Sergey E Borisov1, Lia D'Ambrosio2, Rosella Centis3, Simon Tiberi4, Keertan Dheda5, Jan-Willem Alffenaar6, Rohit Amale7, Evgeny Belilowski1, Judith Bruchfeld8, Barbara Canneto9, Justin Denholm10, Raquel Duarte11, Aliasgar Esmail5, Alex Filippov1, Lina Davies Forsman8, Mina Gaga12, Shashank Ganatra7, Gaida Anastasia Igorevna13, Barbara Lazaro Mastrapa14, Vinicio Manfrin15, Selene Manga16, Andrey Maryandyshev13, Gilbert Massard17, Pablo González Montaner18, Jai Mullerpattan7, Domingo Juan Palmero18, Agostina Pontarelli19, Apostolos Papavasileiou20, Emanuele Pontali21, Rodolfo Romero Leyet22, Antonio Spanevello23, Zarir Farokh Udwadia7, Pietro Viggiani19, Dina Visca3, Giovanni Sotgiu24, Giovanni Battista Migliori25. 1. Moscow Government's Health Department, Moscow, Russian Federation. 2. Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, 21049, Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland. 3. Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. 4. Queen Mary University, London, United Kingdom; Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. 5. University of Cape Town, Cape Town, South Africa. 6. University of Groningen, Groningen, the Netherlands. 7. P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India. 8. Solna Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden. 9. University Hospital, Verona, Italy. 10. University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia. 11. Hospital Centre Vila Nova de Gaia and University of Porto, Porto, Portugal. 12. Athens Chest Hospital, Athens, Greece. 13. Northern State Medical University, Arkhangelsk, Russian Federation. 14. Harry Surtie Hospital, Upington, South Africa. 15. S. Bortolo Hospital, Vicenza, Italy. 16. Medicins Sans Frontiers, Ukrainian Mission, Kiev, Ukraine. 17. University Hospital, Strasbourg, France. 18. Municipal Hospital F. J. Munĩz, Buenos Aires, Argentina. 19. AOVV Eugenio Morelli Hospital, Sondalo, Italy. 20. Athens Chest Hospital, Ministry of Health, Athens, Greece. 21. Galliera Hospital, Genoa, Italy. 22. District Clinical Specialist Team, Namakwa District, Springbok, South Africa. 23. Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, 21049, Tradate, Italy; University of Insubria, Varese, Italy. 24. University of Sassari, Italy. 25. Istituti Clinici Scientifici Maugeri IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. Electronic address: giovannibattista.migliori@icsmaugeri.it.
Abstract
OBJECTIVES: No study evaluated the contribution of adjunctive surgery in bedaquiline-treated patients. This study describes treatment outcomes and complications in a cohort of drug-resistant pulmonary tuberculosis (TB) cases treated with bedaquiline-containing regimens undergoing surgery. METHODS: This retrospective observational study recruited patients treated for TB in 12 centres in 9 countries between January 2007 and March 2015. Patients who had surgical indications in a bedaquiline-treated programme-based cohort were selected and surgery-related information was collected. Patient characteristics and surgical indications were described together with type of operation, surgical complications, bacteriological conversion rates, and treatment outcomes. Treatment outcomes were evaluated according to the time of surgery. RESULTS: 57 bedaquiline-exposed cases resistant to a median of 7 drugs had indication for surgery (52 retreatments; 50 extensively drug-resistant (XDR) or pre XDR-TB). Sixty percent of cases initiated bedaquiline treatment following surgery, while 36.4% underwent the bedaquiline regimen before surgery and completed it after the operation. At treatment completion 90% culture-converted with 69.1% achieving treatment success; 21.8% had unfavourable outcomes (20.0% treatment failure, 1.8% lost to follow-up), and 9.1% were still undergoing treatment. CONCLUSIONS: The study results suggest that bedaquiline and surgery can be safely and effectively combined in selected cases with a specific indication.
OBJECTIVES: No study evaluated the contribution of adjunctive surgery in bedaquiline-treated patients. This study describes treatment outcomes and complications in a cohort of drug-resistant pulmonary tuberculosis (TB) cases treated with bedaquiline-containing regimens undergoing surgery. METHODS: This retrospective observational study recruited patients treated for TB in 12 centres in 9 countries between January 2007 and March 2015. Patients who had surgical indications in a bedaquiline-treated programme-based cohort were selected and surgery-related information was collected. Patient characteristics and surgical indications were described together with type of operation, surgical complications, bacteriological conversion rates, and treatment outcomes. Treatment outcomes were evaluated according to the time of surgery. RESULTS: 57 bedaquiline-exposed cases resistant to a median of 7 drugs had indication for surgery (52 retreatments; 50 extensively drug-resistant (XDR) or pre XDR-TB). Sixty percent of cases initiated bedaquiline treatment following surgery, while 36.4% underwent the bedaquiline regimen before surgery and completed it after the operation. At treatment completion 90% culture-converted with 69.1% achieving treatment success; 21.8% had unfavourable outcomes (20.0% treatment failure, 1.8% lost to follow-up), and 9.1% were still undergoing treatment. CONCLUSIONS: The study results suggest that bedaquiline and surgery can be safely and effectively combined in selected cases with a specific indication.
Authors: Payam Nahid; Sundari R Mase; Giovanni Battista Migliori; Giovanni Sotgiu; Graham H Bothamley; Jan L Brozek; Adithya Cattamanchi; J Peter Cegielski; Lisa Chen; Charles L Daley; Tracy L Dalton; Raquel Duarte; Federica Fregonese; C Robert Horsburgh; Faiz Ahmad Khan; Fayez Kheir; Zhiyi Lan; Alfred Lardizabal; Michael Lauzardo; Joan M Mangan; Suzanne M Marks; Lindsay McKenna; Dick Menzies; Carole D Mitnick; Diana M Nilsen; Farah Parvez; Charles A Peloquin; Ann Raftery; H Simon Schaaf; Neha S Shah; Jeffrey R Starke; John W Wilson; Jonathan M Wortham; Terence Chorba; Barbara Seaworth Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: Johanna Kuhlin; Marieke G G Sturkenboom; Samiksha Ghimire; Ioana Margineanu; Simone H J van den Elsen; Noviana Simbar; Onno W Akkerman; Erwin M Jongedijk; Remco A Koster; Judith Bruchfeld; Daan J Touw; Jan-Willem C Alffenaar Journal: Clin Mass Spectrom Date: 2018-10-19