1,721,106 research outputs found
Drug-resistant tuberculosis
No full textPurpose of review: This review discusses the recent evidence on epidemiology, diagnosis, and treatment of drug-resistant and multidrug-resistant (MDR) tuberculosis (TB), an area where solutions for better diagnosis and treatment continually develop. Recent findings: The prevalence of drug resistance has been constantly rising during the recent years. It has peaked in eastern European countries such as Belarus, where a record of 35.5% MDR-TB amongst new cases have been reported from Minsk. New diagnostic tools are becoming available. Xpert MTB/RIF is by far the most promising of these new techniques. Clinical management of drug-resistant TB is still cumbersome. However, after over 40 years of neglect, new drugs are becoming readily available: delamanid, bedaquiline, and PA-824 combined into innovative regimens raise hopes for substantially higher success rates. Summary: The innovative diagnostic tools recently validated are changing the traditional paradigms of TB diagnosis, for too long based on sputum smear, culture, and drug susceptibility testing. New anti-TB compounds, which can be combined with several 'old' drugs with new indications, are gradually modifying the chances of cure for MDR-TB cases. Although initial evidence appears promising, the market use of new drugs must be accompanied by a serious public health approach aimed at preventing the development of further drug resistance. Copyright © 2013 Lippincott Williams & Wilkins
Long-Acting Antibiotics: New Opportunities Beyond Acute Bacterial Skin and Skin Structure Infections (ABSSSIs)!
No full text: Currently, two long-acting antibiotics are available: oritavancin (ORI) and dalbavancin (DBV) [...]
Unexpected high rate of wild-type HIV-1 genotype among inmates failing antiretroviral therapy
No full textPurpose: Combination antiretroviral therapy (ART) has proven to be effective in treating human immunodeficiency virus (HIV) infection. Chronic administration of antiretrovirals presents significant challenges, including the risk of selecting treatment-resistant viral strains that can determine treatment failure and can be transmitted. In many countries, a large proportion of the HlV-infected population goes through the correctional system at least once. Scarce data are available on circulation of resistant HIV strains in correctional facilities. We evaluated the prevalence of antiretroviral resistance among both naïve and treatment-experienced HlV-infected inmates of a correctional institution in Genoa, Italy. Method: The prevalence of antiretroviral resistance among the HlV-infected inmates observed at our institution who underwent genotypic testing from January 2004 to June 2007 was retrospectively reviewed. Results: 45 genotypes from 43 inmates were available. Most of the naïve patients (14/16; 87.5%) showed a wild-type (WT) genotype, as well as most of the ART-experienced patients who had discontinued ART (10/13; 76.9%). A high proportion of WT genotype (6/16; 37.5%) was also observed among the subjects apparently failing HAART. Conclusions: The prevalence of mutated strains in treatment-naïve individuals of the studied cohort is comparable to what is reported in nonimprisoned naïve subjects of our region. The high prevalence of WT genotypes in ART-failing patients makes it likely that they were not taking their treatments, probably to gain legal benefits from their worsening health conditions. Thus, resistance testing can also be considered as an additional tool for assessing adherence to ART for forensic/medicolegal evaluation. However, further and larger studies are necessary to validate it. © 2008 Thomas Land Publishers, Inc
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