Drug resistance

Indo-JHU researchers are using combined geospatial and genotyping methods to describe TB transmission dynamics in a hyperlocal region of Pune City in Western India.

Predictors of Resistance Emergence Evaluation in Multidrug Resistant-Tuberculosis Patients on Treatment (PREEMPT Pilot Study)

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2018-03-20

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Indo-JHU Clinical Resarch Partnership is participating with Brazilian colleagues in a 3-year effort led by Boston University to identify what contributes to TB drug resistance.

Assessing the Impact of the Fogarty HIV-TB Training Program at the Byramjee Jeejeebhoy Government Medical College, Pune, India

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2018-01-19

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This study was terminated in January 2021. It was funded by the Fogarty International Center at the U.S. National Institutes of Health. Johns Hopkins University was funded in 2013 to establish a new post-doctoral training program in HIV-TB epidemiology, clinical and...

The Role of GeneXpert in Bacterial Diagnosis of Spinal Tuberculosis

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2017-10-26

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This study was teriminated June 19, 2019. It was funded by the Fogarty International Center at the U.S. National Institutes of Health. India has the maximum burden of tuberculosis (TB) in the world. In 2014, there were an estimated 9.6 million incident...

Targeting Mycobacterium Tuberculosis Persisters by Enhancing Stringent Response-specific Cellular Immunity

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2017-09-11

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C-TRIUMPH nested study begins to see if stringent response antigen is enhanced while treating drug-susceptible TB using the first-line anti-TB regimen.

Understanding Quality of Life during and Loss to Follow-up from Drug-Resistant Tuberculosis Treatment in Pune, India

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2017-05-15

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This study will examine a) risk factors for loss to follow-up from DR-TB treatment, b) actively trace DR-TB patients lost to follow-up from treatment and c) establish a prospective observational cohort of MDR-TB, XDR-TB and DS-TB patients as well as healthy controls nested within ongoing...

Risk Factors for Unfavourable Treatment Outcomes among Multidrug-Resistant Tuberculosis Patients in Public Sector Treatment in Pune

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2017-03-29

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This study is funded and conducted under the U.S. National Institutes of Health, Fogarty International Center. This study seeks to identify risk factors associated with unfavourable treatment outcomes (death, treatment failure, default, XDR-TB) among multidrug-resistant...

MDR-TB Free: Monitoring Adverse Effects, Utilizing Resources Optimally, Knowing Resistance Patterns, and Treatment Strategy

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2017-03-24

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This study is also known as MDR-TB MUKT: Monitoring Adverse Effects, Utilizing Resources Optimally, Knowing Resistance Patterns, and Treatment Strategy. Purpose: To establish an observational cohort of MDR-TB cases and household contacts with accompanying biorepository at PD Hinduja National...

Impact of HIV and Diabetes Mellitus on TB Drug Resistance and Recurrence

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2017-03-02

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NIRT

This study was terminated in January 2021. Tuberculosis (TB) is the leading cause of mortality globally. With increasing burden of HIV and diabetes mellitus (DM), there is a critical need to understand the microbial response and ensuing disease dynamics of TB in the HIV-infected and diabetic host...

Multicenter Study of the Accuracy of the BD MAX MDR-TB Assay for Detection of M. tuberculosis Complex and Mutations Associated with Resistance to Rifampin or Isoniazid

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2017-03-01

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In a multi-country study, we are assessing the accuracy of the BD MAX rapid MDR-TB assay to detect rifampin and isoniazid resistance.

TREAT Asia Observational Database

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2017-02-09

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Study conducted under the TREAT Asia Network and funded by amfAR. The TREAT Asia Observational Database's primary study objective is to: Examine HIV natural history, including the relationship between access to ART, demographics, and...

Bacterial Antimicrobial Resistance Patterns in Pune, India: Substudy on the Introduction of Triage to a Triage Naïve Emergency Department in Pune, India, and the Effects on Patient Flow

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2017-01-01

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Despite state-of-the-art inpatient facilities, Sassoon General Hospital (SGH) in Pune, India, does not currently have a method of triaging the large volume of patients they care for on a daily basis. Based on prior studies in low to middle income countries...

Establishing an Observational Cohort Database for Patient Care and Research at the Hinduja Hospital Chest Clinic

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2016-08-30

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India has the largest burden of global tuberculosis (TB), accounting for one quarter of the total number of cases reported. Together with South Africa, India sees one-third of the total number of deaths from TB. Drug-resistant strains of the disease are also on the rise, with India having one...

Whole Genome Sequencing and Trek Sensititre Testing of Stored Isolates of Drug-resistant Tuberculosis from a Clinical Cohort at Hinduja Hospital, Mumbai

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2016-05-02

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Among HIV-positive TB patients presenting to Médecins San Frontières (MSF) clinics in Mumbai, 78% carried MDR-TB strains, with nearly half also found to have additional drug resistance. A previously published cohort of 202 patients cared for at these MSF clinics have enrolled in a...

The Human Virome in Health and Disease

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2016-02-21

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This study was terminated in September 2020. This study is part of the Antimicrobial Resistance study referenced below, Some samples were used from the Cohort for Tuberculosis Research by the Indo-US Medical Partnership (C-TRIUMPH), under the Regional...

Whole Genome Sequencing of Clinical Isolates from Patients with Multidrug Resistant Tuberculosis in India

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2015-11-12

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This study was terminated August 9, 2019. Comparative genomic analysis using whole genome sequencing (WGS) offers an opportunity to understand the specific mutations associated with drug resistance and the phenotypic behavior of TB. As treatment programs incorporate more...

A5300/IMPAACT2003: Study of MDR TB Cases and Their Household Contacts: Operational Feasibility to Inform PHOENIx Trial Design

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2015-09-01

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This clinical trial was terminated July 18, 2017. It was a study conducted under both the AIDS Clinical Trial Group (ACTG) and the the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT) Network, and funded by the U.S. National Institutes of Health. Dr...

Bacterial Antimicrobial Resistance Patterns in Pune, India: Substudy on Community Health-Seeking Behavior Among Patients Admitted with Acute Febrile Illness

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2015-05-28

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Objectives: To describe the patterns of health-care seeking behavior and prior outpatient care among patients admitted with acute febrile illness to Sassoon Hospital To determine the effects of outpatient behaviors and prior treatments on the antimicrobial...

Barriers for Intervention to Prevent Occupationally Acquired Tuberculosis in Healthcare Workers

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2015-05-21

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This study was terminated April 20, 2017; it was funded by the Fogarty International Center at the U.S. National Institutes of Health. Observational study to assess the current status of implementation of interventions for preventing occupationally acquired...

Factors associated with prevalent Mycobacterium tuberculosis infection and disease among adolescents and adults exposed to rifampin-resistant tuberculosis in the household

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2023-03-17

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PLOS ONE

Background: Understanding factors associated with prevalent Mycobacterium tuberculosis infection and prevalent TB disease in household contacts of patients with drug-resistant tuberculosis (TB) may be useful for TB program staff conducting contact investigations. Methods: Using data from a cross-...

Pharmacokinetic analysis of linezolid for multidrug resistant tuberculosis at a tertiary care centre in Mumbai, India

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2023-01-04

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Frontiers in Pharmacology

Linezolid is an oxazolidinone used to treat multidrug-resistant tuberculosis (MDR-TB), including in the recently-endorsed shorter 6-month treatment regimens. Due to its narrow therapeutic index, linezolid is often either dose-adjusted or discontinued due to intolerance or toxicity during treatment...

Whole Genome Sequencing Assessing Impact of Diabetes Mellitus on Tuberculosis Mutations and Type of Recurrence in India

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2022-10-06

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Clinical Infectious Diseases

Dr. Vidya Mave and colleagues concluded considerable intrahost mycobacterium tuberculosis mutation rates were present at recurrence among patients with diabetes mellitus.

Cycloserine did not increase depression incidence or severity at standard dosing for MDR-TB

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2022-03-24

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European Respitory Journal

In 2018 cycloserine was elevated to World Health Organization (WHO) group B status for multidrug-resistant tuberculosis (MDR-TB), and is recommended in longer MDR-TB treatment regimens [ 1 ]. Inclusion of cycloserine is associated with improved MDR-TB treatment success and reduced mortality, but is...

Tuberculosis Pathways to Care and Transmission of Multidrug Resistance in India

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2022-01-15

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American Journal of Respiratory Critical Care Medicine

Abstract Rationale: India is experiencing a regional increase in cases of multidrug-resistant tuberculosis (MDR-TB). Objectives: Given the complexity of MDR-TB diagnosis and care, we sought to address key knowledge gaps in MDR risk factors, care delays, and drivers of delay to help guide disease...

Increased Moxifloxacin Dosing among MDR-TB Patients with Low-Level Resistance to Moxifloxacin did not Improve Treatment Outcomes in a Tertiary Care Center in Mumbai, India

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2021-12-23

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Open Forum Infectious Diseases

Background Mycobacterium tuberculosis (Mtb) strains resistant to isoniazid and rifampin (multidrug-resistant tuberculosis [MDR-TB]) are increasingly reported worldwide, requiring renewed focus on the nuances of drug resistance. Patients with low-level moxifloxacin resistance may benefit from higher...

Resistance to Mycobacterium tuberculosis infection among household contacts: a multinational study

Post Date:

2021-09-15

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Clinical Infectious Diseases

Background Some contacts of patients with tuberculosis remain negative on tests for tuberculosis infection, despite prolonged exposure, suggesting they might be resistant to Mycobacterium tuberculosis infection. The objective of this multinational study was to estimate the proportion of household...

Drug susceptibility patterns of Mycobacterium tuberculosis from adults with Multidrug-Resistant Tuberculosis and Implications for a Household Contact Preventive Therapy Trial

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2021-02-24

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BMC Infectious Diseases

Background Drug susceptibility testing (DST) patterns of Mycobacterium tuberculosis (MTB) from patients with rifampicin-resistant tuberculosis (RR-TB) or multidrug-resistant TB (MDR-TB; or resistant to rifampicin and isoniazid (INH)), are important to guide preventive therapy for their household...

Pharmacogenetic interactions of rifapentine plus isoniazid with efavirenz or nevirapine

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2021-01-15

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Pharmacogenetics and Genomics

Objectives: The effect of rifapentine plus isoniazid on efavirenz pharmacokinetics was characterized in AIDS Clinical Trials Group protocol A5279 (NCT01404312). The present analyses characterize pharmacogenetic interactions between these drugs, and with nevirapine. Methods: A subset of HIV-positive...

Drug resistant TB spine in a two year old child: A case report

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2020-07-14

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Indian Journal of Tuberculosis

Spinal tuberculosis (TB) is a disease of high morbidity that is associated with deformity and neurological sequelae, especially in growing children. Children diagnosed with spinal TB need to be monitored closely for clinical improvements. Previous history of antituberculous therapy (ATT), poor...

Re: A Shorter Regimen for Rifampin-Resistant Tuberculosis

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2019-09-12

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New England Journal of Medicine

Dr. Jeff Tornheim and colleagues respond to an NEJM article about shorter course TB treatment.

Third-line antiretroviral therapy in low-income and middle-income countries (ACTG A5288): a prospective strategy study

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2019-07-29

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Lancet HIV

BACKGROUND: Antiretroviral therapy (ART) management is challenging for individuals in resource-limited settings presenting for third-line treatment because of complex resistance patterns, partly due to reduced access to viral load monitoring. We aimed to evaluate use of newer...

Infection free "resisters" among household contacts of adult pulmonary tuberculosis

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2019-07-18

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NIRT

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PLoS One

Despite substantial exposure to infectious pulmonary tuberculosis (TB) cases, some household contacts (HHC) never acquire latent TB infection (LTBI). Characterizing these "resisters" can inform who to study immunologically for the development of TB vaccines. We enrolled HHCs of culture-confirmed...

Few eligible for the newly recommended short course MDR-TB regimen at a large Mumbai private clinic

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2019-01-28

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BMC Infectious Diseases

BACKGROUND: India has the world's highest tuberculosis burden, and Mumbai is particularly affected by multidrug resistant tuberculosis (MDR-TB). WHO recommends short, intensive treatment ("Short Course") for previously untreated pulmonary MDR-TB patients but does not require universal...

HIV testing uptake among the household contacts of multidrug-resistant tuberculosis index cases in eight countries

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2019-01-07

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International Journal of Tuberculosis and Lung Disease

International Journal of Tuberculosis and Lung Disease : The Indo-JHU Clinical Research Parentership participated in this multinational study to determine if it's feasible to provide HIV testing for household contacts of MDR-TB cases.

Multiplex-PCR to detect pAmpC β-lactamases among Enterobacteriaceae at a tertiary care laboratory in Mumbai, India

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2018-12-13

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Microbiology

Drug-resistance due to AmpC β-lactamases represents a growing problem worldwide. In this study, a previously collected sample of 108 cefoxitin-resistant clinical isolates was assessed for AmpC β-lactamase production through routine phenotypic testing and double-disc cefoxitin/cloxcallin (DD-CC),...

The mortality burden of multidrug-resistant pathogens in India: a retrospective observational study

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2018-11-08

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Clinical Infectious Diseases

We conducted a retrospective, ten hospital study of the relationship between multidrug-resistant pathogens and mortality in India. This is one of the largest studies undertaken in an LMIC to measure the burden of antibiotic resistance.

Drug-resistant Enterobacteriaceae colonization is associated with healthcare utilization and antimicrobial use among inpatients in Pune, India

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2018-10-04

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BMC Infectious Diseases

BACKGROUND: Healthcare exposure may increase drug-resistant Enterobacteriaceae colonization risk. Nascent antimicrobial stewardship efforts in low- and middle-income countries require setting-specific data. We aimed to evaluate risk factors for inpatient drug resistant...

Failure in TB control: why should the rapid diagnostic test bear the blame?

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2018-09-01

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International Journal of Tuberculosis and Lung Disease

Dr. Sachit Atre's correspondence published in the International Journal of Tuberculosis and Lung Disease.

Resource utilization for multidrug-resistant tuberculosis household contact investigations (A5300/I2003)

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2018-09-01

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