Diagnosis and Treatment of Multidrug-Resistant Tuberculosis: Insights from New Research and Clinical Trials

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 15 September 2025 | Viewed by 2744

Special Issue Editors


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Guest Editor
Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-900, RJ, Brazil
Interests: TB; TB/HIV; HIV/AIDS; treatment outcomes; MDR-TB; adverse drug reactions; pharmacogenomics; single-nucleotide polymorphisms

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Guest Editor
Vanderbilt Tuberculosis Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
Interests: tuberculosis; infectious diseases; epidemiology; contact tracing

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Guest Editor
Institute of Collective Health, Federal University of Bahia, Salvador 40170-110, Brazi
Interests: epidemiology; infectious diseases; virology

Special Issue Information

Dear Colleagues,

This Special Issue focuses on innovations in the diagnosis and treatment of multidrug-resistant tuberculosis (MDR-TB) and aims to provide insights from institutions' collaboration research and clinical trials. MDR-TB is a significant global health concern, posing challenges to effective diagnosis and treatment. The Issue aims to address the current situation of MDR-TB and explore various aspects related to diagnosis, treatment, innovations, research, clinical trials, collaboration, and institutions. By examining these areas, we hope to gain a comprehensive understanding of the challenges and opportunities in managing MDR-TB.

We welcome original research, clinical trial results, and comprehensive reviews as submissions. Scholars are encouraged to propose innovative approaches and interventions to address the challenges posed by MDR-TB. This may involve developing new diagnostic tools, evaluating novel treatment regimens, exploring predictive models, and examining the impact of institutional collaboration.

Through the collaboration of diverse perspectives and expertise, we can foster an environment that promotes knowledge exchange and facilitates advancements in the diagnosis and treatment of MDR-TB.

Dr. Felipe Ridolfi
Dr. María Belen Arriaga Gutiérrez
Dr. Juan P. Aguilar Ticona
Guest Editors

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Keywords

  • multidrug-resistant tuberculosis
  • diagnosis
  • treatment
  • innovations
  • clinical trials
  • institutional collaboration

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Published Papers (2 papers)

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Research

12 pages, 648 KiB  
Article
Clinical Characteristics of Nontuberculous Mycobacterial Positivity Occurring During Multidrug-Resistant Tuberculosis Treatment: A Retrospective Study
by Min Wang, Muhammad Tahir Khan, Zilong Yang, Zhiyu Feng, Hong Zhang, Yuan Yuan, Di Wu, Zeying Chen, Haobin Kuang and Shouyong Tan
Trop. Med. Infect. Dis. 2025, 10(3), 83; https://doi.org/10.3390/tropicalmed10030083 - 20 Mar 2025
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Abstract
The clinical characteristics of multidrug-resistant tuberculosis (MDR-TB) patients with concurrent nontuberculous mycobacterial (NTM) infection present significant challenges to treatment. This study investigated the clinical characteristics of MDR-TB patients with concurrent NTM infection during treatment. A retrospective cohort study was conducted to collect the [...] Read more.
The clinical characteristics of multidrug-resistant tuberculosis (MDR-TB) patients with concurrent nontuberculous mycobacterial (NTM) infection present significant challenges to treatment. This study investigated the clinical characteristics of MDR-TB patients with concurrent NTM infection during treatment. A retrospective cohort study was conducted to collect the clinical data of MDR-TB patients who initiated treatment between January 2020 and December 2022. A total of 389 patients were analyzed, among which 111 patients who were lost to follow-up and 56 patients who missed etiological examination of tuberculosis during the visit period were excluded. A total of 222 patients with complete data were included in this study. The species identification method primarily employed molecular biology techniques, specifically the DNA microarray method and/or MPB64 antigen detection using the colloidal gold method. Patients whose sputum or bronchoalveolar lavage fluid cultures were positive and who were identified at least once as having NTM or as MPB64 negative were included in this study. Imaging data, comorbidities, pre-treatment infection, and nutritional indicators were analyzed during treatment. Among the 222 MDR-TB patients, no concurrent NTM cases were identified at the beginning of treatment. However, 19 cases (8.56%) were presumed to be NTM-positive during treatment, which appeared during anti-tuberculosis treatment from 2 to 12 months, averaging 6 (3, 12) months. Thirteen patients were only tested for MPB64, with five having two negative MPB64 tests. The symptoms of NTM-positive patients varied, and imaging findings were similar to those of MDR-TB but did not worsen. The emergence of presumed NTM-positive cases (8.56%) among MDR-TB patients during treatment highlights the need for monitoring, as symptoms and imaging findings may mimic MDR-TB without worsening. Early and repeated testing, including methods beyond MPB64, may be useful for more accurate diagnosis and tailored management. Full article
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7 pages, 217 KiB  
Article
Comparative Efficacy and Safety of Moxifloxacin and Levofloxacin in a Short Standardised Rifampicin Resistant TB Regimen: A STREAM 2 Secondary Analysis
by Stella M. Fabiane, Chen-Yuan Chiang, Sarah K. Meredith, Meera Gurumurthy, Adamu Bayissa, Andrew J. Nunn and Ruth L. Goodall
Trop. Med. Infect. Dis. 2024, 9(9), 211; https://doi.org/10.3390/tropicalmed9090211 - 11 Sep 2024
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Abstract
(1) Background: The World Health Organisation (WHO) categorises moxifloxacin and levofloxacin as Group A drugs, which should be prioritised in the treatment of rifampicin-resistant tuberculosis. We compare their relative efficacy and safety using data from the STREAM trial; (2) Methods: Marginal structural models [...] Read more.
(1) Background: The World Health Organisation (WHO) categorises moxifloxacin and levofloxacin as Group A drugs, which should be prioritised in the treatment of rifampicin-resistant tuberculosis. We compare their relative efficacy and safety using data from the STREAM trial; (2) Methods: Marginal structural models were used to balance differences in the baseline characteristics of participants receiving the STREAM control regimen containing either moxifloxacin or levofloxacin as this was not a randomised comparison. The difference in proportions between regimens was estimated for favourable outcome, any grade 3/4 adverse event, QTcF increase to ≥500 ms, QTcF increase from baseline by at least 60 ms, and any grade 3/4 adverse event excluding QT events, using weighted analyses; (3) Results: In efficacy analyses (n = 123), the weighted risk difference (moxifloxacin—levofloxacin, wRD) for a favourable outcome was −0.045 (−0.213, 0.123), p = 0.60. Similarly, estimates from the safety analyses (n = 127) showed no evidence of a difference between the fluoroquinolones, other than a suggestion of fewer QTcF increases from baseline on levofloxacin (wRD 0.160 (−0.026, 0.346), p = 0.091); (4) Conclusions: In this small dataset, we found no statistically significant difference in key efficacy or safety outcomes between the moxifloxacin- and levofloxacin-containing regimens; there was a suggestion that QTcF increases from baseline were fewer on levofloxacin. Full article
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