101
|
Migliori GB, Tiberi S, Sotgiu G. Defining the best regimen to treat isoniazid-resistant tuberculosis. THE LANCET RESPIRATORY MEDICINE 2018; 6:233-235. [PMID: 29595499 DOI: 10.1016/s2213-2600(18)30079-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 02/11/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Giovanni Battista Migliori
- World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Care and Research Institute, IRCCS, 21049, Tradate, Italy.
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University, London, UK; Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| |
Collapse
|
102
|
Tuberculosis: advances and challenges in development of new diagnostics and biomarkers. THE LANCET. INFECTIOUS DISEASES 2018; 18:e199-e210. [PMID: 29580818 DOI: 10.1016/s1473-3099(18)30111-7] [Citation(s) in RCA: 196] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 12/18/2017] [Accepted: 01/02/2018] [Indexed: 11/23/2022]
Abstract
Tuberculosis remains the leading cause of death from an infectious disease worldwide. Early and accurate diagnosis and detection of drug-sensitive and drug-resistant tuberculosis is essential for achieving global tuberculosis control. Despite the introduction of the Xpert MTB/RIF assay as the first-line rapid tuberculosis diagnostic test, the gap between global estimates of incidence and new case notifications is 4·1 million people. More accurate, rapid, and cost-effective screening tests are needed to improve case detection. Diagnosis of extrapulmonary tuberculosis and tuberculosis in children, people living with HIV, and pregnant women remains particularly problematic. The diagnostic molecular technology landscape has continued to expand, including the development of tests for resistance to several antituberculosis drugs. Biomarkers are urgently needed to indicate progression from latent infection to clinical disease, to predict risk of reactivation after cure, and to provide accurate endpoints for drug and vaccine trials. Sophisticated bioinformatic computational tools and systems biology approaches are being applied to the discovery and validation of biomarkers, with substantial progress taking place. New data have been generated from the study of T-cell responses and T-cell function, serological studies, flow cytometric-based assays, and protein and gene expression studies. Alternative diagnostic strategies under investigation as potential screening and triaging tools include non-sputum-based detection with breath-based tests and automated digital radiography. We review developments and key achievements in the search for new tuberculosis diagnostics and biomarkers. We highlight gaps and challenges in evaluation and rollout of new diagnostics and biomarkers, and prioritise areas needing further investment, including impact assessment and cost-benefit studies.
Collapse
|
103
|
Monedero-Recuero I. Xpert implementation in challenging scenarios: a brand-new car running on the same bumpy old roads. Public Health Action 2018; 8:1. [PMID: 29581935 DOI: 10.5588/pha.18.0012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
104
|
Point of care diagnostics for tuberculosis. Pulmonology 2018; 24:73-85. [DOI: 10.1016/j.rppnen.2017.12.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 12/07/2017] [Indexed: 01/01/2023] Open
|
105
|
Chiang CY, Trébucq A. Tuberculosis re-treatment after exclusion of rifampicin resistance. Eur Respir J 2018; 51:51/2/1702282. [PMID: 29444921 DOI: 10.1183/13993003.02282-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/04/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Chen-Yuan Chiang
- International Union Against Tuberculosis and Lung Disease, Paris, France .,Division of Pulmonary Medicine, Dept of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Dept of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Arnaud Trébucq
- International Union Against Tuberculosis and Lung Disease, Paris, France
| |
Collapse
|
106
|
Efsen AMW, Schultze A, Miller RF, Panteleev A, Skrahin A, Podlekareva DN, Miro JM, Girardi E, Furrer H, Losso MH, Toibaro J, Caylà JA, Mocroft A, Lundgren JD, Post FA, Kirk O. Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study. J Infect 2018; 76:44-54. [PMID: 29061336 PMCID: PMC6293190 DOI: 10.1016/j.jinf.2017.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 10/02/2017] [Accepted: 10/07/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. METHODS In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). RESULTS A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5-74.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. CONCLUSIONS Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care.
Collapse
Affiliation(s)
- A M W Efsen
- CHIP, Department of Infectious Diseases, Finsencentret, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark.
| | - A Schultze
- Department of Infection and Population Health, University College London Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - R F Miller
- Centre for Sexual Health and HIV Research, Mortimer Market Centre, University College London, London WC1E 6JB, UK
| | - A Panteleev
- Department of HIV/TB, TB hospital 2, Ushinskogo str 39/1 - 122, St. Petersburg 195267, Russia
| | - A Skrahin
- Clinical Department, Republican Research and Practical Centre for Pulmonology and TB, Minsk, Belarus
| | - D N Podlekareva
- CHIP, Department of Infectious Diseases, Finsencentret, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - J M Miro
- Infectious Diseases Service, Hospital Clinic - IDIBAPS, University of Barcelona, Villarroel, 170, Barcelona 08036, Spain
| | - E Girardi
- Department of Infectious Diseases INMI "L. Spallanzani", Ospedale L Spallanzani, Via Portuense, 292, Rome 00149, Italy
| | - H Furrer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern CH-3010, Switzerland
| | - M H Losso
- Department of immunocompromised, Hospital J.M. Ramos Mejia, Pabellón de Cliníca, 2do Piso, Buenos Aires CP 1221, Argentina
| | - J Toibaro
- Department of immunocompromised, Hospital J.M. Ramos Mejia, Pabellón de Cliníca, 2do Piso, Buenos Aires CP 1221, Argentina
| | - J A Caylà
- Agencia de Salud Pública de Barcelona, Barcelona, Spain; Programa Integrado de Investigación en Tuberculosis de SEPAR (PII-TB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - A Mocroft
- Department of Infection and Population Health, University College London Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - J D Lundgren
- CHIP, Department of Infectious Diseases, Finsencentret, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - F A Post
- Department of Sexual Health, Caldecot Centre, King's College Hospital, Bessemer Road, London SE5 9RS, UK
| | - O Kirk
- CHIP, Department of Infectious Diseases, Finsencentret, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen 2100, Denmark
| |
Collapse
|
107
|
|
108
|
Liu D, Zhao B, Ou X, Zheng H, Ma A, He W, Wang S, Zhou Y, Xia H, Zheng Y, Hou P, He G, Zhao Y. A novel isothermal amplification-based method to detect Mycobacterium tuberculosis complex. J Microbiol Methods 2017; 145:59-65. [PMID: 29109010 DOI: 10.1016/j.mimet.2017.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/25/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
Abstract
Mycobacterium tuberculosis (MTB) is the causative agent of pulmonary tuberculosis. Rapid and accurate diagnosis is crucial to tuberculosis control and prevention. A series of diagnostic methods has been available for MTB detection; however, new rapid, simple and affordable methods are needed. In this study, a multiple cross displacement amplification (MCDA)-based assay was developed to detect the IS6110 gene of the M. tuberculosis complex. Hydroxy naphthol blue (HNB), a colorimetric indicator, was used to detect amplification products. Amplification was carried out at a constant temperature (68°C) for only 40min, followed by direct determination of amplification products through observation of color variations. The entire detection procedure, from processing of specimens to reading of results, required only 85min. Moreover, this assay, hereafter designated MTB-MCDA-HNB, was able to detect as little as 1pg of DNA extracted from the Bacille Calmette-Guerin (BCG) strain of Mycobacterium bovis. No cross-reaction with nontuberculous mycobacteria (NTM) species was observed. Moreover, during testing of clinical samples, the sensitivity and specificity of MCDA results were 94.7% and 92.9%, respectively, when compared to results obtained using the Xpert MTB/RIF method. Therefore, the MTB-MCDA-HNB method developed in this study holds promise for application as an effective point-of-care test to detect M. tuberculosis.
Collapse
Affiliation(s)
- Dongxin Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Bing Zhao
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Xichao Ou
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Huiwen Zheng
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Aijing Ma
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Wencong He
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Shengfen Wang
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Yang Zhou
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Hui Xia
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Yang Zheng
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Ping Hou
- Haerbin Tuberculosis Control Institute, Daoli, Hongxia Street 62, Haerbin 150000, China
| | - Guangxue He
- Science and Technology Department, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China
| | - Yanlin Zhao
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Changping, Changbai Road 155, Beijing 102206, China.
| |
Collapse
|