Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.

<h4>Background</h4>Multi-drug resistant tuberculosis (MDR-TB) is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Philly O'Riordan, Uli Schwab, Sarah Logan, Graham Cooke, Robert J Wilkinson, Robert N Davidson, Paul Bassett, Robert Wall, Geoffrey Pasvol, Katie L Flanagan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2008
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cc253087c17a40e1ae2f760eac475ef4
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:cc253087c17a40e1ae2f760eac475ef4
record_format	dspace
spelling	oai:doaj.org-article:cc253087c17a40e1ae2f760eac475ef42021-11-25T06:18:41ZRapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.1932-620310.1371/journal.pone.0003173https://doaj.org/article/cc253087c17a40e1ae2f760eac475ef42008-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/18779863/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Multi-drug resistant tuberculosis (MDR-TB) is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions.<h4>Methodology/principal findings</h4>This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB) mutations as a surrogate for MDR-TB. Forty two MDR-TB cases and 84 fully sensitive TB controls were matched by date of diagnosis; and factors including demographics, clinical presentation, microbiology findings, management and outcome were analysed using their medical records. Conventionally recognised risk factors for MDR-TB were absent in almost half (43%) of the cases, and 15% of cases were asymptomatic. A significant number of MDR-TB cases were identified in new entrants to the country. Using rpoB mutation testing, the time to diagnosis of MDR-TB was dramatically shortened by a median of 6 weeks, allowing patients to be commenced on appropriate therapy a median of 51days earlier than those diagnosed by conventional culture and sensitivity testing.<h4>Conclusions/significance</h4>MDR-TB is frequently an unexpected finding, may be asymptomatic, and is particularly prevalent among TB infected new entrants to the country. Molecular resistance testing of all acid fast bacilli positive specimens has the potential to rapidly identify MDR-TB patients and commence them on appropriate therapy significantly earlier than by conventional methods.Philly O'RiordanUli SchwabSarah LoganGraham CookeRobert J WilkinsonRobert N DavidsonPaul BassettRobert WallGeoffrey PasvolKatie L FlanaganPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 3, Iss 9, p e3173 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Philly O'Riordan Uli Schwab Sarah Logan Graham Cooke Robert J Wilkinson Robert N Davidson Paul Bassett Robert Wall Geoffrey Pasvol Katie L Flanagan Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
description	<h4>Background</h4>Multi-drug resistant tuberculosis (MDR-TB) is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions.<h4>Methodology/principal findings</h4>This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB) mutations as a surrogate for MDR-TB. Forty two MDR-TB cases and 84 fully sensitive TB controls were matched by date of diagnosis; and factors including demographics, clinical presentation, microbiology findings, management and outcome were analysed using their medical records. Conventionally recognised risk factors for MDR-TB were absent in almost half (43%) of the cases, and 15% of cases were asymptomatic. A significant number of MDR-TB cases were identified in new entrants to the country. Using rpoB mutation testing, the time to diagnosis of MDR-TB was dramatically shortened by a median of 6 weeks, allowing patients to be commenced on appropriate therapy a median of 51days earlier than those diagnosed by conventional culture and sensitivity testing.<h4>Conclusions/significance</h4>MDR-TB is frequently an unexpected finding, may be asymptomatic, and is particularly prevalent among TB infected new entrants to the country. Molecular resistance testing of all acid fast bacilli positive specimens has the potential to rapidly identify MDR-TB patients and commence them on appropriate therapy significantly earlier than by conventional methods.
format	article
author	Philly O'Riordan Uli Schwab Sarah Logan Graham Cooke Robert J Wilkinson Robert N Davidson Paul Bassett Robert Wall Geoffrey Pasvol Katie L Flanagan
author_facet	Philly O'Riordan Uli Schwab Sarah Logan Graham Cooke Robert J Wilkinson Robert N Davidson Paul Bassett Robert Wall Geoffrey Pasvol Katie L Flanagan
author_sort	Philly O'Riordan
title	Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
title_short	Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
title_full	Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
title_fullStr	Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
title_full_unstemmed	Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
title_sort	rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.
publisher	Public Library of Science (PLoS)
publishDate	2008
url	https://doaj.org/article/cc253087c17a40e1ae2f760eac475ef4
work_keys_str_mv	AT phillyoriordan rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT ulischwab rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT sarahlogan rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT grahamcooke rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT robertjwilkinson rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT robertndavidson rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT paulbassett rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT robertwall rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT geoffreypasvol rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy AT katielflanagan rapidmoleculardetectionofrifampicinresistancefacilitatesearlydiagnosisandtreatmentofmultidrugresistanttuberculosiscasecontrolstudy
_version_	1718413953683423232

Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.

Ejemplares similares