Publicaties
Bedaquiline microheteroresistance after cessation of tuberculosis treatment Universiteit Antwerpen
Bedaquiline- and clofazimine- selected Mycobacterium tuberculosis mutants: further insights on resistance driven largely by Rv0678 Instituut voor Tropische Geneeskunde
Drug-resistant tuberculosis is a serious global health threat. Bedaquiline (BDQ) is a relatively new core drug, targeting the respiratory chain in Mycobacterium tuberculosis (Mtb). While mutations in the BDQ target gene, atpE, are rare in clinical isolates, mutations in the Rv0678 gene, a transcriptional repressor regulating the efflux pump MmpS5-MmpL5, are increasingly observed, and have been linked to worse treatment outcomes. Nevertheless, ...
Safety and effectiveness of all-oral and injectable-containing, bedaquiline-based long treatment regimen for pre-XDR tuberculosis in Vietnam Instituut voor Tropische Geneeskunde
Background: The World health organization (WHO) recently recommended standardized all-oral shorter regimens for rifampicin resistant Tuberculosis (RR-TB). For highly resistant Tuberculosis patients such as pre-XDR-TB: RR-TB plus additional resistance to fluoroquinolones (FQ), the 6-9-months bedaquiline (bedaquiline)-based regimens or BDQ-based long regimens are recommended. The role of second-line injectable (SLI) drugs in the treatment of ...
Mycobactericidal effects of different regimens measured by molecular bacterial load assay among people treated for multidrug-resistant tuberculosis in Tanzania Instituut voor Tropische Geneeskunde
Rifampin or multidrug-resistant tuberculosis (RR/MDR-TB) treatment has largely transitioned to regimens free of the injectable aminoglycoside component, despite the drug class' purported bactericidal activity early in treatment. We tested whether Mycobacterium tuberculosis killing rates measured by tuberculosis molecular bacterial load assay (TB-MBLA) in sputa correlate with composition of the RR/MDRTB regimen. Serial sputa were collected ...
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 ...
Effectiveness and safety of bedaquiline-based, modified all-oral 9-11-month treatment regimen for rifampicin-resistant tuberculosis in Vietnam Instituut voor Tropische Geneeskunde
World Health Organization recommends a 7-drug 9–11-month rifampicin-resistant tuberculosis (RR-TB) short treatment regimen (STR). To reduce the pill burden, we assessed the safety and effectiveness of a 5-drug 9–11-month modified STR (mSTR).
Methods
Prospective cohort study of an all-oral mSTR (comprising bedaquiline, levofloxacin, linezolid [LZD], clofazimine, and/or pyrazinamide) for patients with RR-TB ...
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 ...
Standardised shorter regimens versus individualised longer regimens for rifampin- or multidrug-resistant tuberculosis Instituut voor Tropische Geneeskunde
We sought to compare the effectiveness of two World Health Organization (WHO)-recommended regimens for the treatment of rifampin- or multidrug-resistant (RR/MDR) tuberculosis (TB): a standardised regimen of 9-12 months (the "shorter regimen") and individualised regimens of >= 20 months ("longer regimens").
We collected individual patient data from observational studies identified through systematic reviews and a public call for ...
Multicentre study to establish interpretive criteria for clofazimine drug susceptibility testing Instituut voor Tropische Geneeskunde Universiteit Antwerpen
OBJECTIVE: To conduct a multicentre study to establish the critical concentration (CC) for clofazimine (CFZ) for drug susceptibility testing (DST) of Mycobacterium tuberculosis on the MGIT (TM) 960 (TM) system using the distribution of minimum inhibitory concentrations (MIC) and genotypic analyses of Rv0678 mutations.
DESIGN: In phase I of the study, the MIC distribution of laboratory strains (H37Rv and in vitro-selected Rv0678 ...