Einzeltreffer — DigiBib

Background: Ukraine remains a high World Health Organization priority country for drug-resistant tuberculosis (TB). Rifampicin-resistant TB (RR-TB) has a more protracted, more complicated, and more expensive treatment. In 2021, Ukraine reported 4025 RR-TB cases - 5.4 times more (751) than all 30 European Union/ European Economic Area countries together.

Objectives: The objective of the study was to determine the diagnostic accuracy of line probe assay (LPA), AID Autoimmun Diagnostika GmbH, for detecting resistance to anti-TB drugs and its clinical application for selecting treatment regimens.

Design: A prospective observational cohort study.

Methods: From May 2019 to June 2020, we consecutively enrolled patients with active TB hospitalized at the Regional Phthisiopulmonology Center (Vinnytsia, Ukraine), aged between 18 and 82 years. The LPA was performed in the Genetic Research Laboratory at National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

Results: A total of 84 clinical specimens and 97 culture isolates from 126 TB patients were tested during the study. Accuracy (95% confidence interval) of LPA for clinical samples in comparison with phenotypic drug susceptibility test (DST) was 80.1 (68.5-89.0) for isoniazid (H), 74.7 (62.4-84.6) for rifampicin (R), 74.4 (62.5-84.1) for ethambutol, 71.4 (41.9-91.6) for streptomycin, 84.6 (62.4-96.5) for prothionamide/ethionamide, and 84.6 (73.6-92.3) for levofloxacin (Lfx), respectively. We found a significantly higher sensitivity of LPA for H, R, and Lfx for the culture isolates compared to clinical specimens ( p < 0.05). LPA detected different mutations in 6 out of 17 (35.5%) patients susceptible to R by Xpert. A shorter treatment regimen with an injectable agent demonstrated a low suitability rate of 5% (8/156) in a cohort of RR-TB patients from Ukraine.

Conclusion: Initial LPA testing accurately identifies resistance to anti-TB drugs and facilitates the selection of an appropriate treatment regimen, minimizing exposure to empirical therapy.

Titel:	Impact of line probe assay-based molecular testing on individualized treatment in patients with rifampicin-resistant tuberculosis: data from the prospective INNOVA4TB cohort study in Ukraine.
Autor/in / Beteiligte Person:	Dudnyk, A ; Hempel, M ; Lytvyniuk, O ; Liudkevych, H ; Matsera, V ; Nikitchenko, T ; Blyzniuk, S ; Molina-Moya, B ; Preyer, R ; Domínguez, J
Link:	Full Text Finder (Volltext)
Zeitschrift:	Therapeutic advances in respiratory disease, Jg. 18 (2024), S. 17534666241249841
Veröffentlichung:	London, UK : SAGE Publications, 2024
Medientyp:	academicJournal
ISSN:	1753-4666 (electronic)
DOI:	10.1177/17534666241249841
Schlagwort:	Humans Prospective Studies Adult Ukraine Male Middle Aged Female Young Adult Aged Adolescent Antitubercular Agents pharmacology Antitubercular Agents administration & dosage Microbial Sensitivity Tests Aged, 80 and over Antibiotics, Antitubercular therapeutic use Antibiotics, Antitubercular pharmacology Predictive Value of Tests Precision Medicine Reproducibility of Results Rifampin pharmacology Tuberculosis, Multidrug-Resistant drug therapy Tuberculosis, Multidrug-Resistant diagnosis Tuberculosis, Multidrug-Resistant microbiology Mycobacterium tuberculosis drug effects Mycobacterium tuberculosis genetics Mycobacterium tuberculosis isolation & purification
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Observational Study Language: English [Ther Adv Respir Dis] 2024 Jan-Dec; Vol. 18, pp. 17534666241249841. MeSH Terms: Rifampin* / pharmacology ; Tuberculosis, Multidrug-Resistant* / drug therapy ; Tuberculosis, Multidrug-Resistant* / diagnosis ; Tuberculosis, Multidrug-Resistant* / microbiology ; Mycobacterium tuberculosis* / drug effects ; Mycobacterium tuberculosis* / genetics ; Mycobacterium tuberculosis* / isolation & purification ; Humans ; Prospective Studies ; Adult ; Ukraine ; Male ; Middle Aged ; Female ; Young Adult ; Aged ; Adolescent ; Antitubercular Agents / pharmacology ; Antitubercular Agents / administration & dosage ; Microbial Sensitivity Tests ; Aged, 80 and over ; Antibiotics, Antitubercular / therapeutic use ; Antibiotics, Antitubercular / pharmacology ; Predictive Value of Tests ; Precision Medicine ; Reproducibility of Results References: Diagn Microbiol Infect Dis. 2019 Oct;95(2):159-161. (PMID: 31279584) ; Lancet Infect Dis. 2022 Feb;22(2):242-249. (PMID: 34627496) ; Infect Genet Evol. 2021 Dec;96:105142. (PMID: 34800711) ; Ann Clin Microbiol Antimicrob. 2021 Oct 13;20(1):73. (PMID: 34645463) ; Emerg Infect Dis. 2020 Mar;26(3):481-490. (PMID: 32091369) ; Antimicrob Agents Chemother. 2021 Oct 18;65(11):e0116421. (PMID: 34460306) ; Eur Respir J. 2017 Jan 18;49(1):. (PMID: 28100546) ; BMJ Open. 2016 Nov 14;6(11):e012799. (PMID: 28137831) ; J Clin Microbiol. 2014 Aug;52(8):2876-80. (PMID: 24871222) ; J Infect. 2015 Apr;70(4):400-8. (PMID: 25305498) ; Am J Respir Crit Care Med. 2016 Oct 15;194(8):1029-1031. (PMID: 27685538) ; Am J Respir Crit Care Med. 2020 Jun 1;201(11):1416-1424. (PMID: 31945300) ; N Engl J Med. 2022 Dec 22;387(25):2331-2343. (PMID: 36546625) ; Eur Respir J. 2022 Apr 14;59(4):. (PMID: 35422426) ; Int J Tuberc Lung Dis. 2021 Oct 1;25(10):832-838. (PMID: 34615580) ; Clin Infect Dis. 2021 Dec 6;73(11):e3929-e3936. (PMID: 33124668) ; Antimicrob Agents Chemother. 2017 Mar 24;61(4):. (PMID: 28137812) ; Lancet Infect Dis. 2023 Apr;23(4):e122-e137. (PMID: 36868253) ; Int J Tuberc Lung Dis. 2022 May 1;26(5):426-432. (PMID: 35505490) ; ERJ Open Res. 2021 Feb 08;7(1):. (PMID: 33585652) ; J Clin Tuberc Other Mycobact Dis. 2020 Aug 01;20:100176. (PMID: 32793816) ; BMC Microbiol. 2020 Sep 16;20(1):284. (PMID: 32938393) Contributed Indexing: Keywords: TB treatment; drug-resistant tuberculosis; line probe assay; molecular diagnostics ; Local Abstract: [plain-language-summary] Study about the impact of rapid resistance detection on the treatment of patients with tuberculosis in Ukraine written by healthcare and biomedical professionals to better understand how we can improve the results of treatment and to prevent spreading of resistant bacteria Why was the study done? Ukraine has over 4000 patients with tuberculosis (TB) resistant to at least one drug (rifampicin) - five times that of all 30 European Union/European Economic Area countries combined. Unfortunately, only about 60% of such patients have been successfully treated in 2019. At that time, the majority of people suffering from tuberculosis in Ukraine, after checking resistance to rifampicin, initially received standard combinations of the first-line or second-line anti-TB medicines before the result of traditionally used tests (usually few weeks later) became available to individualize the treatment. Alternatively, the sputum could be transported to some overloaded reference laboratories located hundreds of km away from the treatment places.What did the researchers do? The INNOVA4TB team implemented rapid diagnostics of drug resistance in routine practice, guiding key antibiotics use in TB patients. A total of 181 samples from 126 individuals were tested during 2019-2020.What did the researchers find? This new diagnostic technology accurately detected resistance to 9 anti-TB drugs in sputum samples. It could be helpful to select appropriate TB treatment regimens, reducing time for decision from 1 month up to 2 days. Recommended at the study time 9-month shorter standardized treatment regimen with injectable agent was suitable only for 5% of patients for whom it was indicated in Vinnytsia region of Ukraine.What do the findings mean? The study has demonstrated successful implementation of the new molecular diagnostic technology from scratch in a country with restricted resources and limited TB laboratory capacity. This test can facilitate optimal distribution of available wards among patients with different profiles of resistance and correct choice between treatment options. Substance Nomenclature: VJT6J7R4TR (Rifampin) ; 0 (Antitubercular Agents) ; 0 (Antibiotics, Antitubercular) Entry Date(s): Date Created: 20240531 Date Completed: 20240531 Latest Revision: 20240606 Update Code: 20240607 PubMed Central ID: PMC11143817

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Impact of line probe assay-based molecular testing on individualized treatment in patients with rifampicin-resistant tuberculosis: data from the prospective INNOVA4TB cohort study in Ukraine.