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204 results for “Drug-resistance”
Figure 1 in Challenges of drug-resistant malaria
Figure 1. Different proteins present inside the parasitic organelle that contribute to drug resistance in malaria under selective drug pressure and new drugs in development, targeting the same pathway to rescue resistance. PRBC: parasitized red blood cell, ER: endoplasmic reticulum, MT: mitochondria, DHPS: dihydropterate synthetase, DHFR: dihydrofolate reductase, ATPase6: sacro/endoplasmic reticulum calcium dependent ATPase orthologue, CRT: chloroquine resistance transporter, MDR1: multidrug resistance.
Renal Denervation for Management of Drug-Resistant Hypertension
ClinicalTrials.gov study NCT01505010. IPD Sharing: YES. Countries: 1. Publications: 2.
Comparative assessment of line-probe assays and targeted next-generation sequencing in drug-resistant tuberculosis diagnosis
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Outcomes and adverse events of pre- and extensively drug-resistant tuberculosis patients in Kinshasa, Democratique Republic of the Congo: retrospective cohort study
<p><strong>Abstract</strong></p> <p><strong>Background</strong>: Extensively drug-resistant tuberculosis (XDR TB) is a very serious form of tuberculosis that is burdened with a heavy mortality toll, especially before the advent of new TB drugs. The Democratic Republic of the Congo (DRC) is among the countries most affected by this new epidemic.</p> <p><strong>Methods:</strong> A retrospective analysis was performed of the records of all patients with pre- and extensively drug-resistant tuberculosis hospitalized from January 1, 2015 to December 31, 2017 and monitored for at least 6 months to one year after the end of their treatment in Kinshasa; an individualized therapeutic regimen with bedaquiline for 20 months was built for each patient. The adverse effects were systematically monitored.</p> <p><strong>Results:</strong> Of the 40 laboratory-confirmed patients, 32 (80%) patients started treatment, including 29 preXRB and 3 XDR TB patients. In the eligible group, 3 patients (9.4%) had HIV-TB coinfections. The therapeutic success rate was 53.2%, and the mortality rate was 46.8% (15/32); there were no relapses, failures or losses to follow-up. All coinfected HIV–TB patients died during treatment. The cumulative patient survival rate was 62.5% at 3 months, 53.1% at 6 months and 53.1% at 20 months. The most common adverse events were vomiting, Skin rash, anemia and peripheral neuropathy.</p> <p><strong>Conclusion: </strong>Bedaquiline based treatment improves patient survival in the DRC despite the still high mortality rate. The new anti-tuberculosis<br> drugs are a real hope for the management of Drug Resistant tuberculosis patient and other new therapeutic combinations may improve favorable outcomes.</p>
Antibiotics can be used to contain drug-resistant bacteria by maintaining sufficiently large sensitive populations
<p>Standard infectious disease practice calls for aggressive drug treatment that rapidly eliminates the pathogen population before resistance can emerge. When resistance is absent, this elimination strategy can lead to complete cure. However, when resistance is already present, removing drug-sensitive cells as quickly as possible removes competitive barriers that may slow the growth of resistant cells. In contrast to the elimination strategy, the containment strategy aims to maintain the maximum tolerable number of pathogens, exploiting competitive suppression to achieve chronic control. Here we combine <em>in vitro</em> experiments in computer-controlled bioreactors with mathematical modeling to investigate whether containment strategies can delay failure of antibiotic treatment regimens. To do so, we measured the "escape time" required for drug-resistant <em>E. coli</em> populations to eclipse a threshold density maintained by adaptive antibiotic dosing. Populations containing only resistant cells rapidly escape the threshold density, but we found that matched resistant populations that also contain the maximum possible number of sensitive cells could be contained for significantly longer. The increase in escape time occurs only when the threshold density--the acceptable bacterial burden--is sufficiently high, an effect that mathematical models attribute to increased competition. The findings provide decisive experimental confirmation that maintaining the maximum number of sensitive cells can be used to contain resistance when the size of the population is sufficiently large.</p>
Figure 2 in Challenges of drug-resistant malaria
Figure 2. Different parameters that contribute to antimalarial resistance.
Bacterial mediated green synthesis of silver nanoparticles and their antibacterial and antifungal activities against drug-resistant pathogens
<p>In the healthcare sector, the production of bioactive silver nanoparticles (AgNPs) with antimicrobial properties is of great importance. In this study, a novel bacterial strain, <em>Paenibacillus</em> sp. MAHUQ-63, was identified as a potential candidate for facile and rapid biosynthesis of AgNPs. The synthesized AgNPs were used to control the growth of human pathogens, <em>Salmonella</em> Enteritidis and <em>Candida</em> <em>albicans</em>. The bacterial culture supernatant was utilized to synthesize the nanoparticles. FE-TEM examination showed spherical-shaped nanoparticles with 15 to 55 nm in size. FTIR analysis identified various functional groups. The synthesized AgNPs demonstrated remarkable activity against <em>S</em>. Enteritidis and <em>C. albicans</em>. The zone of inhibition (ZOI) for 100 µL (0.5 mg/mL) of AgNPs against <em>S</em>. Enteritidis and <em>Candida</em> <em>albicans</em> were 18.0 ± 1.0 and 19.5 ± 1.3 mm, respectively. The minimum inhibitory concentrations (MICs) were 25.0 and 12.5 μg/mL against <em>S</em>. Enteritidis and <em>Candida albicans</em>, respectively. Additionally, the minimum bactericidal concentrations (MBC) were 25.0 μg/mL against both pathogenic microbes. The FE-SEM analysis showed that the treatment of AgNPs caused morphological and structural damage to both <em>S</em>. Enteritidis and <em>Candida albicans</em>. Therefore, these AgNPs can be used as a new and effective antimicrobial agent.</p>
Study to Test the Efficacy and Safety of Padsevonil as Adjunctive Treatment of Focal-onset Seizures in Adults With Drug-resistant Epilepsy
ClinicalTrials.gov study NCT03373383. IPD Sharing: YES. Countries: 19. Publications: 2.
Evaluation of 8 Weeks of Treatment With the Combination of Moxifloxacin, PA-824 and Pyrazinamide in Patients With Drug Sensitive and Multi Drug-Resistant Pulmonary Tuberculosis (TB) (NC-002)
ClinicalTrials.gov study NCT01498419. IPD Sharing: Not stated. Countries: 2. Publications: 1.
A Phase 2 to Evaluate the Efficacy, Safety and Tolerability of Combinations of Bedaquiline, Moxifloxacin, PA-824 and Pyrazinamide in Adult Subjects With Drug-Sensitive or Multi Drug-Resistant Pulmonar
ClinicalTrials.gov study NCT02193776. IPD Sharing: Not stated. Countries: 3. Publications: 1.
Trial to Evaluate the Efficacy, Safety and Tolerability of BPaMZ in Drug-Sensitive (DS-TB) Adult Patients and Drug-Resistant (DR-TB) Adult Patients
ClinicalTrials.gov study NCT03338621. IPD Sharing: YES. Countries: 8. Publications: 1.
Evaluating the Safety, Tolerability, and Pharmacokinetics of Bedaquiline and Delamanid, Alone and in Combination, For Drug-Resistant Pulmonary Tuberculosis
ClinicalTrials.gov study NCT02583048. IPD Sharing: Not stated. Countries: 2. Publications: 2.
A Study to Test the Efficacy and Safety of Padsevonil as Treatment of Focal-onset Seizures in Adult Subjects With Drug-resistant Epilepsy
ClinicalTrials.gov study NCT03739840. IPD Sharing: YES. Countries: 28. Publications: 1.
Assessment of the Efficacy and Safety of 2 Doses of Retigabine Immediate Release (900 mg/Day and 600 mg/Day) Used as Adjunctive Therapy in Adult Asian Subjects With Drug-resistant Partial-onset Seizur
ClinicalTrials.gov study NCT01648101. IPD Sharing: YES. Countries: 7. Publications: 1.
Trial for the Treatment of Extensively Drug-Resistant Gram-negative Bacilli (OVERCOME)
ClinicalTrials.gov study NCT01597973. IPD Sharing: Not stated. Countries: 7. Publications: 1.
Outcomes and adverse events of pre- and extensively drug-resistant tuberculosis patients in Kinshasa, Democratique Republic of the Congo: retrospective cohort study
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Data from: Evaluating culture-free targeted next-generation sequencing for diagnosing drug-resistant tuberculosis: A multicentre clinical study of two end-to-end commercial workflows
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Antibiotics can be used to contain drug-resistant bacteria by maintaining sufficiently large sensitive populations
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Bacterial mediated green synthesis of silver nanoparticles and their antibacterial and antifungal activities against drug-resistant pathogens
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Data from: Delays and loss to follow up before treatment of drug-resistant TB following implementation of Xpert MTB/RIF in South Africa: a retrospective cohort study
Background: South Africa has a large burden of rifampicin-resistant tuberculosis (RR-TB), with 18,734 patients diagnosed in 2014. The number of diagnosed patients has increased substantially with the introduction of the Xpert MTB/RIF test, used for TB diagnosis for all patients with presumptive TB. Routine aggregate data suggest a large treatment gap (pre-treatment loss to follow up) between the numbers of laboratory confirmed RR-TB patients and those reported to have started second-line treatment. We aimed to assess the impact of Xpert MTB/RIF implementation on the delay to treatment initiation and loss to follow-up before second-line treatment for RR-TB across South Africa. Methods and findings: A nationwide retrospective cohort study was conducted to assess second-line treatment initiation and treatment delay among laboratory diagnosed RR-TB patients. Cohorts, including approximately 300 sequentially diagnosed RR-TB patients per South African province, were drawn from 2011 and 2013, before and after Xpert implementation. Patients with prior laboratory RR-TB diagnoses within 6 months and currently treated patients were excluded. Treatment initiation was determined through data linkage with national and local treatment registers, medical record review, interviews with healthcare staff, and direct contact with patients or household members. Additional laboratory data were used to track cases. National estimates of percentage treatment initiation and time to treatment were weighted to account for the sampling design. There were 2,508 and 2,528 eligible patients in the 2011 and 2013 cohorts respectively; 92% were newly diagnosed with RR-TB (new RR-TB, no prior RR-TB diagnoses). Nationally, among 2,340 and 2,311 new RR-TB patients in the 2011 and 2013 cohorts, 55% (95% CI 53-57) and 63% (95% CI 61-65) respectively started treatment within 6 months of their diagnostic specimen being sent (p<0.001). However, in 2013, there was no difference in the percentage of patients who initiated treatment at six months between the 1,368174 new RR-TB patients diagnosed by Xpert (62%, 95% CI 59-65) and the 943ose diagnosed by other methods (64%, 95% CI 61-67) (p=0.39). The median time to treatment decreased from 44 (IQR 20-69) days in 2011 to 22 (IQR 2-43) days in 2013 (p<0.001). In 2013, across the nine provinces, there were substantial variations in both treatment initiation (range 51-73% by six months) and median time to treatment (range 15-36 days, N=1,450), and only 53% of 1,448 new RR-TB who received treatmented patients were recorded on the national RR-TB register. This retrospective study is limited by the lack of information to assess reasons for non-initiation of treatment, particularly pre-treatment mortality data. Other limitations include the use of names and dates of birth to locate patient-level data, potentially resulting in missed treatment initiation among some patients. Conclusions: In 2013, there was a large treatment gap for RR-TB in South Africa which varied significantly across provinces. Xpert implementation, while reducing treatment delay, had not contributed substantially to reducing the treatment gap in 2013. However, given improved case detection with Xpert, overall a larger proportion of the total RR-TB burden has received treatment, with reduced delays. Nonetheless, strategies to further improve linkage to treatment for all diagnosed RR-TB patients are urgently required.
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Allen Brain Atlas
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DANDI Archive for NWB datasets
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International Brain Laboratory public data
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OpenNeuro
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