Antituberculosis drug resistance patterns in adults with tuberculous meningitis: results of haydarpasa-iv study.


BACKGROUND:Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to antituberculosis drugs is an increasingly common clinical problem. This study aimed to evaluate drug resistance profiles of TBM isolates in adult patients in nine European countries involving 32 centers to provide insight into the empiric treatment of TBM. METHODS:Mycobacterium tuberculosis was cultured from the cerebrospinal fluid (CSF) of 142 patients and was tested for susceptibility to first-line antituberculosis drugs, streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). RESULTS:Twenty of 142 isolates (14.1 %) were resistant to at least one antituberculosis drug, and five (3.5 %) were resistant to at least INH and RIF, [multidrug resistant (MDR)]. The resistance rate was 12, 4.9, 4.2 and 3.5 % for INH, SM, EMB and RIF, respectively. The monoresistance rate was 6.3, 1.4 and 0.7 % for INH, SM and EMB respectively. There was no monoresistance to RIF. The mortality rate was 23.8 % in fully susceptible cases while it was 33.3 % for those exhibiting monoresistance to INH, and 40 % in cases with MDR-TBM. In compared to patients without resistance to any first-line drug, the relative risk of death for INH-monoresistance and MDR-TBM was 1.60 (95 % CI, 0.38-6.82) and 2.14 (95 % CI, 0:34-13:42), respectively. CONCLUSION:INH-resistance and MDR rates seemed not to be worrisome in our study. However, considering their adverse effects on treatment, rapid detection of resistance to at least INH and RIF would be most beneficial for designing anti-TB therapy. Still, empiric TBM treatment should be started immediately without waiting the drug susceptibility testing.


Senbayrak S,Ozkutuk N,Erdem H,Johansen IS,Civljak R,Inal AS,Kayabas U,Kursun E,Elaldi N,Savic B,Simeon S,Yilmaz E,Dulovic O,Ozturk-Engin D,Ceran N,Lakatos B,Sipahi OR,Sunbul M,Yemisen M,Alabay S,Beovic B,Ulu-Kil




Has Abstract


2015-11-04 00:00:00










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    authors: Ueno S,Minaba M,Nishiuchi Y,Taichi M,Tamada Y,Yamazaki T,Kato Y

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    authors: Paniagua GL,Monroy E,Rodríguez R,Arroniz S,Rodríguez C,Cortés JL,Camacho A,Negrete E,Vaca S

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    authors: Falcao MB,Cimerman S,Luz KG,Chebabo A,Brigido HA,Lobo IM,Timerman A,Angerami RN,da Cunha CA,Bacha HA,Alves JR,Barbosa AN,Teixeira RF,Weissmann L,Oliveira PR,Cyrillo MA,Bandeira AC

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  • A second-generation anti TB vaccine is long overdue.

    abstract::Mycobacterium bovis BCG vaccine significantly reduces the risk of tuberculosis by 50% and continues to be used to prevent tuberculosis around the world. However, it has been shown to be ineffective in some geographical regions. The existence of different BCG strains was described more than 60 years ago, these vary in ...

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    authors: Kart L,Altin R,Tor M,Gulmez I,Oymak SF,Atmaca HM,Erdem F

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    authors: Tay SC,Badu K,Mensah AA,Gbedema SY

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    authors: Polilli E,Ursini T,Mazzotta E,Sozio F,Savini V,D'Antonio D,Barbato M,Consorte A,Parruti G

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    authors: Witzel Cde L,Fortaleza CM,de Souza CS,Riboli DF,da Cunha Mde L

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    journal_title:Annals of clinical microbiology and antimicrobials

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    authors: Cheng C,Sun J,Zheng F,Wu K,Rui Y

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    authors: Iversen BG,Eriksen HM,Bø G,Hagestad K,Jacobsen T,Engeset E,Lassen J,Aavitsland P

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    pub_type: 杂志文章,评审


    authors: Chegini Z,Khoshbayan A,Taati Moghadam M,Farahani I,Jazireian P,Shariati A

    更新日期:2020-09-30 00:00:00

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