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Abhilasha Tiwari, Pankaj Wagh
Tuberculosis (TB) is among the most predominant infectious illnesses in developing areas around the globe. As stated by the World Health Organization (WHO), the number of instances of drug-resistant tuberculosis (DR-TB) has increased lately. This case report describes the effective diagnosis and customized treatment for primary extra-pulmonary multidrug-resistant tubercular pleural effusion, a disease which is difficult to identify due to relatively low bacterial count as well as frequently negative staining on Ziehl Neelsen (ZN) for acid-fast bacilli (AFB)...
March 2024: Curēus
#22
JOURNAL ARTICLE
Himani Mongia, Fatima Mamnoon, Arunima Silsarma, Raman Mahajan, Alpa Dalal, Miriam Arago Galindo, Aparna Iyer, Pramila Singh, Homa Mansoor, Mrinalini Das, Mabel Morales, Hannah Spencer, Petros Isaakidis
BACKGROUND: World Health Organization suggests concurrent bedaquiline-delamanid (BDQ-DLM) as part of individualised regimens for eligible patients with pulmonary drug-resistant tuberculosis (DR-TB); however, data for patients with drug-resistant extrapulmonary tuberculosis (EPTB) is extremely limited. This study documents the treatment outcomes and adverse events associated with concurrent BDQ-DLM-based regimens in patients with drug-resistant EPTB at a Médecins Sans Frontières clinic in Mumbai, India...
May 2024: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
#23
JOURNAL ARTICLE
Aparna Bhanushali, Sachin Atre, Preethi Nair, Geethanjali Anilkumar Thandaseery, Sanchi Shah, Sanjana Kuruwa, Amrutraj Zade, Chaitali Nikam, Mangala Gomare, Anirvan Chatterjee
UNLABELLED: Treatment decisions for tuberculosis (TB) in the absence of full drug-susceptibility data can result in amplifying resistance and may compromise treatment outcomes. Genomics of Mycobacterium tuberculosis ( M.tb ) from clinical samples enables detection of drug resistance to multiple drugs. We performed whole-genome sequencing (WGS) for 600 clinical samples from patients with tuberculosis to identify the drug-resistance profile and mutation spectrum. We documented the reasons reported by clinicians for referral...
April 10, 2024: Microbiology Spectrum
#24
JOURNAL ARTICLE
Jingtao Gao, Mengqiu Gao, Jian Du, Yu Pang, Gary Mao, Nacer Lounis, Nyasha Bakare, Yanxin Jiang, Ying Zhan, Yuhong Liu, Liang Li
INTRODUCTION: The lack of safe, effective, and simple short-course regimens (SCRs) for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment has significantly impeded TB control efforts in China. METHODS: This phase 4, randomized, open-label, controlled, non-inferiority trial aims to assess the efficacy and safety of a 9-month all-oral SCR containing bedaquiline (BDQ) versus an all-oral SCR without BDQ for adult MDR-TB patients (18-65 years) in China...
April 1, 2024: Trials
#25
REVIEW
Ming Wang, Peixuan Men, Weihe Zhang, Jing Wu, Yuzhen Gu, Fen Wang, Hairong Huang, Xia Yu, Hongfei Duan
OBJECTIVE: This study aims to estimate the overall in vitro activity of bedaquiline (BDQ) against clinical isolates of Mycobacterium abscessus complex (MABS) and Mycobacterium avium complex (MAC), considering BDQ as a repurposed drug for non-tuberculous mycobacteria (NTM) infections. METHODS: We conducted a systematic review of publications in PubMed/ MEDLINE, Web of Science, and Embase up to April 15, 2023. Studies were included if they followed the Clinical and Laboratory Standards Institute (CLSI) criteria for drug susceptibility testing (DST)...
March 30, 2024: Journal of Global Antimicrobial Resistance
#26
JOURNAL ARTICLE
Thomas Maitre, Lorenzo Guglielmetti, Jérôme Robert, Alexandra Aubry, Nicolas Veziris
ADVANCES IN ANTIBIOTIC THERAPY FOR TUBERCULOSIS. Treatment of tuberculosis is experiencing significant advancements. For the first time, a therapeutic regimen based on rifapentine and moxifloxacin allows for a reduction of treatment duration of drug-susceptible tuberculosis from 6 to 4 months. Regarding multidrug-resistant tuberculosis, combinations of new antituberculosis drugs (bedaquiline, linezolid, delamanid/pretomanid, moxifloxacin) have the potential to reduce the treatment duration from 20 to 6 months...
March 2024: La Revue du Praticien
#27
JOURNAL ARTICLE
Kusum Sharma, Megha Sharma, Ritu Shree, Neeraj Singla, Himanshu Joshi, Tanish Modi, Manoj Goyal, Aman Sharma, Navneet Sharma, Manish Modi
SETTING AND OBJECTIVE: To develop and evaluate newer molecular tests that identify drug resistance according to contemporary definitions in Tuberculous meningitis (TBM), the most severe form of EPTB. DESIGN: 93 cerebrospinal fluid (CSF) specimens [41 culture-positive and 52 culture-negative], were subjected to Truenat MTB Plus assay along with chips for rifampicin, isoniazid, fluoroquinolones and bedaquiline resistance. The performance was compared against phenotypic drug susceptibility testing (pDST), Line probe assay (LPA) and gene sequencing...
March 24, 2024: Tuberculosis
#28
REVIEW
Lubna Osman, Christopher Lopez, Yoichiro Natori, Shweta Anjan, Julia Bini Viotti, Jacques Simkins
Mycobacterium abscessus complex (MABC), a rapidly growing Mycobacterium , is one of the most common causes of non-tuberculous mycobacteria (NTM) infections in the United States of America, and it has been associated with a wide spectrum of infections in immunocompetent and immunosuppressed individuals. Eradicating MABC is very challenging, even with prolonged combination therapies. The management of MABC infections in solid organ transplant (SOT) patients is usually complex given their net state of immunosuppression, associated comorbidities, and potential drug-drug interactions, among other things...
March 16, 2024: Microorganisms
#29
JOURNAL ARTICLE
Meenal Datta, Laura E Via, Véronique Dartois, Danielle M Weiner, Matthew Zimmerman, Firat Kaya, April M Walker, Joel D Fleegle, Isaac D Raplee, Colton McNinch, Maksym Zarodniuk, Walid S Kamoun, Changli Yue, Ashwin S Kumar, Sonu Subudhi, Lei Xu, Clifton E Barry, Rakesh K Jain
Host-directed therapies (HDTs) represent an emerging approach for bacterial clearance during tuberculosis (TB) infection. While most HDTs are designed and implemented for immuno-modulation, other host targets-such as nonimmune stromal components found in pulmonary granulomas-may prove equally viable. Building on our previous work characterizing and normalizing the aberrant granuloma-associated vasculature, here we demonstrate that FDA-approved therapies (bevacizumab and losartan, respectively) can be repurposed as HDTs to normalize blood vessels and extracellular matrix (ECM), improve drug delivery, and reduce bacterial loads in TB granulomas...
April 2, 2024: Proceedings of the National Academy of Sciences of the United States of America
#30
JOURNAL ARTICLE
Krina Mehta, Pavel Balazki, Piet H van der Graaf, Tingjie Guo, J G Coen van Hasselt
BACKGROUND AND OBJECTIVE: The use of bedaquiline as a treatment option for drug-resistant tuberculosis meningitis (TBM) is of interest to address the increased prevalence of resistance to first-line antibiotics. To this end, we describe a whole-body physiologically based pharmacokinetic (PBPK) model for bedaquiline to predict central nervous system (CNS) exposure. METHODS: A whole-body PBPK model was developed for bedaquiline and its metabolite, M2. The model included compartments for brain and cerebrospinal fluid (CSF)...
March 26, 2024: Clinical Pharmacokinetics
#31
JOURNAL ARTICLE
J-D K Lotz, J Porter, H Conradie, T Boyles, B Gaunt, S Dimanda, D Cort
BACKGROUND: Progressive interventions have recently improved programmatic outcomes in drug-resistant tuberculosis (DR-TB) care in South Africa (SA). Amidst these, a shorter regimen was introduced in 2017 with weak evidence, and has shown mixed results. Outcomes still fall short of national targets, and the coronavirus disease 2019 pandemic has undermined progress to date. OBJECTIVES: To describe the outcomes of participants treated for DR-TB using a shorter, compared with a longer, regimen in a deeply rural SA setting, and to explore other factors affecting these outcomes...
November 6, 2023: South African Medical Journal
#32
REVIEW
Keertan Dheda, Fuad Mirzayev, Daniela Maria Cirillo, Zarir Udwadia, Kelly E Dooley, Kwok-Chiu Chang, Shaheed Vally Omar, Anja Reuter, Tahlia Perumal, C Robert Horsburgh, Megan Murray, Christoph Lange
Tuberculosis (TB) remains the foremost cause of death by an infectious disease globally. Multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB; resistance to rifampicin and isoniazid, or rifampicin alone) is a burgeoning public health challenge in several parts of the world, and especially Eastern Europe, Russia, Asia and sub-Saharan Africa. Pre-extensively drug-resistant TB (pre-XDR-TB) refers to MDR/RR-TB that is also resistant to a fluoroquinolone, and extensively drug-resistant TB (XDR-TB) isolates are additionally resistant to other key drugs such as bedaquiline and/or linezolid...
March 24, 2024: Nature Reviews. Disease Primers
#33
JOURNAL ARTICLE
M A Lyons, A Obregon-Henao, M E Ramey, A A Bauman, S Pauly, K Rossmassler, J Reid, B Karger, N D Walter, G T Robertson
A major challenge for tuberculosis (TB) drug development is to prioritize promising combination regimens from a large and growing number of possibilities. This includes demonstrating individual drug contributions to the activity of higher-order combinations. A BALB/c mouse TB infection model was used to evaluate the contributions of each drug and pairwise combination in the clinically relevant Nix-TB regimen [bedaquiline-pretomanid-linezolid (BPaL)] during the first 3 weeks of treatment at human equivalent doses...
March 19, 2024: Antimicrobial Agents and Chemotherapy
#34
JOURNAL ARTICLE
Christian Utpatel, Milagros Zavaleta, Daniel Rojas-Bolivar, Andreas Mühlbach, Janet Picoy, Walter Portugal, Ana Esteve-Solé, Laia Alsina, Paolo Miotto, Daniella C Bartholomeu, Jorge Sanchez, Diego F Cuadros, Jorge O Alarcon, Stefan Niemann, Moises A Huaman
BACKGROUND: We sought to identify resistance patterns and key drivers of recent multidrug-resistant tuberculosis (MDR-TB) transmission in a TB-prevalent area in Peru. METHODS: Cross-sectional study including MDR Mycobacterium tuberculosis complex (Mtbc) strains identified in Callao-Peru between April 2017 and February 2019. Mtbc DNA was extracted for whole genome sequencing which was used for phylogenetic inference, clustering, and resistance mutation analyses. Clusters indicative of recent transmission were defined based on a strain-to-strain distance of ≤5 (D5) single nucleotide polymorphisms (SNPs)...
March 2024: Lancet Reg Health Am
#35
JOURNAL ARTICLE
Aimei Liu, Sang Liu, Kangyan Lv, Qingdong Zhu, Jun Wen, Jianpeng Li, Chengyuan Liang, Xuegang Huang, Chunming Gong, Qingfeng Sun, Hongcang Gu
BACKGROUND: Resistance to anti-tuberculous drugs is a major challenge in the treatment of tuberculosis (TB). We aimed to evaluate the clinical availability of nanopore-based targeted next-generation sequencing (NanoTNGS) for the diagnosis of drug-resistant tuberculosis (DR-TB). METHODS: This study enrolled 253 patients with suspected DR-TB from six hospitals. The diagnostic efficacy of NanoTNGS for detecting Mycobacterium tuberculosis and its susceptibility or resistance to first- and second-line anti-tuberculosis drugs was assessed by comparing conventional phenotypic drug susceptibility testing (pDST) and Xpert MTB/RIF assays...
2024: Frontiers in Microbiology
#36
JOURNAL ARTICLE
Gunar Günther, Lorenzo Guglielmetti, Yousra Kherabi, Raquel Duarte, Christoph Lange, Tonia Adamides, Onno Akkerman, Aase Bengaard Andersen, Ágnes Bakos, Agnar Bjarnason, Judith Bruchfeld, Dumitru Chesov, Luigi Ruffo Codecasa, Daniela Cirillo, Manfred Danilovits, Edita Davidavičienė, Raquel Duarte, Maria Luiza De Souza Galvão, Sandrine Garnier, Majlinda Gjocaj, Gunar Günther, Elmira Ibraim, Michael Kappnik, Naira Khachatryan, Dzmitry Klimuk, Liga Kuksa, Mathilde Frechet Jachym, Kamilla Josefsdottir, Anna Kaluzhenina, Christoph Lange, Ulrich Mack, Mateja Jankovic Makek, Katerina Manika, Anne-Marie Mclaughlin, Donika Mema, Anne Torunn Mengshoel, Inge Muylle, Zorica Nanovic, Şeref Özkara, Sivan Perl, Dragica Pesut, Despo Pierdou, Galym Ryskulov, Marcin Skowroński, Ivan Solovic, Mariia Sukholytka, Petra Svetina, Yana Terleeva, Simon Tiberi, Tamara Togonidze, Stefania Torri, Laziz Turaev, Ruzilya Usmanova, Gil Wirtz, Tuula Vasankari, Elena Zhdanova
OBJECTIVES: Multidrug-resistant/Rifampicin-resistant tuberculosis (TB) is a major obstacle to successful TB control. The recommendation by the World Health Organization to use bedaquiline, pretomanid, linezolid and moxifloxacin (BPaL(M)) for 6 months, based on results of three trials with high efficacy and low toxicity, has revolutionized treatment options. METHODS: In this study, representatives of the Tuberculosis Network European Trialsgroup (TBnet) in 44/54 countries of the WHO Europe region document the availability of the medicines and drug susceptibility testing (DST) of the BPaL(M) regimen through a structured questionnaire between September to November 2023...
March 13, 2024: Clinical Microbiology and Infection
#37
JOURNAL ARTICLE
Paolo Miotto, Daniela M Cirillo, Thomas Schön, Claudio U Köser
In the accompanying study, Nimmo and colleagues estimated the dates of emergence of mutations in mmpR5 (Rv0678), the most important resistance gene to the anti-tuberculosis drug bedaquiline, in over 3500 geographically diverse Mycobacterium tuberculosis genomes. This provided important insights to improve the design and analysis of clinical trials, as well as the World Health Organization catalogue of resistance mutations, the global reference for interpreting genotypic antimicrobial susceptibility testing results...
March 13, 2024: Genome Medicine
#38
JOURNAL ARTICLE
Cristina Villellas, Frederik Stevenaert, Bart Remmerie, Koen Andries
Multidrug-resistant tuberculosis (MDR-TB) patients not cured at the time of stopping treatment are exposed to Minimum Inhibitory Concentration (MIC) and sub-MIC levels for many months after discontinuing bedaquiline (BDQ) or clofazimine (CFZ) treatment. In vitro cultures treated with BDQ and CFZ sub-MIC concentrations clearly showed enrichment in the Rv0678 mutant population, demonstrating that pre-existing Rv0678 mutants can be selected by sub-MIC concentrations of BDQ and CFZ if not protected by an alternative MDR-TB treatment...
March 12, 2024: Antimicrobial Agents and Chemotherapy
#39
JOURNAL ARTICLE
Andriansjah Rukmana, Cynthia Gozali, Linda Erlina
Tuberculosis (TB) is caused by Mycobacterium tuberculosis infection. Indonesia is ranked second in the world for TB cases. New anti-TB drugs from groups A and B, such as bedaquiline, clofazimine, and linezolid, have been shown to be effective in curing drug resistance in TB patients, and Indonesia is already using these drugs to treat patients. However, studies comparing the TB strain types with anti-TB resistance profiles are still relevant to understanding the prevalent strains in the country and their phenotypic characteristics...
2024: International Journal of Microbiology
#40
REVIEW
Ahmad Reza Yosofi, Anita Mesic, Tom Decroo
BACKGROUND: Treatment for rifampicin-resistant tuberculosis (RR-TB) has been shortened to 12 months or less, with duration depending on the regimen used and treatment response. Treatment shortening has the potential to increase the risk of relapse, with a new episode of RR-TB after cure or completion. The proportion of relapses after standardized all-oral short (12 months or less) RR-TB regimens has not yet been systematically reviewed, which is the main objective of this review...
May 2024: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
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