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

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dc.contributor.authorDemers, Anne-Marieen_ZA
dc.contributor.authorKim, Soyeonen_ZA
dc.contributor.authorMcCallum, Saraen_ZA
dc.contributor.authorEisenach, Kathleenen_ZA
dc.contributor.authorHughes, Michaelen_ZA
dc.contributor.authorNaini, Lindaen_ZA
dc.contributor.authorMendoza-Ticona, Albertoen_ZA
dc.contributor.authorPradhan, Neetaen_ZA
dc.contributor.authorNarunsky, Kimen_ZA
dc.contributor.authorPoongulali, Selvamuthuen_ZA
dc.contributor.authorBadal-Faesen, Sharlaaen_ZA
dc.contributor.authorUpton, Carynen_ZA
dc.contributor.authorSmith, Elizabethen_ZA
dc.contributor.authorShah, N. S.en_ZA
dc.contributor.authorChurchyard, Gavinen_ZA
dc.contributor.authorGupta, Amitaen_ZA
dc.contributor.authorHesseling, Annekeen_ZA
dc.contributor.authorSwindells, Susanen_ZA
dc.date.issued2021-02-24
dc.descriptionDemers, A. M., et al. 2021. Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial. BMC Infectious Diseases, 21:205, doi:10.1186/s12879-021-05884-4
dc.description.abstractBackground: 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.
dc.description.urihttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05884-4
dc.description.versionPublisher's version
dc.format.extent10 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/110410
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)en_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosisen_ZA
dc.subjectDrug resistanceen_ZA
dc.subjectAntimicrobial susceptibility testingen_ZA
dc.subjectMycobacterium tuberculosisen_ZA
dc.titleDrug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trialen_ZA
dc.typeArticleen_ZA
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