Abstract:
BACKGROUND:Increasing incidence of multidrug-resistant Mycobacterium tuberculosis infections is hampering global tuberculosis control efforts. Kuwait is a low-tuberculosis-incidence country, and ~ 1% of M. tuberculosis strains are resistant to rifampicin and isoniazid (MDR-TB). This study detected mutations in seven genes predicting resistance to rifampicin, isoniazid, pyrazinamide, ethambutol and streptomycin in MDR-TB strains. Sequence data were combined with spoligotypes for detecting local transmission of MDR-TB in Kuwait. METHODS:Ninety-three MDR-TB strains isolated from 12 Kuwaiti and 81 expatriate patients and 50 pansusceptible strains were used. Phenotypic drug susceptibility was determined by MGIT 460 TB/960 system. Mutations conferring resistance to rifampicin, isoniazid, pyrazinamide, ethambutol and streptomycin were detected by genotype MTBDRplus assay and/or PCR sequencing of three rpoB regions, katG codon 315 (katG315) + inhA regulatory region, pncA, three embB regions and rpsL + rrs-500-900 regions. Spoligotyping kit was used, spoligotypes were identified by SITVIT2, and phylogenetic tree was constructed by using MIRU-VNTRplus software. Phylogenetic tree was also constructed from concatenated sequences by MEGA7 software. Additional PCR sequencing of gidB and rpsA was performed for cluster isolates. RESULTS:Pansusceptible isolates contained wild-type sequences. Mutations in rpoB and katG and/or inhA were detected in 93/93 and 92/93 MDR-TB strains, respectively. Mutations were also detected for pyrazinamide resistance, ethambutol resistance and streptomycin resistance in MDR-TB isolates in pncA, embB and rpsL + rrs, respectively. Spoligotyping identified 35 patterns with 18 isolates exhibiting unique patterns while 75 isolates grouped in 17 patterns. Beijing genotype was most common (32/93), and 11 isolates showed nine orphan patterns. Phylogenetic analysis of concatenated sequences showed unique patterns for 51 isolates while 42 isolates grouped in 16 clusters. Interestingly, 22 isolates in eight clusters by both methods were isolated from TB patients typically within a span of 2 years. Five of eight clusters were confirmed by additional gidB and rpsA sequence data. CONCLUSIONS:Our study provides the first insight into molecular epidemiology of MDR-TB in Kuwait and identified several potential clusters of local transmission of MDR-TB involving 2-6 subjects which had escaped detection by routine surveillance studies. Prospective detection of resistance-conferring mutations can identify possible cases of local transmission of MDR-TB in low MDR-TB settings.
journal_name
Eur J Med Resjournal_title
European journal of medical researchauthors
Al-Mutairi NM,Ahmad S,Mokaddas EMdoi
10.1186/s40001-019-0397-2subject
Has Abstractpub_date
2019-12-05 00:00:00pages
38issue
1eissn
0949-2321issn
2047-783Xpii
10.1186/s40001-019-0397-2journal_volume
24pub_type
杂志文章abstract::Infectious diseases remain a major cause of morbidity and mortality in the year 2000. 17 million deaths per year or roughly a third of all deaths are caused by infections. Infectious diseases also pose a serious economic threat. While many well-established pathogens have not been contained several new infectious agent...
journal_title:European journal of medical research
pub_type: 总体
doi:
更新日期:2000-11-30 00:00:00
abstract:BACKGROUND:Serotonin (5-HT) and its receptors are present in central, the brain stem, and peripheral, the carotid body, tissues controlling the ventilatory responses to hypoxia. The exact action of serotonin and its nature are, however, unsettled. We hypothesized that the discrepant results on the ventilatory action of...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-15-s2-128
更新日期:2010-11-04 00:00:00
abstract:AIM:Antiseptics are commonly used in clinical practice to disinfect tissue and to avoid infections. However, topical antiseptics are assumed to have an influence on skin microcirculation, per se. Thus, the aim of the study was to analyse the influence of topically applied antiseptics on the microcirculation of intact s...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2004-09-29 00:00:00
abstract:BACKGROUND:The current pilot study compares the impact of an intravenous infusion of Ringer's lactate to an acetate-based solution with regard to acid-base balance. The study design included the variables of the Stewart approach and focused on the effective strong ion difference. Because adverse hemodynamic effects hav...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783X-17-21
更新日期:2012-07-06 00:00:00
abstract::The influence of heparin on Polymorphonuclear (PMN s) leukocytes was investigated using a new whole-blood cytofluorometric method (patent granted for the test with the number P 4334935.8-41) with Candida albicans and Staphylococcus aureus as test microorganisms. After comparing the effect of equal volumes of two widel...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:1997-12-31 00:00:00
abstract::Severe pulmonary hypertension is a lethal group of disorders which preferentially afflicts women. It appears that in recent years the patient profile has shifted towards older, obese, and postmenopausal women, suggesting that endocrine factors may be important. Several studies have revealed an increased prevalence of ...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-14-10-433
更新日期:2009-09-28 00:00:00
abstract:BACKGROUND:Chondral or osteochondral lesions, post-traumatic contracture and loose bodies of the elbow are often associated with chronic pain, stiffness, repetitive swelling and joint blockages. Therefore, arthroscopy of the elbow is often used in the elderly for the treatment of osteochondral defects or arthrolysis. T...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/s40001-018-0338-5
更新日期:2018-09-15 00:00:00
abstract:OBJECTIVE:replication of HIV-1 after cell entry is essentially dependent on the reverse transcriptase (RT). Antiretroviral drugs impairing the function of the RT currently aim at the polymerase subunit. One reason for failure of antiretroviral treatment is the evolvement of resistance-associated mutations in the viral ...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-15-10-415
更新日期:2010-10-25 00:00:00
abstract::In 1973 copper-associated liver disease was first described in an Australian boy of non-Indian origin who died at the age of 15 months with liver cirrhosis. At necropsy the hepatic copper concentration was excessively high (> 300 mg/g dry weight). It was shown that the boy s disease was caused by consumption of copper...
journal_title:European journal of medical research
pub_type: 历史文章,杂志文章
doi:
更新日期:1999-06-28 00:00:00
abstract::The gum resin of Boswellia serrata, known in Indian Ayurvedic system of medicine as Salai guggal, contains boswellic acids, which have been shown to inhibit leukotriene biosynthesis. In a double-blind, placebo-controlled study forty patients, 23 males and 17 females in the age range of 18 - 75 years having mean durati...
journal_title:European journal of medical research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-11-17 00:00:00
abstract:BACKGROUND:Prophylaxis efforts for the maintenance of tooth health led to a distinctive decrease in caries frequency with children and young persons. Because the toothbrush can still be described as the most important oral hygiene aid, possible differences between the effectivity of electric and manual toothbrushes sho...
journal_title:European journal of medical research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-01-29 00:00:00
abstract::In the absence of thromboprophylaxis, venous thromboembolism (VTE) affects about 50 to 80% of the patients after total hip replacement (THR), total knee replacement (TKR), or hip fracture surgery. Since stratification of patients in those who will become symptomatic and those who will not, is not possible, primary hig...
journal_title:European journal of medical research
pub_type: 杂志文章,评审
doi:
更新日期:2004-03-30 00:00:00
abstract::CCR5 receptor inhibitors are currently being introduced into clinical practice. In some instances treatment failure is related to the selection of pre-existing CXCR4-tropic minority virus strains. Up to date it is unclear whether the outgrowth of a CXCR4 using reservoir is associated with accelerated HIV-disease. In a...
journal_title:European journal of medical research
pub_type: 杂志文章,评审
doi:
更新日期:2007-10-15 00:00:00
abstract:OBJECTIVE:To report on radiological and epidemiological characteristics of pulmonary disease in patients with HIV infection in times of highly active antiretroviral therapy (HAART). METHODS:Clinical data of 130 HIV infected adults with acute pulmonary symptoms were compared with findings in chest radiography (n = 130)...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2007-08-16 00:00:00
abstract:OBJECTIVE:We intended to determine the reliability of a brief life satisfaction scale in a sample of patients with chronic diseases, and to analyze its external validity. METHODS:Reliability and factor analysis of the 8-item "Brief Multidimensional Life Satisfaction Scale" (BMLSS) were performed according to standard ...
journal_title:European journal of medical research
pub_type: 杂志文章,多中心研究
doi:10.1186/2047-783x-14-4-171
更新日期:2009-04-16 00:00:00
abstract:AIM:The aim of the in vitro study was to examine the effect of estradiol and progesterone on the proliferation rate of human gingival fibroblasts (HGF) derived from a healthy and a diabetic (type II) individual. METHODS:In the first experiment, cells in the logarithmic proliferative phase were incubated with estradiol...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2003-12-09 00:00:00
abstract::The insulin-like and vasodilatatory polypeptide relaxin (RLX), formerly known as a pregnancy hormone, has gained interest as a potential humoral mediator in human heart failure. Controversy exists about the relation between plasma levels of RLX and the severity of heart failure. The present study was designed to deter...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-14-3-106
更新日期:2009-03-17 00:00:00
abstract::In this study a potential influence of diatomaceus earth to lower blood cholesterol was investigated. During 12 weeks we monitored serum lipid concentrations in 19 healthy individuals with a history of moderate hypercholesterinemia (9 females, 10 males, aged 35 - 67 years). Individuals administered orally 250 mg diato...
journal_title:European journal of medical research
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-04-08 00:00:00
abstract:OBJECTIVE:To compare two reduced dose indinavir (IDV) + ritonavir (RTV) combinations guided by therapeutic drug monitoring (TDM) in treatment-naive HIV1-infected patients. METHODS:HIV1-infected treatment naive patients were prospectively randomized to treatment with IDV 600 mg or 400 mg BID each in combination with RT...
journal_title:European journal of medical research
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2007-07-26 00:00:00
abstract::Exposure to high concentrations of oxygen is known to induce changes in lung function through effects on several pulmonary cell types, including alveolar macrophages (AM). In this study, we studied the in vitro effects of hyperoxia on the release of proinflammatory cytokines and the expression of surface receptors in ...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:1997-04-21 00:00:00
abstract:BACKGROUND:Exacerbations of chronic obstructive pulmonary disease (COPD) are sporadic, acute worsening of symptoms. Identifying predictors of exacerbation frequency may facilitate medical interventions that reduce exacerbation frequency and severity. The objective of this study was to determine predictors of exacerbati...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783X-19-18
更新日期:2014-04-08 00:00:00
abstract::The purpose of this report is to document a case of unsuspected ameloblastoma involving the right man dibular subpontic region in a 38-year-old Cambodian female patient. This lesion was purportedly preceded by multiple radiolucencies which were diagnosed as radicular cysts and treated a few times in the past years by ...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-15-3-135
更新日期:2010-03-30 00:00:00
abstract::The occurrence of acute promyelocytic leukemia (APL) in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-14-1-42
更新日期:2009-01-28 00:00:00
abstract::Drug development in the field of HIV treatment is rapid. New nucleoside analogues (NRTI), non-nucleoside analogue reverse transcriptase inhibitors (NNRTI), and protease inhibitors (PI) are currently being investigated in human trials. Furthermore, inhibitors of HIV attachment, fusion and integrase with novel modes of ...
journal_title:European journal of medical research
pub_type: 杂志文章,评审
doi:
更新日期:2007-10-15 00:00:00
abstract:BACKGROUND:In intestinal epithelium, tyrosine kinase receptor Ephrin B3 (Eph B3) maintains the architecture of the crypt-villus axis by repulsive interaction with its ligand ephrin-B1. While loss of Eph B3 is linked to colorectal cancer initiation, overexpression of Eph B3 in cancer cell lines inhibits growth and induc...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783X-17-10
更新日期:2012-05-14 00:00:00
abstract:BACKGROUND:Reporting of all serious adverse events (SAEs) is a requirement for regulatory approval of a drug. Can equally rigorous reporting standards be expected in studies of non-drug treatments and how can underreporting, if any, be detected and proven? Using data from our large-scale prospective cohort study of acu...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2004-12-22 00:00:00
abstract::Coronary angiograms performed at the time of an acute coronary syndrome typically present vessel occlusions, ruptured plaques or thrombotic lesions that require reperfusion therapy. However, occasionally, no coronary artery stenoses are detected. Myocardial ischemia frequently causes left ventricular wall motion abnor...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2008-08-18 00:00:00
abstract::The aim of the study was to investigate whether cholecystokinin, neurotensin, and cholinergic mechanisms act as mediators of bile salt-stimulated exocrine pancreatic secretion. Ten fasting healthy subjects provided with a double-lumen tube received 2, 4, and 6 g cattle bile and 200, 400, and 600 mg Na-taurodeoxycholat...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVES:Several epidemiological studies address psychosomatic self regulation as a measure of quality of life aspects. However, although widely used in studies with a focus on complementary cancer treatment, and recognized to be associated with better survival of cancer patients, it is unclear what the self regulati...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:10.1186/2047-783x-14-5-223
更新日期:2009-05-14 00:00:00
abstract::Gadolinium chelates are widely used in magnetic resonance imaging as contrast medium in patients with nephropathy. However, only few studies have investigated the effect of gadolinium on serum creatinine concentration and estimated GFR as surrogate markers of renal function. This study was performed to evaluate the ef...
journal_title:European journal of medical research
pub_type: 杂志文章
doi:
更新日期:2005-04-20 00:00:00