Designing effective multidrug-resistant-TB treatments based on DNA sequencing
Globally, tuberculosis is the most common bacterial infectious disease leading to death. The pathogen causing tuberculosis, Mycobacterium tuberculosis, has a number of peculiarities. One is that it is growing very slowly. While other typical pathogens, such as pneumococcal and pseudomonads, can already be identified by their growth in the microbiological laboratory in the first 72 hours, several weeks usually pass before tuberculosis bacteria grow in the lab. Thus it often takes one to two months before the efficacy of individual medicines can be tested.
However, these efficacy tests are essential for the effective treatment of multidrug-resistant tuberculosis (MDR-TB), which is becoming increasingly common. In these cases, the pathogen has become resistant, i.e. insensitive, to the best tuberculosis drugs, rifampicin and isoniazid. This is due to changes in the genome, so-called mutations, which almost a
The successful treatment of multidrug-resistant tuberculosis requires clarification in advance as to which antibiotics the pathogens are resistant to. Classic testing is very time-consuming and delays the start of therapy. Researchers from the Research Center Borstel and the DZIF have now prepared a catalogue of all mutations in the genome of tuberculosis bacteria and on the basis of a genome sequencing can quickly and cheaply predict which medicines are most effective for tuberculosis treatment.
New biomarker predicts individual anti-tuberculosis treatment duration
When can tuberculosis therapy be stopped without risk of relapse? Doctors are faced with this question time and again, because the lack of detection of the tuberculosis pathogen Mycobacterium tuberculosis is no guarantee for a permanent cure of the lung infection.
Patients who respond to the standard therapy may be out of treatment after six months. But for resistant cases, more than 18 months of treatment duration is currently advised. This is a very long time for those affected, who often have to take more than four antibiotics every day and suffer from side effects , explains Prof. Dr. Christoph Lange, Clinical Director at the Research Center Borstel and director of the study, conducted at the German Center for Infection Research (DZIF) in cooperation with the German Center for Lung Research (DZL). We urgently need a biomarker that enables the implementation of an individualized treatment duration, he emph
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