1
|
Jindani A, Atwine D, Grint D, Bah B, Adams J, Ticona ER, Shrestha B, Agizew T, Hamid S, Jamil B, Byamukama A, Kananura K, Mugisha Taremwa I, Bonnet M, Camara LM, Bah-Sow OY, Bah KS, Bah NM, Sow M, Ticona Huaroto CE, Mugruza Pineda R, Tandukar B, Raya BB, Shrestha N, Mathoma A, Mathebula-Modongo UP, Basotli J, Irfan M, Begum D, Muzammil A, Ahmed I, Hasan R, Burgos MV, Sultan F, Hassan M, Masood I, Robb C, Decker J, Grubnic S, Butcher PD, Witney A, Dhillon J, Munshi T, Fielding K, Harrison TS. Four-Month High-Dose Rifampicin Regimens for Pulmonary Tuberculosis. NEJM Evid 2023; 2:EVIDoa2300054. [PMID: 38320155 DOI: 10.1056/evidoa2300054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
High-Dose Rifampicin Regimen for Pulmonary TuberculosisThis randomized, controlled trial tested the efficacy and safety of high-dose rifampicin (1200 or 1800 mg/d) as part of the treatment regimen for pulmonary tuberculosis. Four-month high-dose rifampicin regimens had no dose-limiting side effects but failed to meet noninferiority criteria compared with the standard 6-month control regimen.
Collapse
Affiliation(s)
- Amina Jindani
- Institute for Infection and Immunity, St. George's, University of London, London
| | - Daniel Atwine
- Epicentre/Mbarara Research Base, Mbarara, Uganda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Daniel Grint
- London School of Hygiene and Tropical Medicine, London
| | - Boubacar Bah
- Centre Hospitalier Universitaire Ignace Deen, Conakry, Guinea
| | - Jack Adams
- Institute for Infection and Immunity, St. George's, University of London, London
| | | | - Bhabana Shrestha
- German Nepal TB Project (GENETUP)/Nepal Anti TB Association (NATA), Kathmandu, Nepal
| | | | - Saeed Hamid
- Aga Khan University Hospital, Karachi, Pakistan
| | | | | | | | | | - Maryline Bonnet
- Epicentre/Mbarara Research Base, Mbarara, Uganda
- University of Montpellier, Recherche translationelles sur le virus de l'immunodéficience humaine et les maladies infectieuses, Institut de recherche pour le developpement, Institut national de la santé et de la recherche médicale, Montpellier, France
| | | | | | - Kindy Sadio Bah
- Centre Hospitalier Universitaire Ignace Deen, Conakry, Guinea
| | - Nene Mamata Bah
- Centre Hospitalier Universitaire Ignace Deen, Conakry, Guinea
| | - Maimouna Sow
- Centre Hospitalier Universitaire Ignace Deen, Conakry, Guinea
| | | | | | - Bijesh Tandukar
- German Nepal TB Project (GENETUP)/Nepal Anti TB Association (NATA), Kathmandu, Nepal
| | - Bijendra Bhakta Raya
- German Nepal TB Project (GENETUP)/Nepal Anti TB Association (NATA), Kathmandu, Nepal
| | - Neko Shrestha
- German Nepal TB Project (GENETUP)/Nepal Anti TB Association (NATA), Kathmandu, Nepal
| | | | | | | | | | | | | | - Imran Ahmed
- Aga Khan University Hospital, Karachi, Pakistan
| | | | - Marcos V Burgos
- Division of Infectious Diseases, University of New Mexico, Albuquerque, NM
| | - Faisal Sultan
- Shaukat Khanum Research Centre and Cancer Hospital, Lahore, Pakistan
| | - Mariam Hassan
- Shaukat Khanum Research Centre and Cancer Hospital, Lahore, Pakistan
| | - Iqra Masood
- Shaukat Khanum Research Centre and Cancer Hospital, Lahore, Pakistan
| | - Claire Robb
- Institute for Infection and Immunity, St. George's, University of London, London
| | - Jonathan Decker
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sisa Grubnic
- Clinical Academic Group in Infection and Immunity, St. George's University Hospitals National Health Service Foundation Trust, London
| | - Philip D Butcher
- Institute for Infection and Immunity, St. George's, University of London, London
| | - Adam Witney
- Institute for Infection and Immunity, St. George's, University of London, London
| | - Jasvir Dhillon
- Institute for Infection and Immunity, St. George's, University of London, London
| | - Tulika Munshi
- Institute for Infection and Immunity, St. George's, University of London, London
| | | | - Thomas S Harrison
- Institute for Infection and Immunity, St. George's, University of London, London
- Clinical Academic Group in Infection and Immunity, St. George's University Hospitals National Health Service Foundation Trust, London
- Medical Reserach Council Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| |
Collapse
|
2
|
Gagneux S, Burgos MV, DeRiemer K, Enciso A, Muñoz S, Hopewell PC, Small PM, Pym AS. Impact of bacterial genetics on the transmission of isoniazid-resistant Mycobacterium tuberculosis. PLoS Pathog 2006; 2:e61. [PMID: 16789833 PMCID: PMC1479046 DOI: 10.1371/journal.ppat.0020061] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Accepted: 05/05/2006] [Indexed: 11/19/2022] Open
Abstract
Understanding the ecology of drug-resistant pathogens is essential for devising rational programs to preserve the effective lifespan of antimicrobial agents and to abrogate epidemics of drug-resistant organisms. Mathematical models predict that strain fitness is an important determinant of multidrug-resistant Mycobacterium tuberculosis transmission, but the effects of strain diversity have been largely overlooked. Here we compared the impact of resistance mutations on the transmission of isoniazid-resistant M. tuberculosis in San Francisco during a 9-y period. Strains with a KatG S315T or inhA promoter mutation were more likely to spread than strains with other mutations. The impact of these mutations on the transmission of isoniazid-resistant strains was comparable to the effect of other clinical determinants of transmission. Associations were apparent between specific drug resistance mutations and the main M. tuberculosis lineages. Our results show that in addition to host and environmental factors, strain genetic diversity can influence the transmission dynamics of drug-resistant bacteria.
Collapse
Affiliation(s)
- Sebastien Gagneux
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, United States of America
- Institute for Systems Biology, Seattle, Washington, United States of America
- * To whom correspondence should be addressed. E-mail: (SG), (ASP)
| | - Marcos V Burgos
- Department of Internal Medicine, Division of Infectious Diseases, University of New Mexico, Albuquerque, New Mexico, United States of America
- Veterans Affairs Medical Center, Albuquerque, New Mexico, United States of America
| | - Kathryn DeRiemer
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, United States of America
- School of Medicine, University of California Davis, Davis, California, United States of America
| | - Antonio Enciso
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, United States of America
- Unidad de Investigacion Medica de Zacatecas, Zacatecas, Mexico
| | - Samira Muñoz
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, United States of America
| | - Phillip C Hopewell
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Peter M Small
- Institute for Systems Biology, Seattle, Washington, United States of America
- Bill and Melinda Gates Foundation, Seattle, Washington, United States of America
| | - Alexander S Pym
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, United States of America
- Unit for Clinical and Biomedical TB Research, South African Medical Research Council, Durban, South Africa
- * To whom correspondence should be addressed. E-mail: (SG), (ASP)
| |
Collapse
|
3
|
Burgos MV, Méndez JC, Ribon W. Molecular epidemiology of tuberculosis: methodology and applications. Biomedica 2004; 24 Supp 1:188-201. [PMID: 15495586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The resurgence of tuberculosis around the world has renewed interest in understanding the epidemiology and pathogenesis of this disease. A revolutionary advance in the field of tuberculosis research has been the development of molecular techniques that permit identification and tracking of individual strains of Mycobacterium tuberculosis. With these techniques, molecular epidemiology has been established as a new discipline that adds another dimension to the classical epidemiology of tuberculosis and has increased our understanding of the transmission dynamics of M. tuberculosis. The increased epidemiological knowledge has led to discovery of inadequacies in tuberculosis control programs; this information has helped garner resources for program improvement and has highlighted the need for the continuous surveillance of tuberculosis. Additional genetic methods are being developed based on the knowledge of the genome sequence of M. tuberculosis. These simpler and less costly genotyping techniques promise to expand the application of molecular epidemiology to developing nations (where 90% of the disease burden occurs) in support of national tuberculosis programs. Furthermore, these tools permit ever more effective probes into the dynamics of transmission, the population structure, evolution and pathogenesis of M. tuberculosis.
Collapse
Affiliation(s)
- Marcos V Burgos
- Division of Infectious Diseases, University of New Mexico, Health Sciences Center, Department of Internal Medicine, Albuquerque, NM, USA.
| | | | | |
Collapse
|
4
|
Abstract
Despite the almost 50 yrs since the introduction of curative antituberculosis drugs, Mycobacterium tuberculosis continues to exert an enormous toll on world health, and tuberculosis remains the world's leading cause of death due to a single infectious agent. This has stimulated research efforts into finding new tools to tackle the continuing tuberculosis pandemic. One of the few successes to date has been the development of a new discipline, molecular epidemiology. This has added a further dimension to the classical epidemiology of tuberculosis and enhanced understanding of how M. tuberculosis continues to be successfully transmitted within populations. In the process, inadequacies in tuberculosis control programmes have been identified, helping accumulate resources for their improvement. Other technologies, based on knowledge of the complete genome sequence of M. tuberculosis, which will provide newer tools for probing the epidemiology of tuberculosis, are now emerging. In spite of these advances, tuberculosis continues to remain a devastating infectious disease, disproportionately impacting on the world's poorest countries. The future challenge for molecular epidemiology is to provide better understanding of the transmission dynamics of tuberculosis in these settings and to stimulate the implementation of control measures on a more global scale.
Collapse
Affiliation(s)
- M V Burgos
- Dept of Medicine, Stanford University Medical Centre, CA 94305-5107, USA.
| | | |
Collapse
|