Inadequate treatment regimens and poor compliance have led to increased rates of drug resistance in Mycobacterium tuberculosis around the world, leading to the emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) strains. In Peru MDR-TB rates are amongst the highest in the world and XDR-TB cases have been reported for almost a decade. Drug susceptibility tests detect cases with resistant strains, providing the best treatment option to the patient and diminishing the spread of the disease. This review is directed at the non-specialist physician, focusing upon the drug susceptibility tests approved by the National TB Program of Peru and others currently still under research.

Inadequate treatment regimens and poor compliance have led to increased rates of drug resistance in Mycobacterium tuberculosis around the world, leading to the emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) strains. In Peru MDR-TB rates are amongst the highest in the world and XDR-TB cases have been reported for almost a decade. Drug susceptibility tests detect cases with resistant strains, providing the best treatment option to the patient and diminishing the spread of the disease. This review is directed at the non-specialist physician, focusing upon the drug susceptibility tests approved by the National TB Program of Peru and others currently still under research.

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Most culture-based methods for tuberculosis diagnosis remain low-cost options for low- and mid-income countries. The MODS culture is a rapid and low-cost assay to diagnose tuberculosis and determine drug susceptibility. However, its implementation is limited due to the low accessibility to supplies required for the enriched medium. In this study, we evaluate two alternative culture media: A powder-based mixed (PM) and a lyophilized media (LM). Catalase, PANTA, and gamma irradiation were evaluated as additions to PM and LM. The culture performance of the alternative media was compared with the standard MODS medium (MM) using Mycobacterium tuberculosis isolates and positive acid-fast smear sputum samples. Overall, no significant difference was observed in the bacterial growth between PM and LM with MM. However, PANTA and gamma irradiation combined reduced bacterial growth significantly in ...

La mayoría de los métodos basados en cultivos para el diagnóstico de la tuberculosis siguen siendo opciones de bajo costo para los países de ingresos bajos y medianos. El cultivo MODS es un ensayo rápido y de bajo costo para diagnosticar la tuberculosis y determinar la susceptibilidad a los medicamentos. Sin embargo, su implementación está limitada debido a la baja accesibilidad a los suministros requeridos para el medio enriquecido. En este estudio, evaluamos dos medios de cultivo alternativos: un medio mixto en polvo (PM) y un medio liofilizado (LM). Se evaluaron la catalasa, el PANTA y la irradiación gamma como adiciones a los medios PM y LM. El rendimiento del cultivo de los medios alternativos se comparó con el medio MODS estándar (MM) utilizando aislados de Mycobacterium tuberculosis y muestras de esputo con baciloscopía positiva. En general, no se observó una diferenci...

Background: Tuberculosis (TB) is a communicable, preventable and curable disease caused by the bacterium Mycobacterium tuberculosis (MTB). Peru is amongst the 30 countries with the highest burden of multidrug-resistant tuberculosis (MDR-TB) worldwide. In the fight against drug-resistant tuberculosis, the UKMYC6 microdilution plate was developed and validated by the CRyPTIC project. The objective of the study was to evaluate the use of the broth microdilution (BMD) plate methodology for susceptibility testing of drug-resistant MTB strains in Peru. Methods: MTB strains isolated between 2015 and 2018 in Peru were used. 496 nationally-representative strains determined as drug-resistant by the routine 7H10 Agar Proportion Method (APM) were included in the present study. The Minimum Inhibitory Concentration (MIC) of 13 antituberculosis drugs were determined for each strain using the UKMYC6 mic...

Whole Genome Sequencing (WGS) is a promising tool in the global fight against tuberculosis (TB). The aim of this study was to evaluate the use of WGS in routine conditions for detection of drug resistance markers and transmission clusters in a multidrug-resistant TB hot-spot area in Peru. For this, 140 drug-resistant Mycobacterium tuberculosis strains from Lima and Callao were prospectively selected and processed through routine (GenoType MTBDRsl and BACTEC MGIT) and WGS workflows, simultaneously. Resistance was determined in accordance with the World Health Organization mutation catalogue. Agreements between WGS and BACTEC results were calculated for rifampicin, isoniazid, pyrazinamide, moxifloxacin, levofloxacin, amikacin and capreomycin. Transmission clusters were determined using different cut-off values of Single Nucleotide Polymorphism differences. 100% (140/140) of strains had val...

Introduction: Cough is a key symptom of tuberculosis (TB) as well as the main cause of transmission. However, a recent literature review found that cough frequency (number of coughs per hour) in patients with TB has only been studied once, in 1969. The main aim of this study is to describe cough frequency patterns before and after the start of TB treatment and to determine baseline factors that affect cough frequency in these patients. Secondarily, we will evaluate the correlation between cough frequency and TB microbiological resolution. Methods: This study will select participants with culture confirmed TB from 2 tertiary hospitals in Lima, Peru. We estimated that a sample size of 107 patients was sufficient to detect clinically significant changes in cough frequency. Participants will initially be evaluated through questionnaires, radiology, microscopic observation drug susceptibility...