…For this reason, more chemotherapeutic agents are still needed. 13 Azole antifungal/antimycobacterial drugs, containing one of the most important classes of heterocycles, such as econazole, miconazole, and clotrimazole, stop the growth of bacteria by inhibiting P450 enzymes (CYP51, CYP121, and CYP130) and show inhibitory potential against MDR-TB in vitro and in vivo (infected mice). [14][15][16] It was also shown that some azole derivatives display a mixed-function oxidase on sterol synthesis in eukaryotic organisms.…”

Some New Hydrazone Derivatives Bearing 1,2,4-Triazole Moiety as Potential Antimycobacterial Agents

“…Current treatment regimens have not been able to reduce the number of MDR-TB and XDR-TB infections while achieving reductions in the number of TB infections and death. For this reason, more chemotherapeutic agents are still needed 9 .…”

“…IR (ATR, cm -1 ); 3232, 3124, 3038, 1603, 1591, 1563, 1517, 1494, 1266 1. H-NMR (DMSO-d6, ppm); δ 10.45 (1H; br; -NH-),9.27 (1H; s; triazole), 8.22 (1H; s; triazole), 7.85 (2H; d; ar. J: 8.8 Hz), 7.84 (1H; s; -N=CH-), 7.78 (2H; d; ar.…”