Publications by authors named "Felicia Dworkin"
Acquired rifamycin resistance among patients with tuberculosis and HIV in new York City, 2001-2023.
J Clin Tuberc Other Mycobact Dis
May 2024
Introduction: Acquired rifamycin resistance (ARR) in tuberculosis (TB) has been associated with HIV infection and can necessitate complicated TB treatment regimens, particularly in people living with HIV (PLWH). This work examines clinical characteristics and treatment outcomes of PLWH who developed ARR from 2001 to 2023 in New York City (NYC) to inform best practices for treating these patients.
Methods: PLWH who developed ARR 2001-2023 were identified from the NYC TB registry.
Background: Although relatively rare, rifampin mono-resistant tuberculosis (RMR TB) poses important challenges to effective TB treatment and control. Information on the burden of RMR TB and treatment outcomes is needed to inform diagnosis and management.
Methods: Standardized variables were collected from the New York City (NYC) tuberculosis surveillance system for patients treated for RMR TB in NYC during 2010-2021.
Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease.
Clin Infect Dis
October 2023
Article Synopsis
- Rifampin-resistant tuberculosis is a major global health issue, with treatment initiation rates low and often poor outcomes; a 6-month BPaL regimen shows high efficacy but initial high doses of linezolid led to significant side effects.
- Data collected from patients treated with BPaL between October 2019 and April 2022 revealed that 97.1% completed treatment, with only a small percentage experiencing relapse or significant adverse effects, largely due to careful dose adjustments of linezolid.
- The study concludes that the BPaL regimen, especially with individualized linezolid dosing and monitoring, has significantly improved treatment for rifampin-resistant tuberculosis, allowing for shorter treatment durations compared to past guidelines.
Both tuberculosis (TB) and COVID-19 can affect the respiratory system, and early findings suggest co-occurrence of these infectious diseases can result in elevated mortality. A retrospective cohort of patients who were diagnosed with TB and COVID-19 concurrently (within 120 days) between March 2020 and June 2022 in New York City (NYC) was identified. This cohort was compared with a cohort of patients diagnosed with TB-alone during the same period in terms of demographic information, clinical characteristics, and mortality.
View Article and Find Full Text PDFRapid and reliable detection of rifampin (RIF) resistance is critical for the diagnosis and treatment of drug-resistant and multidrug-resistant (MDR) tuberculosis. Discordant RIF phenotype/genotype susceptibility results remain a challenge due to the presence of mutations that do not confer high levels of RIF resistance, as have been exhibited in strains with mutations such as Ser450Leu. These strains, termed low-level RIF resistant, exhibit elevated RIF MICs compared to fully susceptible strains but remain phenotypically susceptible by mycobacterial growth indicator tube (MGIT) testing and have been associated with poor patient outcomes.
View Article and Find Full Text PDFBackground: In 2012, the Food and Drug Administration approved use of bedaquiline fumarate as part of combination therapy for multidrug-resistant tuberculosis (MDR TB). We describe treatment outcomes, safety, and tolerability of bedaquiline in our case series.
Methods: Data on patients started on bedaquiline for MDR TB between September 2012 and August 2016 were collected retrospectively through 4 TB programs using a standardized abstraction tool.
Unlabelled: Rationale Linezolid may be effective for the treatment of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB); however, serious adverse events are common and there is little information on the management of these toxicities.
Methods: We retrospectively reviewed public health and medical records of 16 MDR TB patients, including 10 patients with XDR TB, who were treated with linezolid in New York City between January 2000 and December 2006, to determine treatment outcomes and describe the incidence, management and predictors of adverse events.
Results: Linezolid was added to MDR TB regimens for a median duration of 16 months (range: 1-29).