Introduction Surveillance of resistance to drugs against tuberculosis (TB) is a cornerstone of any TB control programme Surveillance data on drug resistance are needed to track the effectiveness of TB prevention and control activities; accurately forecast the need for patient treatments and plan accordingly; design standardized regimens for the treatment of drug-resistant TB; assess epidemiological trends; and promptly identify and respond to outbreaks of drug-resistant TB (1) Since 1994 the Global Project on Anti-Tuberculosis Drug Resistance Surveillance of the World Health Organization (WHO) has supported national TB control programmes worldwide in implementing drug resistance surveillance activities Country data are routinely collected, analysed and disseminated to describe the global problem of drug-resistant TB (2-11) Patients whose mycobacteria are resistant to rifampicin, isoniazid and other anti-TB drugs require longer, expensive and more toxic treatment regimens and are less likely to be cured This presents a formidable challenge to programmes, particularly in low-resource settings (12) Policy guidance on the programmatic management of drug-resistant TB (13-15) and on how to control the transmission of resistant strains (16) has been developed by WHO, and access to quality-assured second-line anti-TB drugs for the treatment of multidrug-resistant TB (MDR-TB) is facilitated through the Green Light Committee mechanism (17) The number of TB patients diagnosed and treated for MDR-TB, which is defined as TB caused by strains of Mycobacterium tuberculosis that are resistant to at least isoniazid and rifampicin, (13) is increasing worldwide, but much remains to be done In 2010, only 16% of the TB patients estimated to have MDR-TB were diagnosed and given appropriate treatment (11,12), Routine surveillance of drug resistance must be linked to patient care Over the past three years, WHO has been actively encouraging countries to establish continuous TB drug resistance surveillance systems based on routine drug susceptibility testing of all patients, with priority given to patients previously treated, who are at highest risk of developing drug resistance (18-20) Although limited laboratory capacity for drug susceptibility testing still represents a major obstacle to the establishment of surveillance systems in low-resource settings, new diagnostic tools such as line probe assays (21) and Xpert MTB/RIF, (22) combined with greater resources for laboratory strengthening, offer an unprecedented opportunity to scale up surveillance systems worldwide In this paper we evaluate the existing information on anti-TB drug resistance surveillance, with an emphasis on data reported in 2007-2010, after the publication of WHO's fourth global report on anti-TB drug resistance surveillance (8,9) We present a global overview of the extent of the problem of MDR-TB, explore associations between MDR-TB and human immunodeficiency virus (HIV) infection and sex, discuss time trends in drug resistance, and present available data on extensively drug-resistant TB (XDR-TB)--the latter defined as MDR-TB plus resistance to a fluoroquinolone and at least one second-line injectable agent (amikacin, kanamycin or capreomycin) (13) Methods Definitions and data collection Drug resistance surveillance data are gathered following three main principles: (i) the data are representative of TB cases in the country or geographical setting under study; (ii) drug resistance among new TB cases is examined separately from drug resistance among previously treated TB cases; and (iii) laboratory methods for drug susceptibility testing are selected from among those that are recommended by WHO, with quality assurance for all laboratory processes conducted in cooperation with a partner supranational reference laboratory from the global network of 29 such laboratories (18,19,23,24) Drug resistance surveillance data are collected separately for new (previously untreated) and previously treated TB cases (25) via special surveys or continuous surveillance …

Surveillance of Anti-Tuberculosis Drug Resistance in the World: An Updated Analysis, 2007-2010/ Surveillance De la Resistance Aux Medicaments Antituberculeux Dans le Monde: Une Analyse Actualisee, 2007-2010/ Vigilancia De la Resistencia a Los Medicamentos Contra la Tuberculosis En Todo El Mundo: Analisis Actualizado, 2007-2010

There is uncertainty regarding whether patients with cancer should be screened for latent tuberculosis infection (LTBI). We performed a systematic review and meta-analysis to estimate the relative incidence of tuberculosis (TB) in cancer. We searched MEDLINE and Embase for studies published before December 21, 2016. We included studies that evaluated the incidence of TB in patients with solid cancers and haematological malignancies relative to a reference group (study control or general population). A pooled estimate of the incidence rate ratio (IRR) was obtained using standard meta-analysis methods. The search strategy identified 13 unique studies including 921 464 patients with cancer. The IRR of TB for adult patients with cancer was 2.61 (95% CI 2.12–3.22; I 2 =91%). In haematological cancers, the IRR was 3.53 (95% CI 1.63–7.64; I 2 =96%); and in solid cancers in adults, it was 2.25 (95% CI 1.96–2.58; I 2 =91%). The highest IRR was found in children with haematological malignancies or solid cancers (IRR 16.82, 95% CI 8.81–32.12; I 2 =79%). Considering the limited duration of maximum immunosuppression in cancer and reduced cumulative lifetime risk of TB because of reduced life expectancy, children, but not adults, appear to be at a sufficient level of risk to warrant systematic screening for LTBI.

https://erj.ersjournals.com/content/erj/50/2/1700157.full.pdf

Risk of tuberculosis in patients with solid cancers and haematological malignancies: a systematic review and meta-analysis.

Background and Objectives: We developed and evaluated the utility of a quadruplex Taqman real-time PCR assay that allows simultaneous identification of vancomycin-resistant genotypes and clinically relevant enterococci. Materials and Methods: The specificity of the assay was tested using reference strains of vancomycin-resistant and susceptible enterococci. In total, 193 clinical isolates were identified and subsequently genotyped using a Quadruplex Taqman real-time PCR assay and melting curve analysis. Representative Quadruplex Taqman real-time PCR amplification curve were obtained for Enterococcus faecium, Enterococcus faecalis, vanA-containing E. faecium, vanB-containing E. faecalis. Results: Phenotypic and genotypic analysis of the isolates gave same results for 82 enterococcal isolates, while in 5 isolates, they were inconsistent. We had three mixed strains, which were detected by the TaqMan real-time PCR assay and could not be identified correctly using phenotypic methods. Conclusion: Vancomycin resistant enterococci (VRE) genotyping and identification of clinically relevant enterococci were rapidly and correctly performed using TaqMan real-time multiplex real-time PCR assay.

/pdf/development-and-evaluation-of-a-quadruplex-taq-man-real-time-5c12qwjhjq.pdf

Development and evaluation of a Quadruplex Taq Man real-time PCR assay for simultaneous detection of clinical isolates of Enterococcus faecalis, Enterococcus faecium and their vanA and vanB genotypes.

Lung cancer and pulmonary tuberculosis caused by Mycobacterium are two major causes of deaths worldwide. Tuberculosis linked lung cancer is known. However, the precise molecular mechanism of Mycobacterium associated increased risk of lung cancer is not understood. We report 45 common human miRNAs deregulated in both pulmonary tuberculosis and lung cancer. We show that sRNA_1096 and sRNA_1414 from M. tuberculosis have sequence homology with human mir-21. Hence, the potential role of these three small non-coding RNAs in rifampicin resistance in pulmonary tuberculosis is implied. Further, the linking of sRNA_1096 and sRNA_1414 from M. tuberculosis with the host lung tumorigenesis is inferred. Nonetheless, further analysis and validation is required to associate these three non-coding RNAs with Mycobacterium associated increased risk of lung cancer.

/pdf/linking-common-non-coding-rnas-of-human-lung-cancer-and-m-1t3igay1zx.pdf

Linking common non-coding RNAs of human lung cancer and M. tuberculosis

Evaluation of three rapid assays for Mycobacterium tuberculosis complex detection in a comprehensive hospital from West China

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)60755-2/pdf

Characterization of Mycobacterium tuberculosis isolated from cancer patients with suspected tuberculosis infection in Egypt: identification, prevalence, risk factors and resistance pattern

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Characterization of Mycobacterium tuberculosis isolated from cancer patients with suspected tuberculosis infection in Egypt: identification, prevalence, risk factors and resistance pattern