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Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial

BACKGROUND: Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household co...

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Autores principales: Demers, Anne-Marie, Kim, Soyeon, McCallum, Sara, Eisenach, Kathleen, Hughes, Michael, Naini, Linda, Mendoza-Ticona, Alberto, Pradhan, Neeta, Narunsky, Kim, Poongulali, Selvamuthu, Badal-Faesen, Sharlaa, Upton, Caryn, Smith, Elizabeth, Shah, N. Sarita, Churchyard, Gavin, Gupta, Amita, Hesseling, Anneke, Swindells, Susan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903693/
https://www.ncbi.nlm.nih.gov/pubmed/33627075
http://dx.doi.org/10.1186/s12879-021-05884-4
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author Demers, Anne-Marie
Kim, Soyeon
McCallum, Sara
Eisenach, Kathleen
Hughes, Michael
Naini, Linda
Mendoza-Ticona, Alberto
Pradhan, Neeta
Narunsky, Kim
Poongulali, Selvamuthu
Badal-Faesen, Sharlaa
Upton, Caryn
Smith, Elizabeth
Shah, N. Sarita
Churchyard, Gavin
Gupta, Amita
Hesseling, Anneke
Swindells, Susan
author_facet Demers, Anne-Marie
Kim, Soyeon
McCallum, Sara
Eisenach, Kathleen
Hughes, Michael
Naini, Linda
Mendoza-Ticona, Alberto
Pradhan, Neeta
Narunsky, Kim
Poongulali, Selvamuthu
Badal-Faesen, Sharlaa
Upton, Caryn
Smith, Elizabeth
Shah, N. Sarita
Churchyard, Gavin
Gupta, Amita
Hesseling, Anneke
Swindells, Susan
author_sort Demers, Anne-Marie
collection PubMed
description BACKGROUND: Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household contacts (HHCs). METHODS: As part of a feasibility study done in preparation for an MDR-TB preventive therapy trial in HHCs, smear, Xpert MTB/RIF, Hain MTBDRplus, culture and DST results of index MDR-TB patients were obtained from routine TB programs. A sputum sample was collected at study entry and evaluated by the same tests. Not all tests were performed on all specimens due to variations in test availability. RESULTS: Three hundred eight adults with reported RR/MDR-TB were enrolled from 16 participating sites in 8 countries. Their median age was 36 years, and 36% were HIV-infected. Routine testing on all 308 were confirmed as having RR-TB, but only 75% were documented as having MDR-TB. The majority of those not classified as having MDR-TB were because only rifampicin resistance was tested. At study entry (median 59 days after MDR-TB treatment initiation), 280 participants (91%) were able to produce sputum for the study, of whom 147 (53%) still had detectable MTB. All but 2 of these 147 had rifampicin DST done, with resistance detected in 89%. Almost half (47%) of the 147 specimens had INH DST done, with 83% resistance. Therefore, 20% of the 280 study specimens had MDR-TB confirmed. Overall, DST for second-line drugs were available in only 35% of the 308 routine specimens and 15% of 280 study specimens. CONCLUSIONS: RR-TB was detected in all routine specimens but only 75% had documented MDR-TB, illustrating the need for expanded DST beyond Xpert MTB/RIF to target preventive therapy for HHC.
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spelling pubmed-79036932021-03-01 Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial Demers, Anne-Marie Kim, Soyeon McCallum, Sara Eisenach, Kathleen Hughes, Michael Naini, Linda Mendoza-Ticona, Alberto Pradhan, Neeta Narunsky, Kim Poongulali, Selvamuthu Badal-Faesen, Sharlaa Upton, Caryn Smith, Elizabeth Shah, N. Sarita Churchyard, Gavin Gupta, Amita Hesseling, Anneke Swindells, Susan BMC Infect Dis Research Article BACKGROUND: Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household contacts (HHCs). METHODS: As part of a feasibility study done in preparation for an MDR-TB preventive therapy trial in HHCs, smear, Xpert MTB/RIF, Hain MTBDRplus, culture and DST results of index MDR-TB patients were obtained from routine TB programs. A sputum sample was collected at study entry and evaluated by the same tests. Not all tests were performed on all specimens due to variations in test availability. RESULTS: Three hundred eight adults with reported RR/MDR-TB were enrolled from 16 participating sites in 8 countries. Their median age was 36 years, and 36% were HIV-infected. Routine testing on all 308 were confirmed as having RR-TB, but only 75% were documented as having MDR-TB. The majority of those not classified as having MDR-TB were because only rifampicin resistance was tested. At study entry (median 59 days after MDR-TB treatment initiation), 280 participants (91%) were able to produce sputum for the study, of whom 147 (53%) still had detectable MTB. All but 2 of these 147 had rifampicin DST done, with resistance detected in 89%. Almost half (47%) of the 147 specimens had INH DST done, with 83% resistance. Therefore, 20% of the 280 study specimens had MDR-TB confirmed. Overall, DST for second-line drugs were available in only 35% of the 308 routine specimens and 15% of 280 study specimens. CONCLUSIONS: RR-TB was detected in all routine specimens but only 75% had documented MDR-TB, illustrating the need for expanded DST beyond Xpert MTB/RIF to target preventive therapy for HHC. BioMed Central 2021-02-24 /pmc/articles/PMC7903693/ /pubmed/33627075 http://dx.doi.org/10.1186/s12879-021-05884-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Demers, Anne-Marie
Kim, Soyeon
McCallum, Sara
Eisenach, Kathleen
Hughes, Michael
Naini, Linda
Mendoza-Ticona, Alberto
Pradhan, Neeta
Narunsky, Kim
Poongulali, Selvamuthu
Badal-Faesen, Sharlaa
Upton, Caryn
Smith, Elizabeth
Shah, N. Sarita
Churchyard, Gavin
Gupta, Amita
Hesseling, Anneke
Swindells, Susan
Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title_full Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title_fullStr Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title_full_unstemmed Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title_short Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
title_sort drug susceptibility patterns of mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903693/
https://www.ncbi.nlm.nih.gov/pubmed/33627075
http://dx.doi.org/10.1186/s12879-021-05884-4
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