Drug resistance

Pharmacokinetic Assessment of MDR-TB Drugs in the Treatment of TB Meningitis

Post Date: 
2020-08-23
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Rationale: MDR-TBM is a devastating disease with high mortality and severe neurologic sequelae among survivors. We recognize the importance of sufficient drug concentrations at the site of infection for efficacy of anti-TB drugs and believe it is likely that drug distribution into brain and CSF...

Utility of Multiplexed Rapid Fever Panel Kit among Hospitalized Febrile Patients in India and Its Impact on Antimicrobial Use and Diagnosis

Post Date: 
2019-10-24
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Introduction Easy to use and multiplex diagnostic tools are needed to identify common causes of fever caused by vector-borne infectious diseases. Chembio has developed dual path platform (DPP) technology which differs from traditional lateral flow rapid diagnostic tests (RDT) by...

Assessing Psychological Distress among Tuberculosis Patients and Their Household Members

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2018-07-17
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By assessing psychological distress, Indo-JHU researchers hope to better understand the correlation between depression and TB severity.

Assessing Tuberculosis Transmission Dynamics, Drug Resistance and Recurrence Using Whole Genome Sequencing in Pune, India

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2018-06-12
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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

Post Date: 
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.

Antimicrobial Use and Diagnosis among Hospitalized Febrile Patients in Pune, India

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2017-08-07
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Antimicrobial resistance, a leading threat to human health, is enabled by unnecessary antibiotic use. Strategies to reduce unnecessary antibiotic use in India, the world’s largest antibiotic consumer, are urgently needed. Although most patients hospitalized in India with acute febrile illness...

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

Post Date: 
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

Post Date: 
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

Post Date: 
2017-03-02
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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

Post Date: 
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

Post Date: 
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

Post Date: 
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...

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Tuberculosis Pathways to Care and Transmission of Multidrug Resistance in India

Post Date: 
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...

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

Post Date: 
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

Post Date: 
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

Post Date: 
2019-07-18
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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

Post Date: 
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

Post Date: 
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

Post Date: 
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

Post Date: 
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?

Post Date: 
2018-09-01
Publication: 
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)

Post Date: 
2018-09-01
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International Journal of Tuberculosis and Lung Disease
Current guidelines recommend evaluation of the household contacts of individuals with multidrug-resistant tuberculosis; however, implementation of this policy is challenging.

Antibiotic utilization and the role of suspected and diagnosed mosquito borne illness among adults and children with acute febrile illness in Pune, India

Post Date: 
2018-05-02
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Clinical Infectious Diseases
Mosquito-borne disease identification is associated with reduced empiric antibiotic use and faster antibiotic discontinuation.

Pyrosequencing to resolve discrepant Xpert MTB/RIF and Mycobacterial Growth Indicator Tube 960

Post Date: 
2018-03-26
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Lung India
Lung India: Indo-JHU researchers find that pyrosequencing can clear up discrepancies about drug resistance in TB.

How feasible is pharmaceutical regulation in India?

Post Date: 
2018-01-29
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The Lancet Global Health
Lancet Global Health: Dr. Sachin Atre outlines factors that complicate pharmaceutical regulation in India, which is a component of WHO's Global Antimicrobial Resistance Action Plan.

Of testing and treatment: Implications of implementing new regimens for multidrug-resistant tuberculosis

Post Date: 
2017-10-01
Publication: 
Clinical Infectious Diseases
A novel, shorter-course regimen for treating multidrug-resistant (MDR) tuberculosis was recently recommended by the World Health Organization. However, the most appropriate use of drug susceptibility testing (DST) to support this regimen is less clear. Implementing countries must therefore...

High burden of antimicrobial resistance and mortality among adults and children with community-onset bacterial infections in India

Post Date: 
2017-04-15
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Journal of Infectious Diseases
Of 133 isolates from 115 patients, 50% were multi-drug resistant; of 33 isolates tested for carbapenem susceptibility, 36% were resistant.

The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis

Post Date: 
2017-03-24
Publication: 
The Lancet Respiratory Medicine
Global tuberculosis incidence has declined marginally over the past decade, and tuberculosis remains out of control in several parts of the world including Africa and Asia. Although tuberculosis control has been effective in some regions of the world, these gains are threatened by the increasing...

Drug-resistant tuberculosis in 2017: at a crossroads

Post Date: 
2017-03-15
Publication: 
Lancet Respiratory Medicine
In The Lancet Respiratory Medicine, Dheda and colleagues present one of the most comprehensive pictures to date of the global epidemic of drug-resistant tuberculosis. This comes at a time of increasing awareness of antimicrobial resistance as a global threat, and Mycobacterium tuberculosis...

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