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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


  2 / 2949 MEDLINE  
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[PMID]:28880875
[Au] Autor:Khaparde S; Raizada N; Nair SA; Denkinger C; Sachdeva KS; Paramasivan CN; Salhotra VS; Vassall A; Hoog AV
[Ad] Endereço:Central TB Division, Government of India, New Delhi, India.
[Ti] Título:Scaling-up the Xpert MTB/RIF assay for the detection of tuberculosis and rifampicin resistance in India: An economic analysis.
[So] Source:PLoS One;12(9):e0184270, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: India is considering the scale-up of the Xpert MTB/RIF assay for detection of tuberculosis (TB) and rifampicin resistance. We conducted an economic analysis to estimate the costs of different strategies of Xpert implementation in India. METHODS: Using a decision analytical model, we compared four diagnostic strategies for TB patients: (i) sputum smear microscopy (SSM) only; (ii) Xpert as a replacement for the rapid diagnostic test currently used for SSM-positive patients at risk of drug resistance (i.e. line probe assay (LPA)); (iii) Upfront Xpert testing for patients at risk of drug resistance; and (iv) Xpert as a replacement for SSM for all patients. RESULTS: The total costs associated with diagnosis for 100,000 presumptive TB cases were: (i) US$ 619,042 for SSM-only; (ii) US$ 575,377 in the LPA replacement scenario; (iii) US$ 720,523 in the SSM replacement scenario; and (iv) US$ 1,639,643 in the Xpert-for-all scenario. Total cohort costs, including treatment costs, increased by 46% from the SSM-only to the Xpert-for-all strategy, largely due to the costs associated with second-line treatment of a higher number of rifampicin-resistant patients due to increased drug-resistant TB (DR-TB) case detection. The diagnostic costs for an estimated 7.64 million presumptive TB patients would comprise (i) 19%, (ii) 17%, (iii) 22% and (iv) 50% of the annual TB control budget. Mean total costs, expressed per DR-TB case initiated on treatment, were lowest in the Xpert-for-all scenario (US$ 11,099). CONCLUSIONS: The Xpert-for-all strategy would result in the greatest increase of TB and DR-TB case detection, but would also have the highest associated costs. The strategy of using Xpert only for patients at risk for DR-TB would be more affordable, but would miss DR-TB cases and the cost per true DR-TB case detected would be higher compared to the Xpert-for-all strategy. As such expanded Xpert strategy would require significant increased TB control budget to ensure that increased case detection is followed by appropriate care.
[Mh] Termos MeSH primário: Antibióticos Antituberculose/uso terapêutico
Bioensaio/métodos
Rifampina/uso terapêutico
Tuberculose/diagnóstico
Tuberculose/tratamento farmacológico
[Mh] Termos MeSH secundário: Seres Humanos
Índia
Escarro/microbiologia
Tuberculose Resistente a Múltiplos Medicamentos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184270


  3 / 2949 MEDLINE  
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[PMID]:28821621
[Au] Autor:Khan MZ; Bhaskar A; Upadhyay S; Kumari P; Rajmani RS; Jain P; Singh A; Kumar D; Bhavesh NS; Nandicoori VK
[Ad] Endereço:From the National Institute of Immunology and.
[Ti] Título:Protein kinase G confers survival advantage to during latency-like conditions.
[So] Source:J Biol Chem;292(39):16093-16108, 2017 Sep 29.
[Is] ISSN:1083-351X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Protein kinase G (PknG), a thioredoxin-fold-containing eukaryotic-like serine/threonine protein kinase, is a virulence factor in , required for inhibition of phagolysosomal fusion. Here, we unraveled novel functional facets of PknG during latency-like conditions. We found that PknG mediates persistence under stressful conditions like hypoxia and abets drug tolerance. PknG mutant displayed minimal growth in nutrient-limited conditions, suggesting its role in modulating cellular metabolism. Intracellular metabolic profiling revealed that PknG is necessary for efficient metabolic adaptation during hypoxia. Notably, the PknG mutant exhibited a reductive shift in mycothiol redox potential and compromised stress response. Exposure to antibiotics and hypoxic environment resulted in higher oxidative shift in mycothiol redox potential of PknG mutant compared with the wild type. Persistence during latency-like conditions required kinase activity and thioredoxin motifs of PknG and is mediated through phosphorylation of a central metabolic regulator GarA. Finally, using a guinea pig model of infection, we assessed the role of PknG in manifestation of disease pathology and established a role for PknG in the formation of stable granuloma, hallmark structures of latent tuberculosis. Taken together, PknG-mediated GarA phosphorylation is important for maintenance of both mycobacterial physiology and redox poise, an axis that is dispensable for survival under normoxic conditions but is critical for non-replicating persistence of mycobacteria. In conclusion, we propose that PknG probably acts as a modulator of latency-associated signals.
[Mh] Termos MeSH primário: Antígenos de Bactérias/metabolismo
Proteínas de Bactérias/metabolismo
Granuloma/etiologia
Tuberculose Latente/microbiologia
Mycobacterium tuberculosis/metabolismo
Processamento de Proteína Pós-Traducional
Proteínas Serina-Treonina Quinases/metabolismo
[Mh] Termos MeSH secundário: Motivos de Aminoácidos
Substituição de Aminoácidos
Animais
Antibióticos Antituberculose/farmacologia
Antígenos de Bactérias/genética
Proteínas de Bactérias/química
Proteínas de Bactérias/genética
Feminino
Deleção de Genes
Granuloma/metabolismo
Granuloma/microbiologia
Cobaias
Isoniazida/farmacologia
Cinética
Tuberculose Latente/metabolismo
Tuberculose Latente/fisiopatologia
Metabolômica/métodos
Viabilidade Microbiana/efeitos dos fármacos
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/crescimento & desenvolvimento
Mycobacterium tuberculosis/fisiologia
Fosforilação/efeitos dos fármacos
Mutação Puntual
Processamento de Proteína Pós-Traducional/efeitos dos fármacos
Proteínas Serina-Treonina Quinases/química
Proteínas Serina-Treonina Quinases/genética
Estresse Fisiológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); 0 (Antigens, Bacterial); 0 (Bacterial Proteins); 0 (CFP17 protein, Mycobacterium tuberculosis); EC 2.7.11.1 (Protein-Serine-Threonine Kinases); EC 2.7.11.1 (protein kinase G, Mycobacterium tuberculosis); V83O1VOZ8L (Isoniazid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170820
[St] Status:MEDLINE
[do] DOI:10.1074/jbc.M117.797563


  4 / 2949 MEDLINE  
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[PMID]:28803492
[Au] Autor:Alfarisi O; Alghamdi WA; Al-Shaer MH; Dooley KE; Peloquin CA
[Ad] Endereço:a Department of Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
[Ti] Título:Rifampin vs. rifapentine: what is the preferred rifamycin for tuberculosis?
[So] Source:Expert Rev Clin Pharmacol;10(10):1027-1036, 2017 Oct.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: One-third of the world's population is infected with Mycobacterium tuberculosis (M.tb.). Latent tuberculosis infection (LTBI) can progress to tuberculosis disease, the leading cause of death by infection. Rifamycin antibiotics, like rifampin and rifapentine, have unique sterilizing activity against M.tb. What are the advantages of each for LTBI or tuberculosis treatment? Areas covered: We review studies assessing the pharmacokinetics (PK), pharmacodynamics (PD), drug interaction risk, safety, and efficacy of rifampin and rifapentine and provide basis for comparing them. Expert commentary: Rifampin has shorter half-life, higher MIC against M.tb, lower protein binding, and better distribution into cavitary contents than rifapentine. Drug interactions for the two drugs maybe similar in magnitude. For LTBI, rifapentine is effective as convenient, once-weekly, 12-week course of treatment. Rifampin is also effective for LTBI, but must be given daily for four months, therefore, drug interactions are more problematic. For drug-sensitive tuberculosis disease, rifampin remains the standard of care. Safety profile of rifampin is better-described; adverse events differ somewhat for the two drugs. The registered once-weekly rifapentine regimen is inadequate, but higher doses of either drugs may shorten the treatment duration required for effective management of TB. Results of clinical trials evaluating high-dose rifamycin regimens are eagerly awaited.
[Mh] Termos MeSH primário: Antibióticos Antituberculose/administração & dosagem
Rifampina/análogos & derivados
Tuberculose/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Antibióticos Antituberculose/efeitos adversos
Antibióticos Antituberculose/farmacocinética
Relação Dose-Resposta a Droga
Meia-Vida
Seres Humanos
Tuberculose Latente/tratamento farmacológico
Testes de Sensibilidade Microbiana
Mycobacterium tuberculosis/efeitos dos fármacos
Rifampina/administração & dosagem
Rifampina/efeitos adversos
Rifampina/farmacocinética
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); VJT6J7R4TR (Rifampin); XJM390A33U (rifapentine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2017.1366311


  5 / 2949 MEDLINE  
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[PMID]:28727491
[Au] Autor:Lessells RJ; Cooke GS; McGrath N; Nicol MP; Newell ML; Godfrey-Faussett P
[Ad] Endereço:1 Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
[Ti] Título:Impact of Point-of-Care Xpert MTB/RIF on Tuberculosis Treatment Initiation. A Cluster-randomized Trial.
[So] Source:Am J Respir Crit Care Med;196(7):901-910, 2017 Oct 01.
[Is] ISSN:1535-4970
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Point-of-care (POC) diagnostics have the potential to reduce pretreatment loss to follow-up and delays to initiation of appropriate tuberculosis (TB) treatment. OBJECTIVES: To evaluate the effect of a POC diagnostic strategy on initiation of appropriate TB treatment. METHODS: We conducted a cluster-randomized trial of adults with cough who were HIV positive and/or at high risk of drug-resistant TB. Two-week time blocks were randomized to two strategies: (1) Xpert MTB/RIF test (Cepheid, Sunnyvale, CA) performed at a district hospital laboratory or (2) POC Xpert MTB/RIF test performed at a primary health care clinic. All participants provided two sputum specimens: one for the Xpert test and the other for culture as a reference standard. The primary outcome was the proportion of participants with culture-positive pulmonary tuberculosis (PTB) initiated on appropriate TB treatment within 30 days. MEASUREMENTS AND MAIN RESULTS: Between August 22, 2011, and March 1, 2013, 36 two-week blocks were randomized, and 1,297 individuals were enrolled (646 in the laboratory arm, 651 in the POC arm), 159 (12.4%) of whom had culture-positive PTB. The proportions of participants with culture-positive PTB initiated on appropriate TB treatment within 30 days were 76.5% in the laboratory arm and 79.5% in the POC arm (odds ratio, 1.13; 95% confidence interval, 0.51-2.53; P = 0.76; risk difference, 3.1%; 95% confidence interval, -16.2 to 10.1). The median time to initiation of appropriate treatment was 7 days (laboratory) versus 1 day (POC). CONCLUSIONS: POC positioning of the Xpert test led to more rapid initiation of appropriate TB treatment. Achieving one-stop diagnosis and treatment for all people with TB will require simpler, more sensitive diagnostics and broader strengthening of health systems. Clinical trial registered with www.isrctn.com (ISRCTN 18642314) and www.sanctr.gov.za (DOH-27-0711-3568).
[Mh] Termos MeSH primário: Antibióticos Antituberculose/uso terapêutico
Sistemas Automatizados de Assistência Junto ao Leito
Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico
Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
Tuberculose Pulmonar/diagnóstico
Tuberculose Pulmonar/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Rifampina
Escarro/metabolismo
Tuberculose Resistente a Múltiplos Medicamentos/metabolismo
Tuberculose Pulmonar/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1164/rccm.201702-0278OC


  6 / 2949 MEDLINE  
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[PMID]:28708053
[Au] Autor:Li Y; Pang Y; Zhang T; Xian X; Wang X; Yang J; Wang R; Chen M; Chen W
[Ad] Endereço:1​Clinical Laboratory, the First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, PR China 2​Clinical Laboratory, Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi'an 710048, PR China.
[Ti] Título:Rapid diagnosis of extrapulmonary tuberculosis with Xpert Mycobacterium tuberculosis/rifampicin assay.
[So] Source:J Med Microbiol;66(7):910-914, 2017 Jul.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: XpertMycobacterium tuberculosis/rifampicin (Xpert MTB/RIF) assay has been endorsed by the World Health Organization (WHO) for diagnosis of extrapulmonary tuberculosis (EPTB), while the sensitivity and specificity have not been fully evaluated. We aimed to evaluate the performance of Xpert MTB/RIF assay in the detection of different extrapulmonary specimens. METHODS: A total of 420 nonrespiratory specimens were detected with acid-fast bacilli (AFB) smear microscopy, solid culture, conventional drug susceptibility testing (DST) and Xpert MTB/RIF assay. Using solid culture and conventional DST as the gold standard, we assessed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of the Xpert MTB/RIF assay for detecting MTB and rifampin resistance, respectively. RESULTS: When setting the solid culture results as the gold standard, the sensitivity, specificity, PPV, NPV and Kappa value of Xpert MTB/RIF assay and AFB smear results were 70.6 % (48/68), 91.96 % (318/346), 63.2 % (48/76), 94.1 % (318/338), 0.60, respectively. In addition, when compared with conventional DST results, the sensitivity, specificity, PPV, NPV and Kappa of the Xpert MTB/RIF assay for detecting rifampin resistance were 91.7 % (11/12), 100.0 % (47/47), 100.0 % (11/11), 97.9 % (47/48) and 0.95, respectively. CONCLUSION: Compared with AFB smear and solid culture, Xpert MTB/RIF assay has high sensitivities and short detection time, so could be used as an alternative for the rapid diagnosis of EPTB and rifampin resistance in clinical practice.
[Mh] Termos MeSH primário: Antibióticos Antituberculose/farmacologia
Técnicas Bacteriológicas/métodos
Técnicas de Diagnóstico Molecular/métodos
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/isolamento & purificação
Rifampina/farmacologia
Tuberculose/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Sensibilidade e Especificidade
Fatores de Tempo
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000522


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[PMID]:28627491
[Au] Autor:Lin T; Wang C; Liu X; Gao F; Xiao D; Zhang D; Zhu X
[Ad] Endereço:East China Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Key Laboratory of East China Sea and Oceanic Fishery Resources Exploitation and Utilization, Ministry of Agriculture, Shanghai 200090, PR China.
[Ti] Título:Survival, growth performance and immune capacity of the juvenile lined seahorse Hippocampus erectus fed with rifampicin-treated copepods.
[So] Source:Dis Aquat Organ;125(1):45-52, 2017 06 19.
[Is] ISSN:0177-5103
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Gastrointestinal disease is one of the most serious diseases in cultured seahorse juveniles. Treatment with antimicrobials of live food (i.e. copepods and Artemia) that is used to feed the juveniles may be a promising measure to alleviate the occurrence of gastrointestinal disease. However, relevant investigations are rare. In the present study, we first investigated the antimicrobial efficacies on bacteria within copepods that were treated with 4 antimicrobials, including 3 antibiotics (i.e. enrofloxacin hydrochloride, oxytetracycline and rifampicin [RFP]) that are approved for use in aquaculture and 1 disinfectant (i.e. povidone iodine). We then assessed the effects of copepods treated with the antimicrobial that had the best antimicrobial efficacy on survival, growth performance and immune capacity of juvenile lined seahorses Hippocampus erectus. The results showed that RFP had the best antimicrobial efficacy on both Pseudoalteromonas spp. and Vibrio spp., 2 dominant bacteria with potential pathogenicity within the copepods; the proper concentration of RFP was 6 mg l-1. Moreover, H. erectus juveniles fed with RFP-treated copepods demonstrated an improved survivorship and immune capacity and had a lower abundance of pathogenic bacteria within their gastrointestinal tracts compared to juveniles fed with untreated copepods. These results suggest that treating live food with RFP is a potential measure for reducing the incidence of gastrointestinal disease in seahorse juveniles.
[Mh] Termos MeSH primário: Ração Animal/análise
Antibióticos Antituberculose/farmacologia
Copépodes/microbiologia
Peixes/crescimento & desenvolvimento
Rifampina/farmacologia
[Mh] Termos MeSH secundário: Animais
Antibióticos Antituberculose/administração & dosagem
Bactérias/efeitos dos fármacos
Peixes/imunologia
Rifampina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.3354/dao03135


  8 / 2949 MEDLINE  
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[PMID]:28591540
[Au] Autor:Rubin EJ
[Ad] Endereço:From the Department of Immunology and Infectious Diseases, the Harvard T.H. Chan School of Public Health, Boston.
[Ti] Título:Reviving a Drug for Tuberculosis?
[So] Source:N Engl J Med;376(23):2292-2294, 2017 Jun 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibióticos Antituberculose/uso terapêutico
Etionamida/uso terapêutico
Isoxazóis/uso terapêutico
Mycobacterium tuberculosis/metabolismo
Pró-Fármacos/uso terapêutico
Proteínas Repressoras/antagonistas & inibidores
Compostos de Espiro/uso terapêutico
Tuberculose/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Antibióticos Antituberculose/metabolismo
Farmacorresistência Bacteriana
Etionamida/metabolismo
Seres Humanos
Isoxazóis/metabolismo
Camundongos
Oxirredutases/metabolismo
Pró-Fármacos/metabolismo
Proteínas Repressoras/metabolismo
Compostos de Espiro/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); 0 (EthR protein, Mycobacterium tuberculosis); 0 (Isoxazoles); 0 (Prodrugs); 0 (Repressor Proteins); 0 (SMARt-420); 0 (Spiro Compounds); EC 1.- (Oxidoreductases); EC 1.3.1.9 (ethA protein, Mycobacterium tuberculosis); OAY8ORS3CQ (Ethionamide)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcibr1703502


  9 / 2949 MEDLINE  
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[PMID]:28591399
[Au] Autor:Santos PFGD; Costa ERD; Ramalho DM; Rossetti ML; Barcellos RB; Nunes LS; Esteves LS; Rodenbusch R; Anthony RM; Bergval I; Sengstake S; Viveiros M; Kritski A; Oliveira MM
[Ad] Endereço:Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa Acadêmico de Tuberculose, Programa de Pós-Graduação em Clínica Médica, Rio de Janeiro, RJ, Brasil.
[Ti] Título:Detection of tuberculosis drug resistance: a comparison by Mycobacterium tuberculosis MLPA assay versus Genotype®MTBDRplus.
[So] Source:Mem Inst Oswaldo Cruz;112(6):396-403, 2017 Jun.
[Is] ISSN:1678-8060
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To cope with the emergence of multidrug-resistant tuberculosis (MDR-TB), new molecular methods that can routinely be used to screen for a wide range of drug resistance related genetic markers in the Mycobacterium tuberculosis genome are urgently needed. OBJECTIVE: To evaluate the performance of multiplex ligaton-dependent probe amplification (MLPA) against Genotype® MTBDRplus to detect resistance to isoniazid (INHr) and rifampicin (RIFr). METHOD: 96 culture isolates characterised for identification, drug susceptibility testing (DST) and sequencing of rpoB, katG, and inhA genes were evaluated by the MLPA and Genotype®MTBDRplus assays. RESULTS: With sequencing as a reference standard, sensitivity (SE) to detect INHr was 92.8% and 85.7%, and specificity (SP) was 100% and 97.5%, for MLPA and Genotype®MTBDRplus, respectively. In relation to RIFr, SE was 87.5% and 100%, and SP was 100% and 98.8%, respectively. Kappa value was identical between Genotype®MTBDRplus and MLPA compared with the standard DST and sequencing for detection of INHr [0.83 (0.75-0.91)] and RIFr [0.93 (0.88-0.98)]. CONCLUSION: Compared to Genotype®MTBDRplus, MLPA showed similar sensitivity to detect INH and RIF resistance. The results obtained by the MLPA and Genotype®MTBDRplus assays indicate that both molecular tests can be used for the rapid detection of drug-resistant TB with high accuracy. MLPA has the added value of providing information on the circulating M. tuberculosis lineages.
[Mh] Termos MeSH primário: Antibióticos Antituberculose/farmacologia
Farmacorresistência Bacteriana Múltipla/genética
Isoniazida/farmacologia
Mycobacterium tuberculosis/efeitos dos fármacos
Rifampina/farmacologia
Tuberculose Resistente a Múltiplos Medicamentos/microbiologia
[Mh] Termos MeSH secundário: DNA Bacteriano/genética
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Genótipo
Seres Humanos
Testes de Sensibilidade Microbiana
Reação em Cadeia da Polimerase Multiplex
Mycobacterium tuberculosis/genética
Fenótipo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); 0 (DNA, Bacterial); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE


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[PMID]:28538778
[Au] Autor:Silva VDD; Mello FCQ; Figueiredo SCA
[Ad] Endereço:. Programa de Pós-Graduação, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.
[Ti] Título:Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a -four-drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil.
[So] Source:J Bras Pneumol;43(2):113-120, 2017 Mar-Apr.
[Is] ISSN:1806-3756
[Cp] País de publicação:Brazil
[La] Idioma:eng; por
[Ab] Resumo:Objective:: To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. Methods:: This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampin-isoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. Results:: The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. Conclusions:: The adoption of the RHZE/FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen. Objetivo:: Estimar as taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com o esquema de dose fixa combinada (DFC) de quatro drogas e avaliar possíveis fatores associados. Métodos:: Estudo observacional retrospectivo com 208 pacientes com diagnóstico confirmado de tuberculose pulmonar registrados no Programa de Controle da Tuberculose Hospitalar do Instituto de Doenças do Tórax, localizado na cidade do Rio de Janeiro. Os pacientes tratados entre janeiro de 2007 e outubro de 2010 receberam o esquema rifampicina-isoniazida-pirazinamida (RHZ), e aqueles tratados entre novembro de 2010 e junho de 2013 receberam o esquema rifampicina-isoniazida-pirazinamida-etambutol em DFC (RHZE/DFC). Os dados dos pacientes sobre recidiva e óbito foram obtidos no Sistema de Informação de Agravos de Notificação e no Sistema de Informação de Mortalidade, respectivamente. O período de acompanhamento foi de dois anos após o encerramento do tratamento. Resultados:: As taxas de cura, abandono e óbito foram de 90,4%, 4,8% e 4,8%, respectivamente. Houve 7 casos de recidivas durante o período de acompanhamento. Não houve diferenças significativas na taxa de recidiva entre os grupos de tratamento RHZ e RHZE/DFC (p = 0,13). Não foram identificados fatores associados com a ocorrência de recidiva, nem houve diferenças estatisticamente significativas na ocorrência dos efeitos adversos ou nas taxas de cura, abandono e óbito entre os grupos de tratamento. Conclusões:: A adoção do esquema de tratamento RHZE/DFC não produziu diferenças estatisticamente significativas nas taxas de recidiva, cura e abandono nem na ocorrência de efeitos adversos em comparação com o esquema RHZ.
[Mh] Termos MeSH primário: Antibióticos Antituberculose/uso terapêutico
Tuberculose Pulmonar/tratamento farmacológico
Tuberculose Pulmonar/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antibióticos Antituberculose/classificação
Brasil/epidemiologia
Cidades/epidemiologia
Quimioterapia Combinada/métodos
Etambutol/uso terapêutico
Feminino
Seres Humanos
Incidência
Isoniazida/uso terapêutico
Masculino
Meia-Idade
Pirazinamida/uso terapêutico
Recidiva
Estudos Retrospectivos
Rifampina/uso terapêutico
Fatores de Risco
Tuberculose Pulmonar/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antibiotics, Antitubercular); 2KNI5N06TI (Pyrazinamide); 8G167061QZ (Ethambutol); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170525
[St] Status:MEDLINE



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