24 research outputs found
BIOSAFETY PROVISIONS IN BACTERIOLOGICAL LABORATORIES OF THE RUSSIAN TB UNITS
The current situation related to biosafety in bacteriological laboratories in the Russian TB units was comprehensively analyzed. Main problems promoting the increased risk of infection of laboratory personnel with tuberculous mycobacteria were detected. It was found out that during the investigated period cases of occupational tuberculosis had been registered in 5 out of 21 (23.8%) laboratories, thus biosafety requirements were not complied with in those laboratories. Causes of active disease development among laboratory personnel were analyzed and the evidence was provided on the need to improve infectious control in bacteriological laboratories of the Russian TB units and to enhance the level of knowledge in laboratory personnel related to provision of biological safety
ОБЕСПЕЧЕНИЕ МЕР БИОЛОГИЧЕСКОЙ БЕЗОПАСНОСТИ В БАКТЕРИОЛОГИЧЕСКИХ ЛАБОРАТОРИЯХ ПРОТИВОТУБЕРКУЛЕЗНЫХ УЧРЕЖДЕНИЙ РФ
The current situation related to biosafety in bacteriological laboratories in the Russian TB units was comprehensively analyzed. Main problems promoting the increased risk of infection of laboratory personnel with tuberculous mycobacteria were detected. It was found out that during the investigated period cases of occupational tuberculosis had been registered in 5 out of 21 (23.8%) laboratories, thus biosafety requirements were not complied with in those laboratories. Causes of active disease development among laboratory personnel were analyzed and the evidence was provided on the need to improve infectious control in bacteriological laboratories of the Russian TB units and to enhance the level of knowledge in laboratory personnel related to provision of biological safety. Проведен всесторонний комплексный анализ современной ситуации по обеспечению мер биологической безопасности в бактериологических лабораториях противотуберкулезных учреждений России.Выявлены основные проблемы, способствовавшие наличию в лабораториях повышенного риска инфицирования сотрудников микобактериями туберкулеза.Установлено, что за изучаемый промежуток времени в 5 лабораториях из 21 (23,8%) зарегистрированы случаи профессионального заболевания туберкулезом, что указывало на неудовлетворительное соблюдение в этих лабораториях санитарно-противоэпидемического режима.Анализ причин заболеваемости лабораторного персонала свидетельствовал о необходимости усиления мер инфекционного контроля в бактериологических лабораториях противотуберкулезных учреждений РФ и повышения уровня знаний сотрудников лабораторий в вопросах обеспечения биологической безопасности
ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ РЕЖИМА ХИМИОТЕРАПИИ, ВКЛЮЧАЮЩЕГО ПРЕПАРАТ SQ109, У БОЛЬНЫХ ТУБЕРКУЛЕЗОМ ЛЕГКИХ С МНОЖЕСТВЕННОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ ВОЗБУДИТЕЛЯ
The objective of the study: to assess efficiency and safety of SQ109 used within standard treatment regimens for multiple drug resistant tuberculosis (MDR TB)Subjects and Methods A multi-center, double, blind, randomized, placebo-controlled study was conducted in two parallel groups from September 21, 2012 to September 30, 2016, in 6 research centers located in 5 cities of the Russian FederationMain results 1 Cessation of bacillary excretion confirmed by cultures on liquid media by the end of the 6th month of the intensive phase of chemotherapy in pulmonary MDR TB patients receiving SQ109 was observed confidently more often versus treatment regimens containing only existing anti-tuberculosis drugs: both for ITT population (610% versus 429%, p = 00412), and PP population (797% versus 614%, p = 00486) 2 There were no statistically significant differences in the achievement of sputum conversion between the groups, but by the end of the 8th week, the sputum converted in 52% of patients in the group treated with SQ109 versus 38% in the group taking a placebo The median time of bacillary excretion cessation confirmed by culture on liquid media in SQ109 group made 56 days, while in the placebo group it was 84 days 3 Use of SQ109 along with basic chemotherapy for pulmonary MDR TB did not result in the higher frequency of adverse events, worsening of their severity, development of new variants of adverse events compared to the basic anti-tuberculosis treatment of this group of patients in combination with placebo 4 Results of the study allow concluding that SQ109 is an effective drug, satisfactory tolerated (compatible with tolerability of placebo) being a part of integral etiotropic chemotherapy of pulmonary MDR TB patients Цель исследования: определение эффективности и безопасности препарата SQ109 в составе стандартных схем лечения, используемых при туберкулезе легких с множественной лекарственной устойчивостью M. tuberculosis (МЛУ МБТ)Материалы и методы. Многоцентровое, двойное, слепое, рандомизированное плацебо-контролируемое исследование в двух параллельных группах проведено с 31 октября 2012 г по 30 сентября 2016 г в 6 исследовательских центрах, расположенных в пяти городах РоссийскойФедерацииОсновные результаты. 1 Прекращение бактериовыделения, подтвержденное посевами мокроты на жидких средах, к концу 6-го мес интенсивной фазы химиотерапии у больных туберкулезом легких с МЛУ МБТ при режиме лечения, включающем препарат SQ109, отмечено достоверно чаще, чем при режиме, содержащем только существующие противотуберкулезные препараты: как для популяции ITT (61,0% против 42,9%, p = 0,0412), так для популяции PP (79,7% против 61,4%, p = 0,0486) 2 Статистически значимых различий в сроках достижения прекращения бактериовыделения между группами не выявлено, но к концу 8-й нед лечения отмечена негативация мокроты у 52% больных группы SQ109 при 38% в группе плацебо Медиана срока прекращения бактериовыделания при исследовании на жидких средах в группе SQ109 составила 56 дней, а в группе плацебо – 84 дня 3 Применение препарата SQ109 на фоне базовой химиотерапии туберкулеза легких с МЛУ МБТ не привело ни к росту частоты нежелательных явлений, ни к увеличению степени их тяжести, ни к появлению новых вариантов нежелательных явлений в сравнении с базисной противотуберкулезной терапией данной группы больных в сочетании с плацебо 4 Результаты исследования позволяют сделать вывод об эффективности и удовлетворительной переносимости (сопоставимой с переносимостью плацебо) препарата SQ109 в составе комплексной этиотропной химиотерапии больных туберкулезом легких с МЛУ МБТ
Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study
Aim Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. Methods TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. Results 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Conclusion Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop
MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network.
The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts. The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines. After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities
Analyzing and Modeling Real-World Phenomena with Complex Networks: A Survey of Applications
The success of new scientific areas can be assessed by their potential for
contributing to new theoretical approaches and in applications to real-world
problems. Complex networks have fared extremely well in both of these aspects,
with their sound theoretical basis developed over the years and with a variety
of applications. In this survey, we analyze the applications of complex
networks to real-world problems and data, with emphasis in representation,
analysis and modeling, after an introduction to the main concepts and models. A
diversity of phenomena are surveyed, which may be classified into no less than
22 areas, providing a clear indication of the impact of the field of complex
networks.Comment: 103 pages, 3 figures and 7 tables. A working manuscript, suggestions
are welcome
DRUG RESISTANCE OF STRAINS OF M. TUBERCULOSIS, ISOLATED FROM PULMONARY TUBERCULOSIS PATIENTS IN VLADIMIR REGION IN 2013
The study presents the analysis of drug susceptibility of tuberculosis mycobacteria isolated from pulmonary tuberculosis patients by the moment of their registration in 2013 on the territory of Vladimir region. Totally 574 pulmonary tuberculosis patients were registered. Of them 432 were new cases, 78 relapses and other cases (in particular treatment failures and defaults) made 64 persons. All the groups demonstrated the increase of multiple drug resistance: in 101 (28.5%) cases of all infectious patients who had drug susceptibility tests done. Among new cases and relapses – 69 (25.9%) and 24 (46.2%) isolates of tuberculosis mycobacteria respectively
Defining critical concentrations of the second line TB drugs (cycloserin and PAS), to establish drug susceptibility testing on the liquid medium of Middlebrook 7Н9
In order to determine critical concentrations of the second line TB drugs, namely cycloserin and PAS, and to use these critical concentrations for establishment of drug susceptibility testing by the proportional method on the liquid medium of Middlebrook 7H9 in the Bactec MGIT 960, 441 cultures of M. Tuberculosis were tested after inoculation of 2534 samples obtained from 1330 TB patients living in Vladimir Region. Upon results of drug susceptibility testing on solid media 4 groups of M. tuberculosis strains, susceptible and resistant to PAS and cycloserin have been identified. Results of searching for minimum inhibiting concentrations of PAS and cycloserin for these groups of strains in the liquid medium of Middlebrook 7H9 allowed finding critical concentrations for PAS (2.0 mkg/ml) and cycloserin (15.0 mkg/ml)