Should treatment of low-level rifampicin mono-resistant tuberculosis be different? Instituut voor Tropische Geneeskunde
Thin-layer-agar-based direct phenotypic drug susceptibility testing on sputum in Eswatini rapidly detects Mycobacterium tuberculosis growth and rifampicin resistance otherwise missed by WHO-endorsed diagnostic tests Instituut voor Tropische Geneeskunde
Xpert MTB/RIF rapidly detects resistance to rifampicin (RR); however, this test misses I491F-RR conferring rpoB mutation, common in southern Africa. In addition, Xpert MTB/RIF does not distinguish between viable and dead Mycobacterium tuberculosis (MTB). We aimed to investigate the ability of thin-layer agar (TLA) direct drug-susceptibility testing (DST) to detect MTB and its drug-resistance profiles in field conditions in Eswatini. ...
Low cycle threshold value in Xpert MTB/RIF assay may herald false detection of tuberculosis and rifampicin resistance: a study of two cases Instituut voor Tropische Geneeskunde
We report 2 cases for whom Xpert MTB/RIF falsely signaled rifampicin-resistant tuberculosis, based on unusually low cycle threshold and 3 of 5 probes missing. Other mycobacterial tests were negative. Further optimization of the Xpert MTB/RIF algorithm is warranted.
Second-line injectable drugs for rifampicin-resistant tuberculosis: better the devil we know? Instituut voor Tropische Geneeskunde
In its 2020 guidelines for the treatment of rifampicin-resistant TB (RR-TB), the WHO recommends all-oral fluoroquinoLone-based regimens, with bedaquiline replacing the second-line injectable drugs (SLIDs). SLIDs were used for their strong acquired resistance-preventing activity. Data from three cohorts showed acquired bedaquiline resistance ranging between 2.5% and 30.8%, with no protection from a SLID in most cases. If bedaquiline resistance ...
Human rights: finding the right balance for rifampicin-resistant TB treatment Instituut voor Tropische Geneeskunde
HERA: a new era for health emergency preparedness in Europe? Instituut voor Tropische Geneeskunde
Management of multidrug-resistant tuberculosis with shorter treatment regimen in Niger: nationwide programmatic achievements Instituut voor Tropische Geneeskunde
Background: In Niger, the Shorter Treatment Regimen (STR) has been implemented nationwide for rifampicin resistant tuberculosis (RR-TB), since 2008. No previous publication has shown the results from countrywide programmatic implementation using few exclusion criteria, nor exhaustively assessed the effect of initial resistance to companion drugs on outcomes.
Methods: The National Tuberculosis Programme and the Damien Foundation ...
World Health Organization 2018 treatment guidelines for rifampicin-resistant tuberculosis: uncertainty, potential risks and the way forward Instituut voor Tropische Geneeskunde
The 2018 World Health Organization (WHO) treatment guidelines for multidrug-/rifampicin-resistant tuberculosis (MDR/RR-TB) give preference to all-oral long regimens lasting for 18-20 months. The guidelines strongly recommend combining bedaquiline, levofloxacin (or moxifloxacin) and linezolid, supplemented by cycloserine and/or clofazimine. The effectiveness of this combination in a long regimen has not been tested in any study to date, with ...
The perceived impact of isoniazid resistance on outcome of first-line rifampicin-throughout regimens is largely due to missed rifampicin resistance Instituut voor Tropische Geneeskunde
BACKGROUND: Meta-analyses on impact of isoniazid-resistant tuberculosis informed the World Health Organization recommendation of a levofloxacin-strengthened rifampicin-based regimen. We estimated the effect of initial rifampicin resistance (Rr) and/or isoniazid resistance (Hr) on treatment failure or relapse. We also determined the frequency of missed initial and acquired Rr to estimate the impact of true Hr.
METHODS: Retrospective ...