Drug Susceptibility Patterns in MDR-TB Patients: Challenges for Future Regimen Design. A Cross-Sectional Study

Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant t...

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Veröffentlicht in:	PloS one Jg. 10; H. 11; S. e0142425
Hauptverfasser:	Stagg, Helen R., Brown, James, Ibraim, Elmira, Riekstiņa, Vija, Viiklepp, Piret, Cīrule, Andra, Cocei, Horia, Danilovitš, Manfred, Dravniece, Gunta, Jackson, Charlotte, White, Peter J.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Public Library of Science 11.11.2015 Public Library of Science (PLoS)
Schlagworte:	Antitubercular Agents - therapeutic use Cross-Sectional Studies Demographics Demography Drug development Drug resistance Drug Resistance, Multiple, Bacterial - drug effects Drug therapy Epidemiology Estonia - epidemiology Female Fluoroquinolones - pharmacology Fluoroquinolones - therapeutic use Hospitals Humans Infectious diseases Innovations Laboratories Latvia - epidemiology Lung diseases Male Medical screening Microbial drug resistance Multidrug resistance Multidrug resistant organisms Patients Pharmacological research Precision medicine Public health Romania - epidemiology Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Tuberculosis, Multidrug-Resistant - microbiology Latvia Romania Estonia United Kingdom > UK
ISSN:	1932-6203, 1932-6203
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Abstract	Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance.
AbstractList	Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance. Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance.Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance.
Audience	Academic
Author	Brown, James Stagg, Helen R. Cocei, Horia Riekstiņa, Vija Cīrule, Andra Dravniece, Gunta Ibraim, Elmira Viiklepp, Piret Jackson, Charlotte White, Peter J. Danilovitš, Manfred
AuthorAffiliation	10 MRC Centre for Outbreak Analysis & Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, London, United Kingdom 5 Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia 3 Division of Medicine, University College London, London, United Kingdom 9 KNCV Tuberculosis Foundation, The Hague, The Netherlands 4 Marius Nasta Institute of Pulmonology, Bucharest, Romania 7 Estonian Tuberculosis Registry, National Institute for Health Development, Tallinn, Estonia University of Padova, Medical School, ITALY 2 Centre for Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom 6 University of Latvia, Riga, Latvia 8 Lung Clinic, Tartu University Hospital, Tartu, Estonia 11 Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom 1 Research Department of Infection and Populatio
AuthorAffiliation_xml	– name: 7 Estonian Tuberculosis Registry, National Institute for Health Development, Tallinn, Estonia – name: 1 Research Department of Infection and Population Health, University College London, London, United Kingdom – name: 3 Division of Medicine, University College London, London, United Kingdom – name: 4 Marius Nasta Institute of Pulmonology, Bucharest, Romania – name: 8 Lung Clinic, Tartu University Hospital, Tartu, Estonia – name: 2 Centre for Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom – name: University of Padova, Medical School, ITALY – name: 5 Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia – name: 9 KNCV Tuberculosis Foundation, The Hague, The Netherlands – name: 10 MRC Centre for Outbreak Analysis & Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, London, United Kingdom – name: 11 Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom – name: 6 University of Latvia, Riga, Latvia
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BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26558611$$D View this record in MEDLINE/PubMed
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CitedBy_id	crossref_primary_10_1016_j_ijtb_2019_02_017 crossref_primary_10_3389_fmicb_2016_00394 crossref_primary_10_1186_s12889_017_4779_5 crossref_primary_10_1128_AAC_01798_18 crossref_primary_10_3201_eid2203_151227 crossref_primary_10_1016_j_ijantimicag_2023_107053 crossref_primary_10_1371_journal_pone_0165222 crossref_primary_10_1016_j_apjtm_2016_01_031 crossref_primary_10_1089_mdr_2016_0208 crossref_primary_10_1186_s12879_020_4758_9
Cites_doi	10.1128/JCM.01775-09 10.1038/nrd4001 10.1016/j.drup.2014.02.003 10.1016/S0140-6736(12)60734-X 10.3201/eid2106.141329
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Copyright	COPYRIGHT 2015 Public Library of Science 2015 Stagg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2015 Stagg et al 2015 Stagg et al
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Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: HRS GD PJW. Analyzed the data: HRS JB CJ GD PJW. Contributed reagents/materials/analysis tools: EI VR PV AC HC MD. Wrote the paper: HRS JB EI VR PV AC HC MD GD CJ PJW. Provision of data: EI VR PV AC HC MD. These authors also contributed equally to this work. Competing Interests: The authors of this manuscript have read the journal's policy and have the following competing interests: Dr. Stagg reports personal fees and other from Otsuka Pharmaceutical, grants from National Institute for Health Research, UK, during the conduct of the study; non-financial support from Sanofi, outside the submitted work. Dr. Brown reports grants and personal fees from Otsuka Pharmaceuticals, during the conduct of the study. Dr. White reports grants and personal fees from Otsuka, during the conduct of the study. Dr. Danilovits reports personal fees and other from Otsuka Pharmaceutical, during the conduct of the study. Dr. Viiklepp reports grants from UCL Consultants Ltd, during the conduct of the study. Dr. Ibraim reports personal fees and non-financial support from Otsuka SA, during the conduct of the study; grants from German Centre for Infection Research- DZIF, outside the submitted work. Dr. Dravniece reports grants and personal fees from Otsuka, during the conduct of the study. Dr. Cocei reports grants from Otsuka SA, during the conduct of the study; grants from Romanian National Tuberculosis Programme, grants from Norway Grants, outside the submitted work. Dr. Jackson reports personal fees from Otsuka Pharmaceutical, grants from National Institute for Health Research, during the conduct of the study. Dr. Riekstina reports personal fees from Otsuka Pharmaceutical (Switzerland) during the conduct of the study. Dr. Cirule has nothing to disclose. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.
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SubjectTerms	Antitubercular Agents - therapeutic use Cross-Sectional Studies Demographics Demography Drug development Drug resistance Drug Resistance, Multiple, Bacterial - drug effects Drug therapy Epidemiology Estonia - epidemiology Female Fluoroquinolones - pharmacology Fluoroquinolones - therapeutic use Hospitals Humans Infectious diseases Innovations Laboratories Latvia - epidemiology Lung diseases Male Medical screening Microbial drug resistance Multidrug resistance Multidrug resistant organisms Patients Pharmacological research Precision medicine Public health Romania - epidemiology Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Tuberculosis, Multidrug-Resistant - microbiology
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Title	Drug Susceptibility Patterns in MDR-TB Patients: Challenges for Future Regimen Design. A Cross-Sectional Study
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Volume	10
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