OBJECTIVETo establish a rapid method for testing drug sussceptibility on Mycobacterium tuberculosis.

METHODSTaking absolute Concentration method for drug susceptibility testing of M. tuberculosis as the "gold standard", we examined the drug-resistant of M. tuberculosis strain with nitrate reducrase assay (NRA) and the drug-resistant of M. tuberculosis germ in sputum with NRA.

RESULTSNRA and absolute concentration method was basically comparable with NRA susceptibility as 96.5% and the specificity was 100%, When comparing with traditional absolute concentration method, NRA could shorten the time about 3 weeks. Using NRA to test the drug-resistant of M. tuberculosis germ in sputum, its susceptibility was more than 66.7% and specificity was 100%, within 10-20 days.

CONCLUSIONNRA could be used as a rapid drug susceptibility testing on M. tuberculosis.

Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Enzyme Assays ; methods ; Humans ; Microbial Sensitivity Tests ; methods ; Mycobacterium tuberculosis ; drug effects ; pathogenicity ; Nitrate Reductase ; metabolism ; Sputum ; microbiology

A worsening scenario of drug-resistant tuberculosis has increased the need for new treatment strategies to tackle this worldwide emergency. There is a pressing need to simplify and shorten the current 6-month treatment regimen for drug-susceptible tuberculosis. Rifamycins and fluoroquinolones, as well as several new drugs, are potential candidates under evaluation. At the same time, treatment outcomes of patients with drug-resistant tuberculosis should be improved through optimizing the use of fluoroquinolones, repurposed agents and newly developed drugs. In this context, the safety and tolerance of new therapeutic approaches must be addressed.
Animals ; Antitubercular Agents/adverse effects/*therapeutic use ; *Drug Discovery ; *Drug Repositioning ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Extensively Drug-Resistant Tuberculosis/drug therapy/microbiology ; Humans ; Lung/*drug effects/microbiology ; Mycobacterium tuberculosis/*drug effects/pathogenicity ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/diagnosis/*drug therapy/microbiology ; Tuberculosis, Pulmonary/diagnosis/*drug therapy/microbiology

Bacterial Vaccines ; biosynthesis ; Drug Resistance, Bacterial ; genetics ; Genetic Engineering ; Humans ; Leptospira interrogans ; genetics ; immunology ; pathogenicity ; Leptospirosis ; prevention & control ; Mycobacterium tuberculosis ; drug effects ; genetics ; Streptococcus pneumoniae ; drug effects ; genetics ; Vaccines, Synthetic ; biosynthesis

BACKGROUND/AIMS: To compare the effect of levofloxacin and moxifloxacin on treatment outcomes among patients with multidrug-resistant tuberculosis (MDR-TB). METHODS: A retrospective analysis of 171 patients with MDR-TB receiving either levofloxacin or moxifloxacin was performed. Treatment responses were categorized into treatment success (cured and treatment completed) or adverse treatment outcome (death, failure, and relapsed). RESULTS: The median age of the patients was 42.0 years. Approximately 56% of the patients were male. Seventeen patients had extensively drug-resistant tuberculosis, and 20 had a surgical resection. A total of 123 patients (71.9%) received levofloxacin for a median 594 days, and 48 patients (28.1%) received moxifloxacin for a median 673 days. Other baseline demographic, clinical, and radiographic characteristics were similar between the two groups. The moxifloxacin group had a significantly higher number of resistant drugs (p < 0.001) and a higher incidence of resistance to ofloxacin (p = 0.005) in the drug sensitivity test. The treatment success rate was 78.9% in the levofloxacin group and 83.3% in the moxifloxacin group (p = 0.42). Adverse reactions occurred at similar rates in the groups (p = 0.44). Patients in the moxifloxacin group were not more likely to have treatment success than those in the levofloxacin group (adjusted odds ratio, 0.76; 95% confidence interval, 0.24 to 2.43; p = 0.65). CONCLUSIONS: Both levofloxacin and moxifloxacin showed equivalent efficacy for treating MDR-TB.
Adult ; Antitubercular Agents/adverse effects/*therapeutic use ; Aza Compounds/adverse effects/*therapeutic use ; Case-Control Studies ; Chi-Square Distribution ; *Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Extensively Drug-Resistant Tuberculosis/*drug therapy/microbiology/mortality ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Mycobacterium tuberculosis/*drug effects/pathogenicity ; Odds Ratio ; Ofloxacin/adverse effects/*therapeutic use ; Quinolines/adverse effects/*therapeutic use ; Recurrence ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/*drug therapy/microbiology/mortality