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Antituberculosis drug resistance is a major factor threatening the success of tuberculosis control programmes. The aim of this study was to reveal the patterns of antituberculosis drug resistance in a secondary hospital in Turkey and to compare with national data. The results of BACTEC MGIT 960 system for susceptibility testing were retrospectively analysed on 76 clinical Mycobacterium tuberculosis complex isolates from different patients. The mean age of 48 men (63.2%) and 28 women was 37 and 39, respectively. Overall resistance rate to isoniazid was 14.5%, followed by streptomycin 9.2%, ethambutol 6.9% and rifampin 5.3%. Female sex and diabetes mellitus but not the presence of cavitary lesion or radiological involvement was a risk factor for the development of drug resistance. Anemia, leukocytosis or thrombocytosis was not associated with the drug resistance. In conclusions, further studies should be conducted regularly to monitor drug resistance in Turkey in order to manage effectively national tuberculosis control efforts.
The main target of the thesis was to investigate the drug resistance reversal on prokaryotic and eukaryotic model organisms. Based on DNA and protein complex formation properties of the given compounds the plasmid elimination of bacteria and the modification of the drug transporter proteins various experimental systems have been studied in bacteria and tumor cells.It was found that E. coli cells isolated from clinical specimen were less sensitive for the plasmid elimination than the laboratory strain carrying F prime plasmid, however, there was a complex formation between the antiplasmid compounds and the plasmid DNA isolated from both the clinical and laboratory strains. In addition there was a difference between the curing effect of two phenothiazines – the PMZ and TFP – on some E. coli strains in this study. The mechanism of action of different antiplasmid compounds was investigated on model nucleic acids such as calf thymus DNA and plasmid DNA. The pyrido[3,2-g] quinoline and phenothiazine derivatives seemed to have a complex formation with the model nucleic acids. Some of the compounds modified the activity of membrane efflux proteins. Based on the effect of trifluoromethyl ketones earlier studied my attention was focused on the combination of the trifluoromethyl ketone proton pump inhibitor TF18 with well-known antiplasmid compounds such as promethazine, trifluoperazine and 9-aminoacridine. In checkerboard studies the interaction between proton pump inhibitor and tricyclic compounds has been examined and it turned out that the interaction of proton pump inhibitor and trifluoperazine exerted synergistic antibacterial and plasmid curing effect on E. coli doxycycline resistant clinical strain due to the alteration of activity of membrane transporters. The role of proton pump system of the bacterial membrane was studied on Helicobacter pylori strains. The trifluoroketone proton pump inhibitor was able to block the proton motive forces and the activity of flagellar motor of both clarithromycin sensitive and resistant isolates of Helicobacter pylori . Since swimming was more sensitive to the inhibition than tumbling, I can suppose that TF18 works as an un-coupler in biological motor. The sensitivity of MDR1 type of eukaryotic ABC-transporter to resistance modifiers was studied on cancer cells. The synthetic benzo[b]-1,8-naphthyridine, pyridoquinoline, aza-oxafluorene and pregnane derivatives exerted reversing action of P-glycoprotein. Furthermore natural compounds, like coumarin derivatives and some fractions of persimmon extracts have been found to be potent resistance reversal agents against tumour cells.
Pathogenic yeasts from the genus Candida can cause serious infection in humans particularly, in immunocompromised patients and are now recognized as major agents of hospital acquired (nosocomial) infections. In the recent years, there has been a marked increase in the incidence of treatment failures in candidiasis patients receiving long-term antifungal therapy, which has posed a serious problem in its successful use in chemotherapy. Candida cells acquire drug resistance (MDR) during the course of the treatment. The mechanisms of resistance to azole antifungal agents have been elucidated in Candida species and can be mainly categorized as (i) changes in the cell wall or plasma membrane, which lead to impaired drug (azole) uptake; (ii) alterations in the affinity of the drug target Erg11p (lanosterol 14∝-demethylase) especially to azoles or in the cellular content of Erg11p due to target site mutation or overexpression of the ERG11 gene; and (iii) the efflux of drugs mediated by membrane transport proteins belonging to the ATP-binding cassette (ABC) transporters, namely CDR1 and CDR2 or to the major facilitator superfamily (MFS) transporter, CaMDR1 . Many such manifestations are associated with the formation of Candida biofilms including those occurring on devices like indwelling intravascular catheters. Biofilm-associated Candida show uniform resistance to a wide spectrum of antifungal drugs. A combination of different resistance mechanisms is responsible for drug resistance in clinical isolates of Candida species.
recent years has also resulted in the development of resistance to these drugs. Drug resistance in fungi, especially to azoles, is becoming more prevalent clinically. After the appearance of resistance to griseofulvin, a case of clinical resistance to
public health challenge of drug-resistant TB. As Côte d'Ivoire does not yet have the capacity to routinely test all TB patients for drug susceptibility, two national drug resistance surveys were conducted in 1995 and 2006. The proportions of new TB cases
, understanding the mechanisms of drug resistance will help the policy and application of current treatment [ 4 ]. Even though epidemiology of tuberculosis is known, the occurrence of NTM-related diseases in Iran has not been well established [ 5 ]. With the
Mutations in the HIV-1 genes associated with resistance to antiretroviral drugs were detected also in primary HIV infected individuals who did not receive antiretroviral treatment. Drug resistance genotyping of HIV pol gene was done by in situ DNA hybridization using a Line Probe Assay and by direct sequencing. Viral variants harbouring resistance mutations such as: M41, T69R, K70R, M184V, T215Y in the pol gene were detected in 14% of the subjects. HIV mutants resistant to NRT inhibitors were found in 10 and 20% of patients infected before and after the year 2000, respectively. Multiple drug resistant viruses (2–3 drug classes) were present in 3.5% of the mainly recently infected patients. In protease gene only minor resistant mutations were found such as L10I and A71V.These findings indicate the evolution of drug resistance showing a correlation with the time of introduction of combination therapy in our country, where more than 70% of HIV infections were by homo/bisexual transmission.This confirms the transmission of drug-resistant HIV shown by genotype testing during primary infection in therapy-naive patients and initiates serious clinical and public health consequences.
bacteria from aquatic environments, as well ( Fluit and Schmitz, 2004 ). However, integron studies on the bacteria isolated from the frogs, which represent carriers of drug resistance in both environments with their aquatic and terrestrial lives, are very
Abstract
Gatifloxacin (GTN) was derivatized to its dithiocarbamate derivative and its radiolabeling with technetium-99m (99mTc) using the [99mTc≡N]2+ core was investigated. The appropriateness of the 99mTcN–gatifloxacin dithiocarbamate (99mTcN–GTND) complex as a potential multi-drug-resistance Streptococcus pneumoniae (MRSP) infection radiotracer was evaluated in terms of stability in saline, serum, in vitro binding with MRSP and biodistribution in artificially MRSP infected Male Wistar Rats (MWR). In saline the 99mTcN–GTND complex showed more than 90% labeling yield up to 4 h with a maximum yield of 98.25 ± 0.20%, after reconstitution. In serum the 99mTcN–GTND complex showed stability up to 16 h of incubation with the appearance of insignificant 15.95% undesirable side products. The 99mTcN–GTND complex demonstrated saturated in vitro binding with MRSP with a maximum value of 75.50 ± 1.00% (at 90 min). In MWR model of group A, almost six times higher uptake of the labeled GTND was monitored in the muscle of MWR infected with live MRSP as compared to the inflamed and normal muscles. Based on the higher labeling yield in saline, in vitro stability in serum, saturated in vitro binding with live MRSP and promising biodistribution in MWR model we recommend 99mTcN–gatifloxacin dithiocarbamate complex as a potential MRSP infection radiotracer.
Mutations in the HIV-1 pol gene associated with resistance to antiretroviral drugs in therapy-naïve Hungarian individuals transmitted as primary infection by their foreign sexual partners originated from African, Asian and other European countries had been analyzed. Drug resistance genotyping of HIV RT and PR genes were performed where mutations of 72 codons — among them 64 specific resistance codons representing 6 nucleoside reverse transcriptase inhibitor (NRTIs), 2 non-nucleoside reverse transcriptase inhibitor (NNRTIs) and 6 proteinase inhibitor (PRIs) drugs — had been analyzed by Truegene HIV-1 Genotyping kit and OpenGene Sequencing System. Viral variants harboring resistance mutations in the po l gene were detected in 14% of the subjects. The highest rate of resistance to a single class of inhibitors was detected towards PR inhibitors (12%), followed by NRTI (8%) and NNRTI (5%). On the contrary, 25% of viruses transmitted by homosexual activity contained mutations led to resistance to NNRT. Viruses from 11 percent of cases were resistant to 2 classes of inhibitors, and 7 percent to three classes of inhibitors. Based upon sequence data non-B subtypes and CRFs were detected in more than 71% of cases. HIV-1 C (10.7%), HIV-F1 (7.2%) and HIV-1 G (3.6%) were detected as the more frequent subtypes. Among the HIV-1 recombinant viruses CRF02_AG variants were found more frequently (28.5%) followed by CRF06_cpx (17.8%) indicating penetration of non-B subtypes and recombinant African variants into Hungary, which raises serious clinical and public health consequences.
