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Perplexing paradoxical reactions: navigating the complexity of protracted tuberculosis meningitis-a case report.
Front Immunol
November 2024
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.
Tuberculous meningitis (TBM) has considerable mortality and morbidity, and it often presents therapeutic challenges when complicated by paradoxical reactions (PRs). Here, the clinical course of four cases of TBM patients complicated by PRs in a longitudinal TB cohort is described while also providing insights from the larger clinical cohort. Research flow cytometry, biomarker analysis, and drug concentrations were performed on available samples.
View Article and Find Full Text PDFDrug-Resistant Characteristics, Genetic Diversity, and Transmission Dynamics of Multidrug-Resistant in Jiangxi, China.
Infect Drug Resist
June 2024
Tuberculosis Control Department, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, People's Republic of China.
Purpose: In this study, we aimed to determine the transmission pattern of multidrug-resistant tuberculosis (MDR-TB) isolates circulating in Jiangxi Province with whole-genome sequencing (WGS). In addition, we also sought to describe mutational resistome of MDR-TB isolates.
Patients And Methods: A total of 115 MDR-TB isolates determined by the phenotypic proportion method of drug susceptibility testing between January 2018 and December 2022 from provincial drug surveillance (DRS) in Jiangxi were included in our analysis.
Evaluating the Sensitivity of Different Molecular Techniques for Detecting Complex in Patients with Pulmonary Infection.
Pol J Microbiol
December 2023
2Biology Department, College of Science, Taibah University, Al-Madinah, Kingdom of Saudi Arabia.
This study aimed to evaluate the accuracy of detecting drug-resistant complex (MTBC)-specific DNA in sputum specimens from 48 patients diagnosed with pulmonary tuberculosis. The presence of MTBC DNA in the specimens was validated using the GeneXpert MTB/RIF system and compared with a specific PCR assay targeting the IS and the 40 gene sequence fragments. Additionally, the results obtained by multiplex PCR assays to detect the most frequently encountered rifampin, isoniazid, and ethambutol resistance-conferring mutations were matched with those obtained by GeneXpert and phenotypic culture-based drug susceptibility tests.
View Article and Find Full Text PDFClinical Whole-Genome Sequencing Assay for Rapid Complex First-Line Drug Susceptibility Testing and Phylogenetic Relatedness Analysis.
Microorganisms
October 2023
Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
The global rise of drug resistant tuberculosis has highlighted the need for improved diagnostic technologies that provide rapid and reliable drug resistance results. Here, we develop and validate a whole genome sequencing (WGS)-based test for identification of mycobacterium tuberculosis complex (MTB) drug resistance to rifampin, isoniazid, pyrazinamide, ethambutol, and streptomycin. Through comparative analysis of drug resistance results from WGS-based testing and phenotypic drug susceptibility testing (DST) of 38 clinical MTB isolates from patients receiving care in Los Angeles, CA, we found an overall concordance between methods of 97.
View Article and Find Full Text PDFPharmacokinetics and safety of first-line tuberculosis drugs rifampin, isoniazid, ethambutol, and pyrazinamide during pregnancy and postpartum: results from IMPAACT P1026s.
Antimicrob Agents Chemother
November 2023
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, California, USA.
Physiological changes during pregnancy may alter the pharmacokinetics (PK) of antituberculosis drugs. The International Maternal Pediatric Adolescent AIDS Clinical Trials Network P1026s was a multicenter, phase IV, observational, prospective PK and safety study of antiretroviral and antituberculosis drugs administered as part of clinical care in pregnant persons living with and without HIV. We assessed the effects of pregnancy on rifampin, isoniazid, ethambutol, and pyrazinamide PK in pregnant and postpartum (PP) persons without HIV treated for drug-susceptible tuberculosis disease.
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