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K.", "lastName": "Jayalakshmi" }, { "creatorType": "author", "firstName": "Peter", "lastName": "Saranchuk" }, { "creatorType": "author", "firstName": "Camilla", "lastName": "Rodrigues" }, { "creatorType": "author", "firstName": "Petros", "lastName": "Isaakidis" } ], "abstractNote": "BACKGROUND: While the high burden of multidrug-resistant tuberculosis (MDR-TB) itself is a matter of great concern, the emergence and rise of advanced forms of drug-resistance such as extensively drug-resistant TB (XDR-TB) and extremely drug-resistant TB (XXDR-TB) is more troubling. The aim of this study was to investigate the trends over time of patterns of drug resistance in a sample of MDR-TB patients in greater metropolitan Mumbai, India.\nMETHODS: This was a retrospective, observational study of drug susceptibility testing (DST) results among MDR-TB patients from eight health care facilities in greater Mumbai between 2005 and 2013. We classified resistance patterns into four categories: MDR-TB, pre-XDR-TB, XDR-TB and XXDR-TB.\nRESULTS: A total of 340 MDR-TB patients were included in the study. Pre-XDR-TB was the most common form of drug-resistant TB observed overall in this Mumbai population at 56.8% compared to 29.4% for MDR-TB. The proportion of patients with MDR-TB was 39.4% in the period 2005-2007 and 27.8% in 2011-2013, while the proportion of those with XDR-TB and XXDR-TB was changed from 6.1% and 0% respectively to 10.6% and 5.6% during the same time period. During the same periods, the proportions of patients with ofloxacin, moxifloxacin and ethionamide resistance significantly increased from 57.6% to 75.3%, from 60.0% to 69.5% and from 24.2% to 52.5% respectively (p<0.05).\nDISCUSSION: The observed trends in TB drug-resistance patterns in Mumbai highlight the need for individualized drug regimens, designed on the basis of DST results involving first- and second-line anti-TB drugs and treatment history of the patient. A drug-resistant TB case-finding strategy based on molecular techniques that identify only rifampicin resistance will lead to initiation of suboptimal treatment regimens for a significant number of patients, which may in turn contribute to amplification of resistance and transmission of strains with increasingly advanced resistance within the community.", "publicationTitle": "PloS One", "publisher": "", "place": "", "date": "2015", "volume": "10", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "e0116798", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "PLoS ONE", "DOI": "10.1371/journal.pone.0116798", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1932-6203", "archive": "", "archiveLocation": "", "shortTitle": "Resistance patterns among multidrug-resistant tuberculosis patients in greater metropolitan Mumbai", "language": "eng", "libraryCatalog": "PubMed", "callNumber": "", "rights": "", "extra": "PMID: 25606853\nPMCID: PMC4301863", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Antitubercular Agents", "type": 1 }, { "tag": "Child", "type": 1 }, { "tag": "Child, Preschool", "type": 1 }, { "tag": "Drug Resistance, Multiple, Bacterial", "type": 1 }, { "tag": "Ethionamide", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Fluoroquinolones", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "India", "type": 1 }, { "tag": "Infant", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Microbial Sensitivity Tests", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Mycobacterium tuberculosis", "type": 1 }, { "tag": "Ofloxacin", "type": 1 }, { "tag": "Precision Medicine", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Tuberculosis, Multidrug-Resistant", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [ "RSKMBCTC" ], "relations": {}, "dateAdded": 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