Worldwide Incidence of Multidrug‐Resistant Tuberculosis

Communicable Diseases, World Health Organization, 1211 Geneva 27, Switzerland.
The Journal of Infectious Diseases (Impact Factor: 6). 05/2002; 185(8):1197-202. DOI: 10.1086/339818
Source: PubMed


Planning for tuberculosis (TB) control requires an assessment of the number and distribution of drug-resistant cases. This
study used results of resistance surveys from 64 countries, together with data predictive of resistance rates from 72 others,
to estimate the number of new multidrugresistant (MDR) TB cases that occurred in 2000. By these methods, an estimated 273,000
(95% confidence limits, 185,000 and 414,000) new cases of MDR TB occurred worldwide in 2000, 3.2% of all new TB cases. The
analysis provides the first comprehensive set of estimates of the MDR TB burden by country and globally.

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Available from: Brian Gerard Williams, Jan 03, 2014
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    • "Though, such highly effective regimens have been developed to treat the tuberculosis patients, but still the duration of drugs is for a minimum of 6 months to cure the disease completely. The non-adherence to this lengthy treatment is reported as one among the major causes of MDR and extensively drug-resistance to Mycobacterium strains, which eventually complicates the treatment schedule and cure of the disease.[1112] Reports are there showing the development of drug-resistance in tuberculosis patients due to altered pharmacokinetics because of other systemic disorders including acquired immunodeficiency syndrome.[1314] "
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    ABSTRACT: Increasing incidences of multiple drug-resistance (MDR) in Mycobacterium tuberculosis are emerging as one among the serious public health threats and socio-economic burden to the third world countries including India. Last couples of decades are witnesses of the dedicated and sustained efforts made toward the development of target specific and cost-effective antimicrobial agents against MDR-M. tuberculosis. However, the drugs in use are still incapable of controlling the upsurge of MDR. Thus, in order to address the issue, we synthesized a library of symmetrical trans-cyclohexane-1, 4-diamine derivatives and evaluated their anti-mycobacterium activity in H37RV strain of M. tuberculosis. A range of efficacy has been recorded in different derivatives of synthesized compounds and compound "9u" having i-propyl group substitution at p-position, was found to have more significant detrimental effects against the tested strain of M. tuberculosis. The present investigations were aimed to study whether the effective anti-mycobacterium concentrations of "9u" are biologically safe to human cells or not? The human lung epithelial cell line-A549 were exposed to a range of concentrations, i.e., at and above the anti-mycobacterium effective dose of "9u" for a period of 0-96 h. The standard endpoints of cytotoxicity viz., tetrazolium bromide salt (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide), neutral red uptake, lactate dehydrogenase release, trypan blue dye exclusion assays; and genotoxicity viz., micronucleus and chromosomal aberrations assays were used to evaluate the bio-safety of test compound. The compound "9u" shows no significant cytotoxicity and genotoxicity in A549 cells exposed to 10(-5) M for 72 h, a concentration substantially higher than the concentration kill the H37Rv strain of M. tuberculosis. The compound 9u was found to be safe up to 10(-4) M if given for 24 h. The data reveal the therapeutic potential of compound 9u against M. tuberculosis without any having any cytotoxicity and genotoxicity responses.
    Full-text · Article · Mar 2014 · Toxicology International
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    • "Tuberculosis, an infectious disease caused by M. tuberculosis, remains an important problem the world is facing due to the alarming increase of people living with HIV and the emergence of multi- and extensively drug-resistant strains [1], [2]. Thus, new drugs against this stubborn disease are urgently needed. "
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    ABSTRACT: UDP-N-acetylglucosamine (UDP-GlcNAc) is a direct glycosyl donor of linker unit (L-Rhamnose-D-GlcNAc) and an essential precursor of peptidoglycan in mycobacteria. Phosphoglucosamine mutase (GlmM) is involved in the formation of glucosamine-1-phosphate from glucosamine-6-phosphate, the second step in UDP-GlcNAc biosynthetic pathway. We have demonstrated that GlmM protein is essential for the growth of M. smegmatis. To facilitate the analysis of the GlmM protein function in mycobacteria, a tetracycline inducible M. smegmatis glmM gene knockdown strain was constructed by using an antisense RNA technology. After induction with 20 ng/ml tetracycline, the expression of GlmM protein in glmM gene knockdown strain was significantly decreased, resulting in a decline of cell growth. The morphological changes of glmM gene knockdown strain induced with 20 ng/ml tetracycline have been observed by scanning electron microscope and transmission electron microscope. Furthermore, insufficient GlmM protein reduced the biofilm formation and increased the sensitivity to isoniazid and ethambutol in M. smegmatis, indicating that GlmM protein had effect on the biofilm formation and the senstivity to some anti-tuberculosis drugs targeting the cell wall. These results provide a new insight on GlmM functions in mycobacteria, suggesting that GlmM could be a potential target for development of new anti-tuberculosis drug.
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    • "In fact, a relapse case is a patient previously declared cured or treatment completed and subsequently diagnosed with a new episode of TB bacteriologically confirmed (sputum smear or culture) [4]. The emergence of MDR-TB associated with relapse may be considered as an additional challenge in TB control [5] [6], notably in developing countries. The prevalence of MDR-TB has been estimated to be low in sub-Saharan Africa, where surveillance of drug resistance is limited [1]. "
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    ABSTRACT: Tuberculosis is explicitly recognized as a major global public health problem. In Côte d’Ivoire, relapse cases represent 66.5% of patients eligible for retreatment according to the National Tuberculosis Control Program. This study objective was to detect multidrug-resistance tuberculosis among relapse cases. Patients were recruited in tuberculosis centers in routine. A standardized questioning was administrated. Two sputum samples were collected and transported at Institut Pasteur. Sputum samples were decontaminated by NALC method. The DNA extraction was realized with 500 μl of decontaminated sputum sample with smear-positive. MTBDRplus assay version 2.0 was performed according to the manufacturer’s instruction. An internal quality control program with positive and negative controls was implemented for interpretation of results. In total 146 relapse cases with smear positive were studied. Out of selected patients, 130 had received the 2RHZE/4RH regimen and 16, the 2RHZES/1RHZE/5HRE. In group of relapse cases previously treated with 2RHZE/4RH regimen, 40 (31.3%, IC95%: [0.23; 0.39]) had punctual mutations at codon 526 in rpoB gene. Although, in patients under treated with 2RHZES/1RHZE/5HRE, a mutation in rpoB gene was identified in 12 of 16 sputum samples. Thirteen mutations conferring a resistance to Isoniazid were observed of which 9 in katG gene and 4 in katG and promoter region of inhA gene. The comparison (Chi-square with Yates correction) of resistance rates to Rifampin estimated showed a statistically significant difference. Conclusion: Use of a rapid method to detect drug-resistance in recurrent TB cases has permitted to identify patients eligible for first-line drugs or not.
    Full-text · Article · Jan 2013 · International Journal of Mycobacteriology
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