title: Drug Susceptibility Patterns in MDR-TB Patients: Challenges for Future Regimen Design. A Cross-Sectional Study.
abstract: Globally, there is substantial concern regarding the challenges of treating complex drug resistance patterns in multidrug resistant tuberculosis cases. Utilising data from three different settings (Estonia, Latvia, Romania) we sought to contrast drug susceptibility profiles for multidrug resistant tuberculosis cases, highlight the difficulties in designing universal regimen, and inform future regimen selection. Demographic and microbiological surveillance data for multidrug resistant tuberculosis cases from 2004-13 were analysed. High levels of additional resistance to currently recommended second line drugs were seen in all settings, with extensive variability between countries. Accurate drug susceptibility testing and drug susceptibility testing data are vital to inform the development of comprehensive, flexible, multidrug resistant tuberculosis guidance.
authors.affiliation: Research Department of Infection and Population Health, University College London, London, United Kingdom.
authors.forename: Helen R
authors.initials: HR
authors.lastname: Stagg
authors.affiliation: Centre for Respiratory Medicine, Royal Free London NHS Foundation Trust, London, United Kingdom.|Division of Medicine, University College London, London, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Brown
authors.affiliation: Marius Nasta Institute of Pulmonology, Bucharest, Romania.
authors.forename: Elmira
authors.initials: E
authors.lastname: Ibraim
authors.affiliation: Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia.|University of Latvia, Riga, Latvia.
authors.forename: Vija
authors.initials: V
authors.lastname: Riekstiņa
authors.affiliation: Estonian Tuberculosis Registry, National Institute for Health Development, Tallinn, Estonia.
authors.forename: Piret
authors.initials: P
authors.lastname: Viiklepp
authors.affiliation: Centre of TB and Lung Diseases, Riga East University Hospital, Riga, Latvia.
authors.forename: Andra
authors.initials: A
authors.lastname: Cīrule
authors.affiliation: Marius Nasta Institute of Pulmonology, Bucharest, Romania.
authors.forename: Horia
authors.initials: H
authors.lastname: Cocei
authors.affiliation: Lung Clinic, Tartu University Hospital, Tartu, Estonia.
authors.forename: Manfred
authors.initials: M
authors.lastname: Danilovitš
authors.affiliation: KNCV Tuberculosis Foundation, The Hague, The Netherlands.
authors.forename: Gunta
authors.initials: G
authors.lastname: Dravniece
authors.affiliation: Research Department of Infection and Population Health, University College London, London, United Kingdom.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Jackson
authors.affiliation: MRC Centre for Outbreak Analysis & Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Department of Infectious Disease Epidemiology, Imperial College School of Public Health, London, United Kingdom.|Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: White
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003710:Demography; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D004957:Estonia / Q000453:epidemiology; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007844:Latvia / Q000453:epidemiology; D008297:Male; D012383:Romania / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones