'Z(S)-MDR-TB' versus 'Z(R)-MDR-TB': improving treatment of MDR-TB by identifying pyrazinamide susceptibility.
'Z(S)-MDR-TB' versus 'Z(R)-MDR-TB': improving treatment of MDR-TB by identifying pyrazinamide susceptibility.
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DOI：
10.1038/emi.2012.18
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发表时间：
2012-07
影响因子：
13.2
通讯作者：
Zhang, Wenhong
中科院分区：
文献类型：
--
作者：
Zhang, Ying;Chang, Kwok Chiu;Leung, Chi-Chiu;Yew, Wing Wai;Gicquel, Brigitte;Fallows, Dorothy;Kaplan, Gilla;Chaisson, Richard E.;Zhang, Wenhong
吡嗪酰胺（PZA，Z）是缩短药物敏感结核病（TB）治疗时间的补充剂，在治疗耐多药结核病（MDR）方面也是必不可少的。虽然耐多药结核病对PZA的耐药性与治疗效果差有关，但对PZA的细菌敏感性沿着氟喹诺酮（FQ）和二线注射药物（SLID）的使用可能预示着耐多药结核病治疗成功率的提高。尽管耐多药结核病患者中PZA耐药率很高（10%-85%），但由于技术挑战，很少进行PZA药敏试验。为了改善耐多药结核病的治疗，我们建议：（i）将耐多药结核病分为PZA敏感的耐多药结核病（PZ-MDR-TB）和PZA耐药的耐多药结核病（ZR-MDR-TB）;（ii）使用分子检测，如DNA测序（pncA、gyrA、rrs等）;（iii）使用基因测序技术，如DNA测序技术，如DNA测序技术，如DNA测序技术。快速鉴别抗-MDR-TB与ZR-MDR-TB以及FQ和SLID的敏感性概况;（iii）在ZR-MDR-TB中避免使用PZA;和（iv）探索用包括PZA加上至少两种杀菌剂（尤其是新的药剂，如TMC 207或PA-824或对杆菌敏感的德拉马尼）以及一种或两种其它药剂的方案缩短抗-MDR-TB的治疗持续时间的可行性。这些措施可能会缩短治疗时间，节省费用，并减少耐多药结核病治疗的副作用。
Indispensable for shortening treatment of drug-susceptible tuberculosis (TB), pyrazinamide (PZA, Z) is also essential in the treatment of multidrug-resistant (MDR)-TB. While resistance to PZA in MDR-TB is associated with poor treatment outcome, bacillary susceptibility to PZA along with the use of fluoroquinolone (FQ) and second-line injectable drugs (SLIDs) may predict improved treatment success in MDR-TB. Despite a high prevalence of PZA resistance among MDR-TB patients (10%–85%), PZA susceptibility testing is seldom performed because of technical challenges. To improve treatment of MDR-TB, we propose to: (i) classify MDR-TB into PZA-susceptible MDR-TB (ZS-MDR-TB) and PZA-resistant MDR-TB (ZR-MDR-TB); (ii) use molecular tests such as DNA sequencing (pncA, gyrA, rrs, etc.) to rapidly identify ZS-MDR-TB versus ZR-MDR-TB and susceptibility profile for FQ and SLID; (iii) refrain from using PZA in ZR-MDR-TB; and (iv) explore the feasibility of shortening the treatment duration of ZS-MDR-TB with a regimen comprising PZA plus at least two bactericidal agents especially new agents like TMC207 or PA-824 or delamanid which the bacilli are susceptible to, with one or two other agents. These measures may potentially shorten therapy, save costs, and reduce side effects of MDR-TB treatment.
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影响因子：
4.2
作者：
Jonmalung J;Prammananan T;Leechawengwongs M;Chaiprasert A
通讯作者：
Chaiprasert A
影响因子：
5.2
作者：
Martin, Anandi;Takiff, Howard;Portaels, Francoise
通讯作者：
Portaels, Francoise
DOI：
10.5588/ijtld.10.0739
发表时间：
2012-01-01
影响因子：
4
作者：
Kim, H. J.;Kwak, H. K.;Lee, K. H.
通讯作者：
Lee, K. H.
影响因子：
56.9
作者：
Andries, K;Verhasselt, P;Jarlier, V
通讯作者：
Jarlier, V
影响因子：
5.2
作者：
Martin, Anandi;Cubillos-Ruiz, Andres;Palomino, Juan Carlos
通讯作者：
Palomino, Juan Carlos