1. Molecular detection of isoniazid monoresistance improves tuberculosis treatment: A retrospective cohort in France.
- Author
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Bachir M, Guglielmetti L, Tunesi S, Billard-Pomares T, Chiesi S, Jaffré J, Langris H, Pourcher V, Schramm F, Lemaître N, and Robert J
- Subjects
- Antitubercular Agents pharmacology, Antitubercular Agents therapeutic use, Humans, Isoniazid pharmacology, Isoniazid therapeutic use, Microbial Sensitivity Tests, Retrospective Studies, Mycobacterium tuberculosis genetics, Tuberculosis diagnosis, Tuberculosis drug therapy, Tuberculosis, Multidrug-Resistant diagnosis, Tuberculosis, Multidrug-Resistant drug therapy
- Abstract
Objectives: Isoniazid-monoresistant tuberculosis (HR-TB) requires early diagnosis and adapted treatment to achieve optimal outcomes. The primary aim of the study was to assess the impact of the implementation of rapid diagnostic tests on HR-TB treatment in France., Methods: We designed a retrospective multicentre study including consecutive HR-TB patients diagnosed in 2016 and 2017. Implementation of a molecular assay detecting isoniazid resistance directly on a clinical sample was recorded. The association between early implementation of such assays and adequate treatment was assessed by a multivariable Cox proportional hazards model., Results: Overall, 99 HR-TB patients were included from 20 University Hospitals. Among all smear-positive HR-TB patients, only 26% beneficiated from early molecular HR detection. This detection was independently associated with shorter time to adequate treatment (HR = 2.0 [1.1-3.8], p = 0.03)., Conclusion: In our study, molecular detection of HR on an initial sample was independently associated with earlier treatment adaptation., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022. Published by Elsevier Ltd.)
- Published
- 2022
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