Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial
Abstract 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 hous...
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doaj-fc245c98756940ee99bd85cedb6660552021-03-11T11:23:13ZengBMCBMC Infectious Diseases1471-23342021-02-0121111010.1186/s12879-021-05884-4Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trialAnne-Marie Demers0Soyeon Kim1Sara McCallum2Kathleen Eisenach3Michael Hughes4Linda Naini5Alberto Mendoza-Ticona6Neeta Pradhan7Kim Narunsky8Selvamuthu Poongulali9Sharlaa Badal-Faesen10Caryn Upton11Elizabeth Smith12N. Sarita Shah13Gavin Churchyard14Amita Gupta15Anneke Hesseling16Susan Swindells17for the ACTG A5300/IMPAACT I2003 PHOENIx Feasibility study teamDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDepartment of Biostatistics, Frontier Science FoundationHarvard T.H. Chan School of Public HealthTB or NOT TB Consulting, LLCHarvard T.H. Chan School of Public HealthSocial & Scientific Systems, Inc.Barranco Clinical Research SiteByramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research SiteUCTLIChennai Antiviral Research and Treatment (CART) Clinical Research Site, Infectious Diseases Medical Center, Voluntary Health ServicesUniversity of the Witwatersrand Helen Joseph (WITS HJH) CRSTASK Applied ScienceDAIDS, NIHCenters for Disease Control and PreventionAurum InstituteByramjee Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research SiteDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityDepartment of Internal Medicine, Section of Infectious Diseases, University of Nebraska Medical CenterAbstract 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.https://doi.org/10.1186/s12879-021-05884-4TuberculosisDrug-resistanceAntimicrobial susceptibility testingTrialPreventive therapy |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne-Marie Demers Soyeon Kim Sara McCallum Kathleen Eisenach Michael Hughes Linda Naini Alberto Mendoza-Ticona Neeta Pradhan Kim Narunsky Selvamuthu Poongulali Sharlaa Badal-Faesen Caryn Upton Elizabeth Smith N. Sarita Shah Gavin Churchyard Amita Gupta Anneke Hesseling Susan Swindells for the ACTG A5300/IMPAACT I2003 PHOENIx Feasibility study team |
spellingShingle |
Anne-Marie Demers Soyeon Kim Sara McCallum Kathleen Eisenach Michael Hughes Linda Naini Alberto Mendoza-Ticona Neeta Pradhan Kim Narunsky Selvamuthu Poongulali Sharlaa Badal-Faesen Caryn Upton Elizabeth Smith N. Sarita Shah Gavin Churchyard Amita Gupta Anneke Hesseling Susan Swindells for the ACTG A5300/IMPAACT I2003 PHOENIx Feasibility study team Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial BMC Infectious Diseases Tuberculosis Drug-resistance Antimicrobial susceptibility testing Trial Preventive therapy |
author_facet |
Anne-Marie Demers Soyeon Kim Sara McCallum Kathleen Eisenach Michael Hughes Linda Naini Alberto Mendoza-Ticona Neeta Pradhan Kim Narunsky Selvamuthu Poongulali Sharlaa Badal-Faesen Caryn Upton Elizabeth Smith N. Sarita Shah Gavin Churchyard Amita Gupta Anneke Hesseling Susan Swindells for the ACTG A5300/IMPAACT I2003 PHOENIx Feasibility study team |
author_sort |
Anne-Marie Demers |
title |
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_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_sort |
drug susceptibility patterns of mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2021-02-01 |
description |
Abstract 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. |
topic |
Tuberculosis Drug-resistance Antimicrobial susceptibility testing Trial Preventive therapy |
url |
https://doi.org/10.1186/s12879-021-05884-4 |
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