Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients.
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Why is it important to finish treatment for tuberculosis (TB)?
Mar 20, 2007 · A fundamental problem in the treatment of tuberculosis (TB) is the long duration of therapy required for cure. The recalcitrance of Mycobacterium tuberculosis (MTB) to eradication is thought to result from its achieving a nonreplicating (dormant) state in the host. Because virtually all classes of antibiotics require bacterial replication for their action, the …
Why is Mycobacterium tuberculosis (MTB) still a worldwide health care challenge?
Mar 21, 2007 · Why is such long treatment needed? Lalita Ramakrishnan (University of Washington) and colleagues say that traditionally the answer was thought to lie in the fact that the tuberculosis microbe...
How long does it take to cure drug resistant tuberculosis?
Long-term antibiotic relative lack of protective immunity Patients with active disease also harbor treatment may cure the infection provided by natural infection makes lesions in various stages of healing, by eradicating these bacterial control all the more dependent on including closed granulomas with populations as they periodically leave complete bacterial eradication from …
Does mycobacterial phenotypic drug resistance exist in chronic tuberculosis (TB)?
treatment of tuberculosis (TB) is the long duration of therapy required for cure. The recalcitrance of Mycobacterium tuberculosis (MTB) to eradication is thought to result from its achieving a...
Why tuberculosis requires a long term antibiotic treatment?
Why mycobacterial infections have to be treated for 6 months or longer?
Does tuberculosis respond to a long course of antibiotic treatment?
Why has it become more difficult to treat TB over time?
Why is Mycobacterium treated with multiple drug regimen?
How long does tuberculosis treatment last?
Why is medication adherence critical in tuberculosis treatment?
Why are mycobacterial infections often persistent?
Why TB has not been eliminated as a disease if it is entirely curable?
What are the 3 biggest challenges to effective TB treatment?
- Five key strategies.
- Barrier 1: Toxic Treatment. ...
- What kind of DR-TB treatment is needed? ...
- Barrier 2: Unidentified TB cases. ...
- How do we find more TB cases? ...
- Barrier 3: Lack of social support. ...
- Solution: ...
- Barrier 4: Centralized drug-resistant TB (DR-TB) care.
How long does it take for TB to relapse?
Mycobacterium tuberculosis (Mtb) is extremely recalcitrant to antimicrobial chemotherapy requiring 6 months to treat drug-sensitive tuberculosis (TB). Despite this, 4–10% of cured patients will develop recurrent disease within 12 months after completing therapy. Reasons for relapse in cured TB patients remains speculative, attributed to both pathogen and host factors. Populations of dormant bacilli are hypothesized to cause relapse in initially cured TB patients however, development of tests to convincingly demonstrate their presence at the end of anti-TB treatment has been challenging. Previous studies have indicated the utility of culture filtrate supplemented media (CFSM) to detect differentially culturable tubercle bacilli (DCTB). Here, we show that 3/22 of clinically cured patients retained DCTB in induced sputum and bronchoalveolar lavage fluid (BALF), with one DCTB positive patient relapsing within the first year of completing therapy. We also show a correlation of DCTB status with “unresolved” end of treatment FDG PET-CT imaging. Additionally, 19 end of treatment induced sputum samples from patients not undergoing bronchoscopy were assessed for DCTB, identifying a further relapse case with DCTB. We further show that induced sputum is a less reliable source for the DCTB assay at the end of treatment, limiting the utility of this assay in a clinical setting. We next investigated the host proteome at the site of disease (BALF) using multiplexed proteomic analysis and compared these to active TB cases to identify host-specific factors indicative of cure. Distinct signatures stratified active from cured TB patients into distinct groups, with a DCTB positive, subsequently relapsing, end of treatment patient showing a proteomic signature closer to active TB disease than cure. This exploratory study offers evidence of live Mtb, undetectable with conventional culture methods, at the end of clinically successful treatment and putative host protein biomarkers of active disease and cure. These findings have implications for the assessment of true sterilizing cure in TB patients and opens new avenues for targeted approaches to monitor treatment response.
What are persisters in bacteria?
Antibiotic persisters (persister cells) are believed to be among the factors that make these infections challenging. Persisters are subpopulations of bacteria which survive treatment with bactericidal antibiotics in otherwise antibiotic-sensitive cultures and were extensively studied in a hope to discover the mechanisms that cause treatment failures in chronically infected patients; however, most of these studies were conducted in the test tube. Research into antibiotic persistence has uncovered large intrapopulation heterogeneity of bacterial growth and regrowth but has not identified essential, dedicated molecular mechanisms of antibiotic persistence. Diverse factors and stresses that inhibit bacterial growth reduce killing of the bulk population and may also increase the persister subpopulation, implying that an array of mechanisms are present. Hopefully, further studies under conditions that simulate the key aspects of persistent infections will lead to identifying target mechanisms for effective therapeutic solutions.
Why is mycobacterium abscessus so difficult to treat?
Mycobacterium abscessus infections are challenging to treat because multidrug resistance necessitates prolonged intravenous (IV) therapy and side effects are perceived to be common. For the best chance of pulmonary disease cure, guidelines from the American Thoracic Society/Infectious Diseases Society of America ...
Is Mycobacterium abscessus resistant to antimicrobials?
Mycobacterium abscessus is often resistant to multiple antimicrobial drugs , and data supporting effective drugs or dosing regimens are limited. To better identify treatment approaches and associated toxicities, we collected a series of case reports from the Emerging Infections Network.
What is the best treatment for pulmonary disease?
For the best chance of pulmonary disease cure, guidelines from the American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) recommend multidrug macrolide-based therapy based on susceptibility testing results and surgical resection.
What is MTB treatment?
Mycobacterium tuberculosis (MTB) remains a worldwide health care challenge despite the relatively recent evolution of effective antituberculous medications and combination drug therapy.
Is MTB a disease?
Mycobacterium tuberculosis : the treatment of active disease. Mycobacterium tuberculosis (MTB) remains a worldwide health care challenge despite the relatively recent evolution of effective antituberculous medications and combination drug therapy. In many parts of the world, the continued high prevalence of MTB disease is caused in part by ...
Is MTB a global health problem?
Mycobacterium tuberculosis (MTB) remains a worldwide health care challenge despite the relatively recent evolution of effective antituberculous medications and combination drug therapy. In many parts of the world, the continued high prevalence of MTB disease is caused in part by the lack of availabi ….
How long does it take to treat TB?
TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH) rifampin (RIF)
What is the best treatment for TB?
TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: 1 isoniazid (INH) 2 rifampin (RIF) 3 ethambutol (EMB) 4 pyrazinamide (PZA)
Can TB make you sick?
TB disease will make a person sick. People with TB disease may spread the bacteria to people with whom they spend many hours. It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed.
Can TB be treated?
It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs.
How many drugs are there for TB?
There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH) rifampin (RIF) ethambutol (EMB) pyrazinamide (PZA) TB Regimens for Drug-Susceptible TB.
What is the first line of anti-TB drugs?
Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: isoniazid (INH) rifampin (RIF) ethambutol (EMB) pyrazinamide (PZA) TB Regimens for Drug-Susceptible TB.
What is XDR TB?
Extensively drug-resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). Treating and curing drug-resistant TB is complicated.