Whole-Genome Sequencing Has the Potential To Improve Treatment for Rifampicin-Resistant Tuberculosis in High-Burden Settings: a Retrospective Cohort Study.
Whole-Genome Sequencing Has the Potential To Improve Treatment for Rifampicin-Resistant Tuberculosis in High-Burden Settings: a Retrospective Cohort Study.
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全基因组测序有可能改善高负担环境下利福平耐药结核病的治疗：一项回溯性队列研究。
DOI：
10.1128/jcm.02362-21
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发表时间：
2022-03-16
影响因子：
9.4
通讯作者：
Furin J
中科院分区：
文献类型：
--
作者：
Cox H;Goig GA;Salaam-Dreyer Z;Dippenaar A;Reuter A;Mohr-Holland E;Daniels J;Cudahy PGT;Nicol MP;Borrell S;Reinhard M;Doetsch A;Beisel C;Gagneux S;Warren RM;Furin J
Treatment of multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB), although improved in recent years with shorter, more tolerable regimens, remains largely standardized and based on limited drug susceptibility testing (DST). More individualized treatment with expanded DST access is likely to improve patient outcomes. To assess the potential of TB drug resistance prediction based on whole-genome sequencing (WGS) to provide more effective treatment regimens, we applied current South African treatment recommendations to a retrospective cohort of MDR/RR-TB patients from Khayelitsha, Cape Town. Routine DST and clinical data were used to retrospectively categorize patients into a recommended regimen, either a standardized short regimen or a longer individualized regimen. Potential regimen changes were then described with the addition of WGS-derived DST. WGS data were available for 1274 MDR/RR-TB patient treatment episodes across 2008 to 2017. Among 834 patients initially eligible for the shorter regimen, 385 (46%) may have benefited from reduced drug dosage or removing ineffective drugs when WGS data were considered. A further 187 (22%) patients may have benefited from more effective adjusted regimens. Among 440 patients initially eligible for a longer individualized regimen, 153 (35%) could have been switched to the short regimen. Overall, 305 (24%) patients had MDR/RR-TB with second-line TB drug resistance, where the availability of WGS-derived DST would have allowed more effective treatment individualization. These data suggest considerable benefits could accrue from routine access to WGS-derived resistance prediction. Advances in culture-free sequencing and expansion of the reference resistance mutation catalogue will increase the utility of WGS resistance prediction.
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影响因子：
56.3
作者：
Zignol, Matteo;Dean, Anna S.;Alikhanova, Natavan;Andres, Sonke;Cabibbe, Andrea Maurizio;Cirillo, Daniela Maria;Dadu, Andrei;Dreyer, Andries;Driesen, Michele;Gilpin, Christopher;Hasan, Rumina;Hasan, Zahra;Hoffner, Sven;Husain, Ashaque;Hussain, Alamdar;Ismail, Nazir;Kamal, Mostofa;Mansjo, Mikael;Mvusi, Lindiwe;Niemann, Stefan;Omar, Shaheed V.;Qadeer, Ejaz;Rigouts, Leen;Ruesch-Gerdes, Sabine;Schito, Marco;Seyfaddinova, Mehriban;Skrahina, Alena;Tahseen, Sabira;Wells, William A.;Mukadi, Ya Diul;Kimerling, Michael;Floyd, Katherine;Weyer, Karin;Raviglione, Mario C.
通讯作者：
Raviglione, Mario C.
影响因子：
3.7
作者：
Horter S;Stringer B;Greig J;Amangeldiev A;Tillashaikhov MN;Parpieva N;Tigay Z;du Cros P
通讯作者：
du Cros P
影响因子：
24.3
作者：
Khan, Faiz Ahmad;Salim, M. A. Hamid;Menzies, Dick
通讯作者：
Menzies, Dick
影响因子：
9.4
作者：
Doyle, Ronan M.;Burgess, Carrie;Breuer, Judith
通讯作者：
Breuer, Judith
影响因子：
9.4
作者：
Shea, Joseph;Halse, Tanya A.;Musser, Kimberlee A.
通讯作者：
Musser, Kimberlee A.