Molecular Epidemiology and Clinical Characteristics of Drug-Resistant Mycobacterium tuberculosis in a Tuberculosis Referral Hospital in China

Wang, Qi; Lau, Susanna K.P.; Liu, Fei; Zhao, Yanlin; Li, Hong Min; Li, Bing Xi; Hu, Yu Jeffrey; Woo, Patrick C. Y.; Liu, Cui Hua

doi:10.1371/journal.pone.0110209

Cited by 10 publications

(12 citation statements)

References 24 publications

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“…This requires careful risk assessment of patients. Previous treatment failure, MDR/RR‐TB exposure, comorbid conditions such as human immunodeficiency virus (HIV) infection (Rajasekaran et al., ) and diabetes (Liu et al., ), malnutrition, genotype (Drobniewski et al., ; Ejo et al., ) and mutation of M.tb strains (Wang et al., ) are the well‐accepted risk factors for MDR/RR‐TB.…”

Section: Introductionmentioning

confidence: 99%

Genetic polymorphism of human leucocyte antigen and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis in Han Chinese from Hubei Province

Zhou

Yang

et al. 2017

Int J Immunogenetics

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We determined the high-resolution allele and haplotype frequencies at the human leucocyte antigen (HLA)A, B and DRB1 loci in the Han population of Hubei province, the TB endemic area of Central China, with pulmonary tuberculosis (PTB), and established the relationship between HLA-A, B and DRB1 alleles as well as haplotypes and susceptibility to multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB). Blood samples were drawn from 174 patients with MDR/RR-TB and 838 patients with drug-susceptible PTB in ethnic Han population from Hubei province (central China). Four-digit allele genotyping of HLA- A, B and DRB1 loci was performed using polymerase chain reaction with sequence-specific oligonucleotide probes (PCR- SSOP). The allele and haplotype frequencies of HLA-A, B and DRB1 were determined and compared between patients with MDR/RR-TB and patients with drug-susceptible PTB. Statistical analysis of the generated data indicated no departure from expectation of Hardy-Weinberg equilibrium (HWE) at all loci of the control group. Multivariate analysis identified allele DRB1*08:01 (p < .0001; OR = 174.5, 95% CI 15.3-1987.2) as independent predictor of MDR/RR-TB, except for old age (p < .0001; OR = 10. 9, 95% CI 7.6-15.8), previous treatment history (p < .0001; OR = 11.0, 95% CI 7.2-16.7) and poor compliance to treatment (p < .0001; OR = 12.9, 95% CI 8.4-20.0). While in the subgroup of new TB cases, DRB1*08:01 (p < .0001; OR = 80.3, 95% CI 7.0-917.1) and older age (p < .0001; OR = 3.9, 95% CI 2.4-6.4) were independent susceptibility factors for primary MDR/RR-TB. Our results suggest that a combination of clinical and host genetic information about tuberculosis patients may contribute to prediction and early detection of MDR/RR-TB.

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Section: Introductionmentioning

confidence: 99%

Genetic polymorphism of human leucocyte antigen and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis in Han Chinese from Hubei Province

Zhou

Yang

et al. 2017

Int J Immunogenetics

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“…Os bacilos presentes nessas secreções são atomizados em gotículas microscópicas que são levadas até a árvore brônquica e atingem os alvéolos, onde os bacilos iniciarão o processo patológico da doença, caso consigam ultrapassar os mecanismos de defesa inespecíficos e multiplicar-se dentro do macrófago alveolar Wang et al, 2014). Se isso ocorrer, será gerada uma reação inflamatória local que leva à formação de um foco pulmonar.…”

Section: Tuberculoseunclassified

“…Portanto, essa pandemia causa impacto no controle da TB e no aumento da frequência das formas graves, extrapulmonares e disseminadas na manifestação da AIDS (Brunello et al, 2011;Liu et al, 2015). Em virtude das elevadas taxas de morbidade e mortalidade por TB em indivíduos HIV positivos, a detecção, o tratamento e a prevenção da TB tornaram-se prioridades nos programas nacionais de controle da AIDS (Organization., 2009;Peruhype et al, 2014 (Wang et al, 2014;Chandra et al, 2015).…”

Section: Tuberculoseunclassified

“…3) tempo de exposição do indivíduo no ambiente contaminado; e 4) estado imunológico do indivíduo exposto à contaminação (Lönnroth et al, 2009 (Drobniewski et al, 1997;Goodfellow et al, 1997 Wang et al, 2014). O gênero Mycobacterium é constituído pelo M. leprae, por espécies que compõem o CMTB e outras micobactérias denominadas micobactérias não tuberculosas (MNT) (Gutierrez, Supply e Brosch et al, 2009;Smith et al, 2009).…”

Section: Tuberculoseunclassified

“…A redução dessas fontes de infecção interrompe a cadeia de transmissão da doença e diminui o problema da TB na comunidade. Dessa forma, a transmissão é reduzida gradativamente após o início do esquema terapêutico recomendado e ao fim de poucas semanas o risco de transmissão diminui significativamente (Costa et al, 2013;Wang et al, 2014). A carga bacilífera diminui para 5% no segundo dia de tratamento e para 0,5% após o décimo segundo dia de terapia (Atif et al, 2015).…”

Section: Tratamentounclassified

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Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal

Lima¹

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Dedico este trabalho aos meus filhos Maria Eduarda e Vítor e ao meu afilhado Matheus, para que desde pequenos valorizem a importância dos estudos; ao meu marido Eduardo, pelo apoio incondicional; aos meus pais, que me permitiram chegar até aqui; à minha irmã Janay,pelo incentivo e por me substituir nas minhas ausências maternas e familiares; e à minha grande amiga Pérola -quem encontrou um amigo encontrou, no meu caso, uma Pérola. AGRADECIMENTOSA Deus, pelas tantas oportunidades que me proporcionou e por ter mе dado saúde е força para superar as dificuldades.Aos meus filhos, por entenderem todas as minhas ausências, eu peço perdão.Ao meu marido, por todas as noites não dormidas e por todas as infinitas formatações e correções gramaticais, a minha eterna gratidão.Aos meus pais, pelo amor, incentivo е apoio incondicionais.À minha orientadora, Professora Dra. Janeth de Oliveira Silva Naves, pela orientação, ensinamentos e confiança depositada durante todo este projeto.À Professora e amiga Dra.

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Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis

Kendall

Fofana

Dowdy

2015

The Lancet Respiratory Medicine

184

142

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BackgroundMultidrug-resistant tuberculosis (MDR-TB) can be acquired through de novo mutation during TB treatment or through transmission from other individuals with active MDR-TB. Understanding the balance between these two mechanisms is essential when allocating resources for MDR-TB.MethodsWe constructed a dynamic transmission model of an MDR-TB epidemic, allowing for both treatment-related acquisition and person-to-person transmission of resistance. We used national TB notification data to inform Bayesian estimates of the fraction of each country’s 2013 MDR-TB incidence that resulted from MDR transmission rather than treatment-related MDR acquisition.FindingsGlobal estimates of 3·5% MDR-TB prevalence among new TB notifications and 20·5% among retreatment notifications translate into an estimate that resistance transmission rather than acquisition accounts for a median 96% (95% UR: 68–100%) of all incident MDR-TB, and 61% (16–95%) of incident MDR-TB in previously-treated individuals. The estimated percentage of MDR-TB resulting from transmission varied substantially with different countries’ notification data; for example, we estimated this percentage at 48% (30–75%) of MDR-TB in Bangladesh, versus 99% (91–100%) in Uzbekistan. Estimates were most sensitive to estimates of the transmissibility of MDR strains, the probability of acquiring MDR during tuberculosis treatment, and the responsiveness of MDR TB to first-line treatment.InterpretationNotifications of MDR prevalence from most high-burden settings are most consistent with the vast majority of incident MDR-TB resulting from transmission rather than new treatment-related acquisition of resistance. Merely improving the treatment of drug-susceptible TB is unlikely to greatly reduce future MDR-TB incidence. Improved diagnosis and treatment of MDR-TB – including new tests and drug regimens – should be highly prioritized.

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Molecular Epidemiology and Clinical Characteristics of Drug-Resistant Mycobacterium tuberculosis in a Tuberculosis Referral Hospital in China

Cited by 10 publications

References 24 publications

Genetic polymorphism of human leucocyte antigen and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis in Han Chinese from Hubei Province

Genetic polymorphism of human leucocyte antigen and susceptibility to multidrug‐resistant and rifampicin‐resistant tuberculosis in Han Chinese from Hubei Province

Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal

Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis

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