Multidrug-resistant TB among previously treated TB cases: A retrospective study in Nagpur, India

Munje, Radha; Deshmukh, Rajesh; Tumane, Kondeshwar

doi:10.1016/j.ijtb.2015.11.002

Cited by 11 publications

(8 citation statements)

References 4 publications

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“…Most of the studies have documented a higher prevalence of MDRTB in the retreated cases in PLHIV as well as those without HIV infection [6, 18]. Even in our study, the only risk factor associated with presence of MDRTB was TB relapse.…”

Section: Discussioncontrasting

confidence: 63%

High prevalence of multi drug resistant tuberculosis in people living with HIV in Western India

Saldanha¹,

Runwal²,

Ghanekar³

et al. 2019

BMC Infect Dis

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Background Most studies assessing drug resistant tuberculosis (DRTB) in human immunodeficiency virus (HIV) co-infected patients in India have used conventional culture- based systems to diagnose DRTB that have a longer turnaround time leading to risk of amplification of resistance to an empirical regimen. We determined the prevalence of DRTB amongst people living with HIV (PLHIV) using the line probe assay and determined risk factors associated with the presence of multi drug resistant tuberculosis (MDRTB). Methods A Cross-sectional study was undertaken at Poona Hospital and Research Center (PHRC) and the Institute of Infectious Diseases, two tertiary level private care centers in Pune, India. Consenting PLHIV with confirmed Pulmonary TB (PTB) and/or extra-pulmonary TB (EPTB) diagnosed based on detection of Mycobacterium TB by line probe assay (Geno Type MTBDRplus version 2) on clinical specimens were included. Those with documented past history of DRTB were excluded. Resistance against anti-TB drugs was determined by the same assay. The prevalence of any form of drug resistant TB (DRTB), MDRTB, Rifampicin resistant TB (RRTB) and Isoniazid (INH) mono-resistant TB were determined as the proportion of these amongst all included PLHIV-TB. A multivariate analysis was conducted to determine risk factors that were statistically associated with MDRTB, DRTB, RRTB and INH mono-resistant TB. Results Two hundred PLHIV were recruited. The prevalence (95% CI) of MDRTB, INH mono- resistance and RR resistance was 12.5% (7.9–17.1%), 9% (6.9–11.2%) and 2.5% (1.4–3.6%), respectively. The prevalence (95% CI) of MDRTB among new and relapsed patients was 8.8% (6.5–11.1%) and 23.1% (17.2–28.9%), respectively. Tuberculosis relapse was the only factor significantly associated with MDRTB, DRTB and INH mono-resistant TB. Conclusion We document a high prevalence of drug resistance to anti-TB drugs including MDRTB among PLHIV in our setting using Geno Type MTBDRplus directly on clinical specimens. This validates the WHO recommendation of performing routine rapid molecular resistance testing prior to initiating anti-TB treatment among all PLHIV with presumptive TB. Using rapid molecular testing especially Geno Type MTBDRplus (that detects resistance to INH and Rifampicin simultaneously) reduces the turn-around time helping in optimizing treatment.

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Section: Discussioncontrasting

confidence: 63%

High prevalence of multi drug resistant tuberculosis in people living with HIV in Western India

Saldanha¹,

Runwal²,

Ghanekar³

et al. 2019

BMC Infect Dis

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“…Th e rate of MDR-TB in our study was 4.3%, which is similar to the 5% global rate established by the WHO report in 2015 [19] . In our study, 11.7% of patients were previously treated for TB, which is similar to that observed in China and India (11% and 12%, respectively) [20][21] . All of the MDR-TB cases also reported having close contact with other TB patients, indicating that close contact with other TB patients is a risk factor for developing DR-TB, which has been confi rmed previously [21] .…”

Section: Discussionsupporting

confidence: 88%

Survey of Drug-Resistant Tuberculosis Patients in a University Tertiary Hospital in Saudi Arabia

et al. 2017

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Objective: Drug-resistant tuberculosis is a major health problem worldwide. In Saudi Arabia, 16.4% of tuberculosis cases were found to be resistant to at least one first-line drug. This study aims to assess and determine patterns of tuberculosis drug resistance among patients with culture-positive tuberculosis in order to develop an appropriate treatment strategy. Methods: Data for 51 patients with culture-proven drug-resistant tuberculosis from January 2006 to January 2017 seeking treatment at the King Abdulaziz University Hospital were retrospectively analyzed. World Health Organization criteria were used to classify cases according to type of resistance: monoresistant, polyresistant, and multidrug resistant. Results: Of the 299 tuberculosis positive cases there were 51 cases of drug-resistant tuberculosis, of which 60.8% were monoresistant (isoniazid, 17.6%; rifampin, 5.88%; pyrazinamide, 11.76%; ethambutol, 3.92%; streptomycin, 21.57%), 25.49% were multidrug-resistant tuberculosis, and 13.73% were polyresistant. Moreover, 18% involved children, 37% adolescents, 17.6% early adults, 17.6% late adults, and 11.76% elderly. Two-thirds of the patients were non-Saudi (76.46%). We found that 5.8% of the patients were HIV positive and 50% of these patients demonstrated monoresistant tuberculosis. Moreover, 47.05% of patients had type 2 diabetes. A total of 45 (88%) patients had primary resistance and 6 had secondary resistance. Radiologically, 60.78% of the patients had cavitary tuberculosis and 64% had bilateral pulmonary disease. Conclusions: Our results show that the pattern of tuberculosis drug resistance observed within King Abdulaziz University Hospital is similar to that observed globally.

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“…In addition to having a greater risk for new Mtb infections, PWH are more likely to experience reactivation of latent TB, have greater rates of TB chemotherapy failure, and experience increased rates of recurrence after treatment [ 25 , 44 , 45 ]. Recurrent TB is also strongly associated with the development of multi-drug resistant (MDR)-TB or extensively drug resistant (XDR)-TB, which represent a global health crisis [ 4 , 46 , 47 ].…”

Section: Humanized Mouse Models Of Hiv and Tbmentioning

confidence: 99%

Advancing our understanding of HIV co-infections and neurological disease using the humanized mouse

et al. 2021

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Humanized mice have become an important workhorse model for HIV research. Advances that enabled development of a human immune system in immune deficient mouse strains have aided new basic research in HIV pathogenesis and immune dysfunction. The small animal features facilitate development of clinical interventions that are difficult to study in clinical cohorts, and avoid the high cost and regulatory burdens of using non-human primates. The model also overcomes the host restriction of HIV for human immune cells which limits discovery and translational research related to important co-infections of people living with HIV. In this review we emphasize recent advances in modeling bacterial and viral co-infections in the setting of HIV in humanized mice, especially neurological disease, and Mycobacterium tuberculosis and HIV co-infections. Applications of current and future co-infection models to address important clinical and research questions are further discussed.

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Multidrug-resistant TB among previously treated TB cases: A retrospective study in Nagpur, India

Cited by 11 publications

References 4 publications

High prevalence of multi drug resistant tuberculosis in people living with HIV in Western India

High prevalence of multi drug resistant tuberculosis in people living with HIV in Western India

Survey of Drug-Resistant Tuberculosis Patients in a University Tertiary Hospital in Saudi Arabia

Advancing our understanding of HIV co-infections and neurological disease using the humanized mouse

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