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[PMID]: 29484749 [Au] Autor: Khosravi AD; Meghdadi H; Ghadiri AA; Alami A; Sina AH; Mirsaeidi M [Ad] Endereço: Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. [Ti] Título: rpoB gene mutations among Mycobacterium tuberculosis isolates from extrapulmonary sites. [So] Source: APMIS;126(3):241-247, 2018 Mar. [Is] ISSN: 1600-0463 [Cp] País de publicação: Denmark [La] Idioma: eng [Ab] Resumo: The aim of this study was to analyze mutations occurring in the rpoB gene of Mycobacterium tuberculosis (MTB) isolates from clinical samples of extrapulmonary tuberculosis (EPTB). Seventy formalin-fixed, paraffin-embedded samples and fresh tissue samples from confirmed EPTB cases were analyzed. Nested PCR based on the rpoB gene was performed on the extracted DNAs, combined with cloning and subsequent sequencing. Sixty-seven (95.7%) samples were positive for nester PCR. Sequence analysis of the 81 bp region of the rpoB gene demonstrated mutations in 41 (61.2%) of 67 sequenced samples. Several point mutations including deletion mutations at codons 510, 512, 513 and 515, with 45% and 51% of the mutations in codons 512 and 513 respectively were seen, along with 26% replacement mutations at codons 509, 513, 514, 518, 520, 524 and 531. The most common alteration was Gln → His, at codon 513, presented in 30 (75.6%) isolates. This study demonstrated sequence alterations in codon 513 of the 81 bp region of the rpoB gene as the most common mutation occurred in 75.6% of molecularly confirmed rifampin-resistant strains. In addition, simultaneous mutation at codons 512 and 513 was demonstrated in 34.3% of the isolates. [Mh] Termos MeSH primário: Antibióticos Antituberculose/farmacologia Proteínas de Bactérias/genética RNA Polimerases Dirigidas por DNA/genética Farmacorresistência Bacteriana/genética Mycobacterium tuberculosis/genética Rifampina/farmacologia Tuberculose/microbiologia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Células Cultivadas Feminino Seres Humanos Masculino Testes de Sensibilidade Microbiana Meia-Idade Mycobacterium tuberculosis/efeitos dos fármacos Mycobacterium tuberculosis/isolamento & purificação Mutação Puntual/genética Deleção de Sequência/genética Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antibiotics, Antitubercular); 0 (Bacterial Proteins); 0 (rpoB protein, Mycobacterium tuberculosis); EC 2.7.7.6 (DNA-Directed RNA Polymerases); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180309 [Lr] Data última revisão: 180309 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180228 [St] Status: MEDLINE [do] DOI: 10.1111/apm.12804

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[PMID]: 29458544 [Au] Autor: Aguilar-Ayala DA; Cnockaert M; Vandamme P; Palomino JC; Martin A; Gonzalez-Y-Merchand J [Ad] Endereço: 2​Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent 9000, Belgium. [Ti] Título: Antimicrobial activity against Mycobacterium tuberculosis under in vitro lipid-rich dormancy conditions. [So] Source: J Med Microbiol;67(3):282-285, 2018 Mar. [Is] ISSN: 1473-5644 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Although tuberculosis treatment is dependent on drug-susceptibility testing (DST) and molecular drug-resistance detection, treatment failure and relapse remain a challenge. This could be partially due to the emergence of antibiotic-tolerant dormant mycobacteria, where host lipids have been shown to play an important role. This study evaluated the susceptibility of Mycobacterium tuberculosis to two antibiotic combinations - rifampicin, moxifloxacin, amikacin and metronidazole (RIF-MXF-AMK-MTZ), and rifampicin, moxifloxacin, amikacin and pretomanid (RIF-MXF-AMK-PA) - in a lipid-rich dormancy model. Although their effectiveness in in vitro cultures with dextrose as a carbon source has been proved, we observed that none of the antibiotic mixtures were bactericidal in the presence of lipids. The presence of lipids may confer tolerance to M. tuberculosis against the mixture of antibiotics tested and such tolerance could be even higher during the dormant stages. The implementation of lipids in DST on clinical isolates could potentially lead to a better treatment strategy. [Mh] Termos MeSH primário: Antibacterianos/farmacologia Lipídeos/farmacologia Mycobacterium tuberculosis/efeitos dos fármacos Mycobacterium tuberculosis/fisiologia [Mh] Termos MeSH secundário: Amicacina/farmacologia Antituberculosos/farmacologia Tolerância a Medicamentos Fluoroquinolonas/farmacologia Aptidão Genética Genótipo Seres Humanos Metabolismo dos Lipídeos Testes de Sensibilidade Microbiana Modelos Biológicos Infecções por Micobactéria não Tuberculosa/microbiologia Mycobacterium tuberculosis/genética Mycobacterium tuberculosis/crescimento & desenvolvimento Nitroimidazóis/farmacologia Rifampina/farmacologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (2-nitro-6-(4-(trifluoromethoxy)benzyloxy)-6,7-dihydro-5H-imidazo(2,1-b)(1,3)oxazine); 0 (Anti-Bacterial Agents); 0 (Antitubercular Agents); 0 (Fluoroquinolones); 0 (Lipids); 0 (Nitroimidazoles); 84319SGC3C (Amikacin); U188XYD42P (moxifloxacin); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180221 [St] Status: MEDLINE [do] DOI: 10.1099/jmm.0.000681

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[PMID]: 29197331 [Au] Autor: Addo KK; Addo SO; Mensah GI; Mosi L; Bonsu FA [Ad] Endereço: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Ghana. kaddo@noguchi.ug.edu.gh. [Ti] Título: Genotyping and drug susceptibility testing of mycobacterial isolates from population-based tuberculosis prevalence survey in Ghana. [So] Source: BMC Infect Dis;17(1):743, 2017 12 02. [Is] ISSN: 1471-2334 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Mycobacterium tuberculosis complex (MTBC) and Non-tuberculosis Mycobacterium (NTM) infections differ clinically, making rapid identification and drug susceptibility testing (DST) very critical for infection control and drug therapy. This study aims to use World Health Organization (WHO) approved line probe assay (LPA) to differentiate mycobacterial isolates obtained from tuberculosis (TB) prevalence survey in Ghana and to determine their drug resistance patterns. METHODS: A retrospective study was conducted whereby a total of 361 mycobacterial isolates were differentiated and their drug resistance patterns determined using GenoType Mycobacterium Assays: MTBC and CM/AS for differentiating MTBC and NTM as well MTBDRplus and NTM-DR for DST of MTBC and NTM respectively. RESULTS: Out of 361 isolates, 165 (45.7%) MTBC and 120 (33.2%) NTM (made up of 14 different species) were identified to the species levels whiles 76 (21.1%) could not be completely identified. The MTBC comprised 161 (97.6%) Mycobacterium tuberculosis and 4 (2.4%) Mycobacterium africanum. Isoniazid and rifampicin monoresistant MTBC isolates were 18/165 (10.9%) and 2/165(1.2%) respectively whiles 11/165 (6.7%) were resistant to both drugs. Majority 42/120 (35%) of NTM were M. fortuitum. DST of 28 M. avium complex and 8 M. abscessus complex species revealed that all were susceptible to macrolides (clarithromycin, azithromycin) and aminoglycosides (kanamycin, amikacin, and gentamicin). CONCLUSION: Our research signifies an important contribution to TB control in terms of knowledge of the types of mycobacterium species circulating and their drug resistance patterns in Ghana. [Mh] Termos MeSH primário: Mycobacterium tuberculosis/efeitos dos fármacos Mycobacterium tuberculosis/genética Micobactérias não Tuberculosas/genética Tuberculose/microbiologia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Claritromicina/farmacologia Farmacorresistência Bacteriana/efeitos dos fármacos Feminino Genótipo Gana Seres Humanos Isoniazida/farmacologia Masculino Testes de Sensibilidade Microbiana Meia-Idade Infecções por Micobactéria não Tuberculosa/microbiologia Mycobacterium tuberculosis/isolamento & purificação Micobactérias não Tuberculosas/efeitos dos fármacos Micobactérias não Tuberculosas/isolamento & purificação Prevalência Estudos Retrospectivos Rifampina/farmacologia Inquéritos e Questionários [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: H1250JIK0A (Clarithromycin); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171204 [St] Status: MEDLINE [do] DOI: 10.1186/s12879-017-2853-3

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[PMID]: 29172708 [Au] Autor: Tang L; Feng S; Gao R; Han C; Sun X; Bao Y; Zhang W [Ad] Endereço: 1 Department of Orthopedics, Tianjin Medical University General Hospital , Tianjin City, China . [Ti] Título: A Comparative Study on the Role of Xpert MTB/RIF in Testing Different Types of Spinal Tuberculosis Tissue Specimens. [So] Source: Genet Test Mol Biomarkers;21(12):722-726, 2017 Dec. [Is] ISSN: 1945-0257 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: AIMS: The aim of the present study was to compare the efficacy of the commercial Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) test for evaluating different types of spinal tuberculosis (TB) tissue specimens. METHODS: Pus, granulation tissue, and caseous necrotic tissue specimens from 223 patients who were diagnosed with spinal TB and who underwent curettage were collected for bacterial culture and the Xpert MTB/RIF assay to calculate the positive rate. Bacterial culture and phenotypic drug sensitivity testing (pDST) were adopted as the gold standards to calculate the sensitivity and specificity of the Xpert bacterial detection and drug resistance (DR) test. RESULTS: The positive rate (68.61% ± 7.35%) from the Xpert MTB/RIF assays of spinal TB patients' tissue specimens was higher compared with bacterial culture (44.39% ± 6.51%, Z = 5.1642, p < 0.01), and the positive rates from Xpert MTB/RIF assays on the three types of specimens were all higher than those of bacterial culture, with statistically significant results for pus and granulation tissue specimens. The positive rates for pus using the two bacteriological tests were higher than those for granulation tissue but were not statistically significant. However, the positive rates obtained from granulation tissue were statistically significantly higher than those obtained from caseous necrotic tissue. With bacterial culture and pDST as the gold standards, the sensitivity of Xpert MTB/RIF assays for MTB was 96.97%, while the sensitivity and specificity of the DR test also remained relatively high. CONCLUSION: For efficient and accurate diagnosis of spinal TB and DR and timely provision of effective treatment, multiple specimens, especially the pus of spinal TB patients, should be collected for Xpert MTB/RIF assays. [Mh] Termos MeSH primário: Técnicas de Diagnóstico Molecular/métodos Tuberculose da Coluna Vertebral/diagnóstico [Mh] Termos MeSH secundário: China Farmacorresistência Bacteriana Feminino Seres Humanos Masculino Mycobacterium tuberculosis/patogenicidade Rifampina/farmacologia Sensibilidade e Especificidade Escarro Tuberculose Pulmonar/diagnóstico Tuberculose Pulmonar/microbiologia Tuberculose da Coluna Vertebral/microbiologia [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE [do] DOI: 10.1089/gtmb.2017.0149

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[PMID]: 27776591 [Au] Autor: Lopez AL; Aldaba JG; Ama CG; Sylim PG; Geraldino XD; Sarol JN; Salonga AM [Ad] Endereço: National Institutes of Health, University of the Philippines Manila, Manila, The Philippines. [Ti] Título: Surveillance for tuberculosis in a rural community in The Philippines. [So] Source: Int J Tuberc Lung Dis;20(11):1495-1500, 2016 Nov. [Is] ISSN: 1815-7920 [Cp] País de publicação: France [La] Idioma: eng [Ab] Resumo: SETTING: Estimates of the tuberculosis (TB) burden in the Philippines are largely dependent on prevalence surveys. OBJECTIVE: To conduct a prospective community-based survey to generate epidemiological data on TB among patients seeking care in public health centres in a rural municipality in the Philippines. DESIGN: Prospective surveillance and follow-up of presumptive TB cases from May 2013 to July 2015. RESULTS: Of 1622 participants with presumptive TB, 468 (28.8%) (95%CI 26.6-31.1) were diagnosed with TB. The annual TB case notification rate in San Juan was 212 (95%CI 184-242) per 100 000 population. There were nine TB-attributable deaths during the study period. Only 8.8% (95%CI 6.2-11.32) of the cases were children aged <15 years; 274 (58.5%) cases were bacteriologically confirmed. Of 210 isolates tested for antimicrobial resistance, 49 (23.3%, 95%CI 17.58-29.02) were resistant. Resistance to isoniazid (INH) was common (n = 33, 15.7%); multidrug-resistant TB was 1.9%. CONCLUSION: TB remains an important health problem in the Philippines. We identified low case detection of TB in children and high INH resistance rates in this rural community. [Mh] Termos MeSH primário: Vigilância da População População Rural Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia Tuberculose/epidemiologia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Antituberculosos/uso terapêutico Criança Pré-Escolar Feminino Seguimentos Seres Humanos Lactente Recém-Nascido Isoniazida/uso terapêutico Canamicina/uso terapêutico Masculino Meia-Idade Filipinas/epidemiologia Prevalência Estudos Prospectivos Saúde Pública Rifampina/uso terapêutico Estreptomicina/uso terapêutico Resultado do Tratamento Tuberculose/diagnóstico Tuberculose/tratamento farmacológico Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antitubercular Agents); 59-01-8 (Kanamycin); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin); Y45QSO73OB (Streptomycin) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE

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[PMID]: 27776587 [Au] Autor: Garcia-Prats AJ; du Plessis L; Draper HR; Burger A; Seddon JA; Zimri K; Hesseling AC; Schaaf HS [Ad] Endereço: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa. [Ti] Título: Outcome of culture-confirmed isoniazid-resistant rifampicin-susceptible tuberculosis in children. [So] Source: Int J Tuberc Lung Dis;20(11):1469-1476, 2016 Nov. [Is] ISSN: 1815-7920 [Cp] País de publicação: France [La] Idioma: eng [Ab] Resumo: SETTING: Isoniazid-resistant rifampicin-susceptible (H R ) tuberculosis (TB) is the most prevalent form of drug-resistant TB globally, and may be a risk factor for poor outcomes, but has been poorly described in children. OBJECTIVE: To characterise the clinical presentation, treatment, and clinical and microbiological outcomes among children with culture-confirmed H R TB. DESIGN: Retrospective hospital-based cohort study. RESULTS: Of the 72 children included in the study, the median age was 50.1 months (IQR 21.5-102.5); 42% were male. Forty-four (51%) had a potential source case; only 13 were confirmed H R TB. Of 66 tested, 12 (17%) were human immunodeficiency virus (HIV) infected, and 36 (60%) of the 60 with pulmonary TB (PTB) had severe disease. Seventy children had treatment data; the median total duration of treatment was 11.3 months (IQR 9-12.3); 25 (36%) initiated treatment with a three-drug intensive phase; 52 (74%) received a fluoroquinolone. Of 63 children with known outcomes, 55 (88%) had a favourable outcome, 1 died and 3 had treatment failure. Ten had positive follow-up cultures at ⩾2 months after starting treatment. Older age (P = 0.008), previous anti-tuberculosis treatment (P = 0.023) and severe PTB (P = 0.018) were associated with failure to culture-convert at ⩾2 months. CONCLUSIONS: Although overall outcomes were good, prolonged culture positivity and cases of treatment failure emphasise the need for additional attention to the management of children with H R TB. [Mh] Termos MeSH primário: Farmacorresistência Bacteriana Múltipla Isoniazida/uso terapêutico Rifampina/uso terapêutico Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico Tuberculose Pulmonar/tratamento farmacológico [Mh] Termos MeSH secundário: Antituberculosos/uso terapêutico Criança Pré-Escolar Feminino Seguimentos Infecções por HIV/tratamento farmacológico Seres Humanos Lactente Masculino Estudos Retrospectivos Fatores de Risco África do Sul Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Nm] Nome de substância: 0 (Antitubercular Agents); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE

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[PMID]: 28464821 [Au] Autor: Leijtens B; Elbers JBW; Sturm PD; Kullberg BJ; Schreurs BW [Ad] Endereço: Department of Orthopaedic Surgery, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. borg.leijtens@radboudumc.nl. [Ti] Título: Clindamycin-rifampin combination therapy for staphylococcal periprosthetic joint infections: a retrospective observational study. [So] Source: BMC Infect Dis;17(1):321, 2017 05 02. [Is] ISSN: 1471-2334 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Staphylococcal species account for more than 50% of periprosthetic joint infections (PJI) and antimicrobial therapy with rifampin-based combination regimens has been shown effective. The present study evaluates the safety and efficacy of clindamycin in combination with rifampin for the management of staphylococcal PJI. METHODS: In this retrospective cohort study, patients were included who received clindamycin-rifampin combination therapy to treat a periprosthetic hip or knee infection by Staphylococcus aureus or coagulase-negative staphylococci. Patients were treated according to a standardized treatment algorithm and followed for a median of 54 months. Of the 36 patients with periprosthetic staphylococcal infections, 31 had an infection of the hip, and five had an infection of the knee. Eighteen patients underwent debridement and retention of the implant (DAIR) for an early infection, the other 18 patients underwent revision of loose components in presumed aseptic loosening with unexpected positive cultures. RESULTS: In this study, we report a success rate of 86%, with five recurrent/persistent PJI in 36 treated patients. Cure rate was 78% (14/18) in the DAIR patients and 94% (17/18) in the revision group. Five patients (14%) discontinued clindamycin-rifampin due to side effects. Of the 31 patients completing the clindamycin-rifampin regimen 29 patients (94%) were cured. CONCLUSION: Combined therapy with clindamycin and rifampin is a safe, well tolerated and effective regimen for the treatment of staphylococcal periprosthetic infection. [Mh] Termos MeSH primário: Antibacterianos/uso terapêutico Clindamicina/uso terapêutico Infecções Relacionadas à Prótese/tratamento farmacológico Rifampina/uso terapêutico Infecções Estafilocócicas/tratamento farmacológico [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Antibacterianos/efeitos adversos Terapia Combinada Desbridamento Quimioterapia Combinada Feminino Prótese de Quadril Seres Humanos Prótese do Joelho Masculino Meia-Idade Estudos Retrospectivos Staphylococcus/patogenicidade Staphylococcus aureus/patogenicidade Resultado do Tratamento [Pt] Tipo de publicação: CLINICAL TRIAL; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Anti-Bacterial Agents); 3U02EL437C (Clindamycin); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 180120 [Lr] Data última revisão: 180120 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170504 [St] Status: MEDLINE [do] DOI: 10.1186/s12879-017-2429-2

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[PMID]: 29248125 [Au] Autor: Weaver ML; Black JH [Ad] Endereço: Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Halsted 668-Surgery, 600 North Wolfe Street, Baltimore, Maryland 21287. [Ti] Título: Aortobronchial and aortoenteric fistula. [So] Source: Semin Vasc Surg;30(2-3):85-90, 2017 Jun - Sep. [Is] ISSN: 1558-4518 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Pathologic communication between the thoracic aorta and esophagus or tracheobronchial tree is a rare vascular condition and most commonly develops after open or endovascular aortic repair complicated by infection. Patients with aortoesophageal or tracheobronchial fistula often present with systemic infection and are at risk for major hemorrhage. Medical management is uniformly fatal. Expeditious definitive management requires operative repair by open repair or a combination of endovascular and open procedures. Appropriate antibiotic regimens are important for preventing graft reinfection. [Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia Doenças da Aorta/cirurgia Implante de Prótese Vascular/efeitos adversos Prótese Vascular/efeitos adversos Fístula Brônquica/cirurgia Materiais Revestidos Biocompatíveis Remoção de Dispositivo Procedimentos Endovasculares/efeitos adversos Fístula Esofágica/cirurgia Infecções Relacionadas à Prótese/cirurgia Stents/efeitos adversos Fístula Vascular/cirurgia [Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem Aneurisma da Aorta Torácica/diagnóstico por imagem Doenças da Aorta/diagnóstico por imagem Doenças da Aorta/microbiologia Aortografia/métodos Implante de Prótese Vascular/instrumentação Fístula Brônquica/diagnóstico por imagem Fístula Brônquica/microbiologia Angiografia por Tomografia Computadorizada Procedimentos Endovasculares/instrumentação Fístula Esofágica/diagnóstico por imagem Fístula Esofágica/microbiologia Feminino Seres Humanos Meia-Idade Infecções Relacionadas à Prótese/diagnóstico por imagem Infecções Relacionadas à Prótese/microbiologia Reoperação Rifampina/administração & dosagem Resultado do Tratamento Fístula Vascular/diagnóstico por imagem Fístula Vascular/microbiologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Anti-Bacterial Agents); 0 (Coated Materials, Biocompatible); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180105 [Lr] Data última revisão: 180105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171218 [St] Status: MEDLINE

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[PMID]: 29248123 [Au] Autor: Glebova NO; Black JH [Ad] Endereço: Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado, Anschutz Medical Campus, 12631 East 17(th) Avenue, Room 5409, Mail Stop C312, Aurora, CO 80045. Electronic address: Natalia.Glebova@UCDenver.edu. [Ti] Título: Current management of infected aortic grafts in patients with connective tissue disorders. [So] Source: Semin Vasc Surg;30(2-3):75-79, 2017 Jun - Sep. [Is] ISSN: 1558-4518 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Patients with connective tissue disorder present a particular clinical challenge in the treatment of aortic graft infections. Specific complexities arise in patients with connective tissue disorders when reoperation for aortic graft infection is required. Herein we describe current management of infected aortic grafts in patients with connective tissue disorders using homograft and rifampin-coated graft replacements using in situ replacement therapy, which is associated with improved outcome compared to graft excision and extra-anatomic bypass. [Mh] Termos MeSH primário: Anti-Infecciosos/administração & dosagem Aorta/cirurgia Implante de Prótese Vascular/efeitos adversos Prótese Vascular/efeitos adversos Materiais Revestidos Biocompatíveis Doenças do Tecido Conjuntivo/complicações Remoção de Dispositivo Infecções Relacionadas à Prótese/cirurgia Rifampina/administração & dosagem [Mh] Termos MeSH secundário: Implante de Prótese Vascular/instrumentação Doenças do Tecido Conjuntivo/diagnóstico Seres Humanos Desenho de Prótese Infecções Relacionadas à Prótese/etiologia Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Anti-Infective Agents); 0 (Coated Materials, Biocompatible); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180105 [Lr] Data última revisão: 180105 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171218 [St] Status: MEDLINE

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[PMID]: 29226732 [Au] Autor: Motta I; Calcagno A; Bonora S [Ad] Endereço: a Unit of Infectious Diseases, Department of Medical Sciences , University of Torino , Torino , Italy. [Ti] Título: Pharmacokinetics and pharmacogenetics of anti-tubercular drugs: a tool for treatment optimization? [So] Source: Expert Opin Drug Metab Toxicol;14(1):59-82, 2018 Jan. [Is] ISSN: 1744-7607 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: INTRODUCTION: WHO global strategy is to end tuberculosis epidemic by 2035. Pharmacokinetic and pharmacogenetic studies are increasingly performed and might confirm their potential role in optimizing treatment outcome in specific settings and populations. Insufficient drug exposure seems to be a relevant factor in tuberculosis outcome and for the risk of phenotypic resistance. Areas covered: This review discusses available pharmacokinetic and pharmacogenetic data of first and second-line antitubercular agents in relation to efficacy and toxicity. Pharmacodynamic implications of optimized drugs and new options regimens are reviewed. Moreover a specific session describes innovative investigations on drug penetration. Expert opinion: The optimal use of available antitubercular drugs is paramount for tuberculosis control and eradication. Whilst trials are still on-going, higher rifampicin doses should be reserved to treatment for tubercular meningitis. Therapeutic Drug Monitoring with limiting sampling strategies is advised in patients at risk of failure or with slow treatment response. Further studies are needed in order to provide definitive recommendations of pharmacogenetic-based individualization: however lower isoniazid doses in NAT2 slow acetylators and higher rifampicin doses in individuals with SLCO1B1 loss of function genes are promising strategies. Finally in order to inform tailored strategies we need more data on tissue drug penetration and pharmacological modelling. [Mh] Termos MeSH primário: Antituberculosos/administração & dosagem Farmacogenética Tuberculose/tratamento farmacológico [Mh] Termos MeSH secundário: Animais Antituberculosos/efeitos adversos Antituberculosos/farmacocinética Relação Dose-Resposta a Droga Monitoramento de Medicamentos/métodos Farmacorresistência Bacteriana Seres Humanos Isoniazida/administração & dosagem Isoniazida/farmacocinética Modelos Biológicos Rifampina/administração & dosagem Rifampina/farmacocinética Tuberculose/genética [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antitubercular Agents); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180101 [Lr] Data última revisão: 180101 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171212 [St] Status: MEDLINE [do] DOI: 10.1080/17425255.2018.1416093

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