Pneumologie
Volume 68, Issue 7, 2014, Pages 496-500

Resistance to second-line drugs in migrants with multidrug-resistant tuberculosis in the Berlin region [Resistenzen gegen Zweitlinienmedikamente bei Migranten mit multiresistenter Tuberkulose in der Region Berlin] (Article) (Open Access)

Otto-Knapp R.* , Bös L. , Schönfeld N. , Wagner S. , Starzacher A.K. , Weiss T. , Vesenbeckh S. , Glaser-Paschke G. , Mauch H. , Rüssmann H. , Bauer T.T.
  • a Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany, Deutsches Zentralkomitee Zur Bekämpfung der Tuberkulose (DZK), Haus Q, Walterhöferstraße 11, 14165 Berlin, Germany
  • b Deutsches Zentralkomitee Zur Bekämpfung der Tuberkulose (DZK), Haus Q, Walterhöferstraße 11, 14165 Berlin, Germany
  • c Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
  • d Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, HELIOS Klinikum Emil von Behring, Berlin, Germany
  • e Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany, Zentrum für Tuberkulosekranke und -gefährdete Menschen, Berlin, Germany
  • f Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany, Zentrum für Tuberkulosekranke und -gefährdete Menschen, Berlin, Germany
  • g Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany, Zentrum für Tuberkulosekranke und -gefährdete Menschen, Berlin, Germany
  • h Zentrum für Tuberkulosekranke und -gefährdete Menschen, Berlin, Germany
  • i Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, HELIOS Klinikum Emil von Behring, Berlin, Germany
  • j Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, HELIOS Klinikum Emil von Behring, Berlin, Germany
  • k Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany, Deutsches Zentralkomitee Zur Bekämpfung der Tuberkulose (DZK), Haus Q, Walterhöferstraße 11, 14165 Berlin, Germany

Abstract

The empiric therapy of multidrug-resistant (MDR) tuberculosis (TB) after rapid molecular testing is rendered difficult by an often several weeks-long period of uncertainty, because results of susceptibility testing for second-line TB drugs are pending. The analysis of regional resistance patterns could lead to a more targeted empiric treatment for migrants depending on their country of origin. The results of the susceptibility testing from 2008 to 2013 of all mycobacteria sent to the Institute of Microbiology, working with the department of Pneumology, Heckeshorn Lung Clinic, Berlin, were reanalysed and tested for regional differences. We found 39 multidrug-resistant Mycobacterium tuberculosis strains among the examined strains. More than half of these strains tested susceptible to the following second line drugs namely, linezolid (97 %), clofazimine (95 %), cycloserine (95 %), capreomycin (90 %), p-aminosalicylic acid (82 %), moxifloxacin (79 %) and amikacin (79 %). The proportion of strains susceptible to pyrazinamide (44 %), ethambutol (28 %), prothionamide (15 %), rifabutin (8 %) and streptomycin (8 %) was lower. The mycobacterial cultures of the Chechen patients (n = 14) showed significantly different susceptibilities to amikacin (57 %) and prothionamide (36 %) compared to the strains from migrants of other regions. In this study, the regional differences in mycobacterial susceptibility to second line drugs suggest that the initial MDR TB therapy of migrants should be tailored to their country of origin. © Georg Thieme Verlag KG Stuttgart · New York.

Author Keywords

[No Keywords available]

Index Keywords

Germany drug effects aminosalicylic acid capreomycin human middle aged statistics and numerical data multidrug resistant tuberculosis Mycobacterium tuberculosis priority journal Tuberculosis, Multidrug-Resistant Aged nonhuman Drug Resistance, Multiple, Bacterial Humans migrant tuberculostatic agent Antitubercular Agents male female risk factor Risk Factors prevalence cycloserine isolation and purification Article protionamide Moxifloxacin streptomycin multidrug resistance adult Clofazimine migration Amikacin antibiotic sensitivity Linezolid rifabutin microbiology antibiotic resistance microbial sensitivity test ethambutol Transients and Migrants Microbial Sensitivity Tests bacterial strain pyrazinamide bacterium culture Berlin
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84904505476&doi=10.1055%2fs-0034-1377226&partnerID=40&md5=7ac71ef0607b9f94383f5251417e4ec7
DOI: 10.1055/s-0034-1377226
ISSN: 09348387
Cited by: 4
Original Language: German