The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1999
SETTING Greater Mymensingh District, a rural area of Bangladesh, at the start of the National Tub... more SETTING Greater Mymensingh District, a rural area of Bangladesh, at the start of the National Tuberculosis Programme (NTP). OBJECTIVES To determine the prevalence of initial and acquired drug resistance of Mycobacterium tuberculosis, and to assess the appropriateness of the NTP's standard regimens. DESIGN Sampling of pre-treatment sputum from all newly registered smear-positive cases in five centres covering the area. Culture and susceptibility testing in a supra-national reference laboratory. RESULTS Initial resistance to isoniazid (H) was 5.4%, and to rifampicin (R) 0.5%. Acquired H and R resistance were 25.9% and 7.4%, respectively. Multidrug resistance (MDR) was observed in one new case only and in 5.6% of previously treated patients. Changing the present NTP indication for retreatment regimen to one month of previous H intake would increase coverage of H-resistant cases from 52% to 89%, adding 6% to drug costs. CONCLUSION The prevalence of drug resistance is surprisingly lo...
The biochemical properties and fatty acid compositions of 16 strains of Mycobacterium haemophilum... more The biochemical properties and fatty acid compositions of 16 strains of Mycobacterium haemophilum from Australian patients were studied. The strains proved to be indistinguishable from each other but could readily be differentiated from other slowly growing mycobacteria with similar cultural features. Mycolic acid analyses revealed the presence of alpha-, methoxy-, and ketomycolates. The fatty acid composition supports the validity of the fact that M. haemophilum is a distinct species. The fatty acid composition was consistent among the 16 strains, but it was unusual in that there was some resemblance to the fatty acid composition of M. leprae. The wide range of pHs (5.4 to 7.4) that supported growth of M. haemophilum on artificial medium is in keeping with suggestions that M. haemophilum exists in an environmental habitat.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 3, 2017
The development of rapid molecular diagnostic assays for pyrazinamide (PZA) resistance is conside... more The development of rapid molecular diagnostic assays for pyrazinamide (PZA) resistance is considered technically challenging as mutations are highly diverse, scattered along the full length of the pncA gene, and not all are associated with PZA resistance. In this study, we evaluated the performance of the novel Genoscholar PZA-TB II line-probe assay (NIPRO Corporation, Japan; 'PZA-LPA2'). To evaluate the applicability of the PZA-LPA2 in clinical settings, we compared the performance of the PZA-LPA2 to a composite reference standard pncA Sanger and Illumina sequencing plus phenotypic susceptibility testing on a panel of 87 Mycobacterium tuberculosis isolates from WHO drug resistance surveys, harbouring mutations previously classified as associated or not associated with resistance according to data from peer-reviewed literature. In addition, the PZA-LPA2 was challenged against a selection of isolates with lineage-specific and non-resistance associated mutations, for which the...
The recently identified insertion element IS6110 is present in most strains of the Mycobacterium ... more The recently identified insertion element IS6110 is present in most strains of the Mycobacterium tuberculosis complex. Restriction fragment length polymorphism (RFLP) based on IS6110 generates strain specific fingerprints and allows typing of M. tuberculosis strains. We present here the results of a RFLP study on 12 multi drug and 10 single drug resistant, recent isolates of M. tuberculosis received from different clinical microbiology laboratories in Belgian hospitals. All isolates originating from different patients yielded distinct RFLP patterns possessing 2 to 13 copies of IS6110. There was no correlation between the number or location of IS6110 copies and the drug resistance patterns. These results illustrate the existence of a broad polymorphism among Belgian isolates. Though this preliminary study did not reveal an outbreak or a micro-epidemic, we consider that the establishment of a DNA fingerprint bank in Belgium will be extremely helpful for tracing recent sources of infection, for the control of a possible spread of multidrug resistant organisms, and for the surveillance of tuberculosis in general.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2015
Molecular techniques rapidly detect resistance to rifampicin (RMP) and isoniazid (INH), but do no... more Molecular techniques rapidly detect resistance to rifampicin (RMP) and isoniazid (INH), but do not eliminate the need for culture-based drug susceptibility testing (DST) against other drugs. The thin-layer agar (TLA) test, a non-commercial direct DST method, has demonstrated good performance for INH and RMP; however, evidence is still limited, and its applicability for DST of ofloxacin (OFX) and kanamycin (KM) is unknown. We compared 279 TLA DST results with those of MGIT for INH and RMP, and 280 results for OFX and KM with those of the 7H11 agar proportion method, obtained from 320 smear-positive samples from 165 Georgian TB patients. Discrepancies were solved by comparison with a composite reference standard. The prevalence of multidrug-resistant tuberculosis (TB) was 30 of 164 patients (18.3%), 2 (6.7%) of whom had extensively drug-resistant TB. TLA showed 94.7%, 98.2%, 100% and 78.9% sensitivity, respectively, for INH, RMP, OFX and KM, with 100% specificity. Average time to resu...
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008
Penitentiary system of Georgia. To determine the prevalence of resistance to second-line drugs am... more Penitentiary system of Georgia. To determine the prevalence of resistance to second-line drugs among prisoners with pulmonary tuberculosis (PTB). Retrospective evaluation of resistance to second-line drugs in tuberculosis (TB) patients treated from 2001 to 2003. The overall observed prevalence of multidrug-resistant TB (MDR-TB) was 14.4% (39/270). The lowest resistance was found for ofloxacin (OFX), which was 2.2% (6/270) overall and 5.1% (2/39) among MDR patients. Isolates from four non-MDR patients who had never received anti-tuberculosis treatment were found to be resistant to OFX. Resistance to kanamycin and capreomycin occurred simultaneously only among MDR patients and was observed in 17/39 cases (43.6%). High rates of resistance to > or =2 second-line drugs (18/39, 46.2%) and > or =3 second-line drugs (10/39, 25.6%) were observed among all MDR-TB patients, reaching respectively 59.3% and 29.6% among previously treated MDR-TB cases. Only one patient was found to be resis...
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
Our multidisciplinary project on TB control in the Free State, South Africa, is targeting two dim... more Our multidisciplinary project on TB control in the Free State, South Africa, is targeting two dimensions for intervention: firstly, patients, to facilitate compliance and improve quality of care; secondly, the health care system, to identify weaknesses that require remedying and best practices to promote better TB control. This communication illustrates how social scientists can contribute towards the implementation of interventions related to their research, thus influencing TB policy, programme planning and practice more directly.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
Greater Mymensingh District, Bangladesh. To determine changes in prevalence of drug resistance of... more Greater Mymensingh District, Bangladesh. To determine changes in prevalence of drug resistance of Mycobacterium tuberculosis under DOTS. Drug susceptibility testing of systematic samples of M. tuberculosis isolated from all sputum smear-positive cases newly registered in sentinel centres during 1995 and 2001. Continuous monitoring of retreatment registrations and resistance of strains from relapse and failure cases. Of 942 strains from the new cases in 2001, 10.8% showed resistance to any drug, 6.2% to isoniazid, 0.4% to rifampicin (all of them multidrug-resistant, MDR), 7.1% to streptomycin, and 1.0% to ethambutol. Corresponding rates for 99 strains from previously treated cases were 32%, 20%, 3%, 20% and 2%, respectively. Although most rates of resistance had decreased since 1995, increased streptomycin resistance was the only significant change when new and previously treated cases were considered separately. However, combined resistance for any drug, isoniazid, rifampicin and MD...
INNO-LiPA Mycobacteria (LiPA; Innogenetics, Zwijnaarde, Belgium) is a kit for the simultaneous de... more INNO-LiPA Mycobacteria (LiPA; Innogenetics, Zwijnaarde, Belgium) is a kit for the simultaneous detection and identification of Mycobacterium species in culture and identifies the Mycobacterium tuberculosis complex, the M. avium complex (MAC), and the following Mycobacterium species: M. kansasii , M. avium , M. intracellulare , M. scrofulaceum , M. gordonae , M. xenopi , and the M. chelonae-M. abscessus complex. The assay, which targets the 16S-23S rRNA spacer region, was evaluated on 157 mycobacterial strains that had been identified by conventional techniques and PCR-restriction enzyme analysis of the hsp65 gene (PRA). Forty-seven reference strains consisting of 37 different species and 110 human clinical isolates were submitted to the test, and all were hybridized with the Mycobacterium genus probe (MYC) on the LiPA strip (100% sensitivity). Ninety-four isolates hybridized to their corresponding species- or complex-specific probes; only one isolate phenotypically identified as M. ...
Childhood tuberculosis (TB) represents an important part of the disease burden, yet its diagnosis... more Childhood tuberculosis (TB) represents an important part of the disease burden, yet its diagnosis remains challenging. This review summarizes the clinical, radiological, and bacteriological approaches to diagnose TB infection and disease in children. Fever (possibly intermittent or low grade), weight loss or failure to thrive, and a persistent cough for >2 weeks are the most important clinical signs for pulmonary tuberculosis. Extra-pulmonary TB, which might occur in over 40% of the patients, can have in addition some specific clinical symptoms or signs. Chest radiographs provide important information in many patients and advanced imaging can be applied in case of (and should be restricted to) inconclusive diagnosis. The Mantoux test is positive in up to 70% of non-immunocompromised TB patients, whereas HIV co-infection or malnourishment results in a lower reactivity. Evidence of an adult TB index case is clue for diagnosis of childhood TB in low-endemic countries. Bacteriological confirmation remains difficult and is useful for doubtful cases or when drug resistance is suspected.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1999
SETTING Greater Mymensingh District, a rural area of Bangladesh, at the start of the National Tub... more SETTING Greater Mymensingh District, a rural area of Bangladesh, at the start of the National Tuberculosis Programme (NTP). OBJECTIVES To determine the prevalence of initial and acquired drug resistance of Mycobacterium tuberculosis, and to assess the appropriateness of the NTP's standard regimens. DESIGN Sampling of pre-treatment sputum from all newly registered smear-positive cases in five centres covering the area. Culture and susceptibility testing in a supra-national reference laboratory. RESULTS Initial resistance to isoniazid (H) was 5.4%, and to rifampicin (R) 0.5%. Acquired H and R resistance were 25.9% and 7.4%, respectively. Multidrug resistance (MDR) was observed in one new case only and in 5.6% of previously treated patients. Changing the present NTP indication for retreatment regimen to one month of previous H intake would increase coverage of H-resistant cases from 52% to 89%, adding 6% to drug costs. CONCLUSION The prevalence of drug resistance is surprisingly lo...
The biochemical properties and fatty acid compositions of 16 strains of Mycobacterium haemophilum... more The biochemical properties and fatty acid compositions of 16 strains of Mycobacterium haemophilum from Australian patients were studied. The strains proved to be indistinguishable from each other but could readily be differentiated from other slowly growing mycobacteria with similar cultural features. Mycolic acid analyses revealed the presence of alpha-, methoxy-, and ketomycolates. The fatty acid composition supports the validity of the fact that M. haemophilum is a distinct species. The fatty acid composition was consistent among the 16 strains, but it was unusual in that there was some resemblance to the fatty acid composition of M. leprae. The wide range of pHs (5.4 to 7.4) that supported growth of M. haemophilum on artificial medium is in keeping with suggestions that M. haemophilum exists in an environmental habitat.
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Jan 3, 2017
The development of rapid molecular diagnostic assays for pyrazinamide (PZA) resistance is conside... more The development of rapid molecular diagnostic assays for pyrazinamide (PZA) resistance is considered technically challenging as mutations are highly diverse, scattered along the full length of the pncA gene, and not all are associated with PZA resistance. In this study, we evaluated the performance of the novel Genoscholar PZA-TB II line-probe assay (NIPRO Corporation, Japan; 'PZA-LPA2'). To evaluate the applicability of the PZA-LPA2 in clinical settings, we compared the performance of the PZA-LPA2 to a composite reference standard pncA Sanger and Illumina sequencing plus phenotypic susceptibility testing on a panel of 87 Mycobacterium tuberculosis isolates from WHO drug resistance surveys, harbouring mutations previously classified as associated or not associated with resistance according to data from peer-reviewed literature. In addition, the PZA-LPA2 was challenged against a selection of isolates with lineage-specific and non-resistance associated mutations, for which the...
The recently identified insertion element IS6110 is present in most strains of the Mycobacterium ... more The recently identified insertion element IS6110 is present in most strains of the Mycobacterium tuberculosis complex. Restriction fragment length polymorphism (RFLP) based on IS6110 generates strain specific fingerprints and allows typing of M. tuberculosis strains. We present here the results of a RFLP study on 12 multi drug and 10 single drug resistant, recent isolates of M. tuberculosis received from different clinical microbiology laboratories in Belgian hospitals. All isolates originating from different patients yielded distinct RFLP patterns possessing 2 to 13 copies of IS6110. There was no correlation between the number or location of IS6110 copies and the drug resistance patterns. These results illustrate the existence of a broad polymorphism among Belgian isolates. Though this preliminary study did not reveal an outbreak or a micro-epidemic, we consider that the establishment of a DNA fingerprint bank in Belgium will be extremely helpful for tracing recent sources of infection, for the control of a possible spread of multidrug resistant organisms, and for the surveillance of tuberculosis in general.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2015
Molecular techniques rapidly detect resistance to rifampicin (RMP) and isoniazid (INH), but do no... more Molecular techniques rapidly detect resistance to rifampicin (RMP) and isoniazid (INH), but do not eliminate the need for culture-based drug susceptibility testing (DST) against other drugs. The thin-layer agar (TLA) test, a non-commercial direct DST method, has demonstrated good performance for INH and RMP; however, evidence is still limited, and its applicability for DST of ofloxacin (OFX) and kanamycin (KM) is unknown. We compared 279 TLA DST results with those of MGIT for INH and RMP, and 280 results for OFX and KM with those of the 7H11 agar proportion method, obtained from 320 smear-positive samples from 165 Georgian TB patients. Discrepancies were solved by comparison with a composite reference standard. The prevalence of multidrug-resistant tuberculosis (TB) was 30 of 164 patients (18.3%), 2 (6.7%) of whom had extensively drug-resistant TB. TLA showed 94.7%, 98.2%, 100% and 78.9% sensitivity, respectively, for INH, RMP, OFX and KM, with 100% specificity. Average time to resu...
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008
Penitentiary system of Georgia. To determine the prevalence of resistance to second-line drugs am... more Penitentiary system of Georgia. To determine the prevalence of resistance to second-line drugs among prisoners with pulmonary tuberculosis (PTB). Retrospective evaluation of resistance to second-line drugs in tuberculosis (TB) patients treated from 2001 to 2003. The overall observed prevalence of multidrug-resistant TB (MDR-TB) was 14.4% (39/270). The lowest resistance was found for ofloxacin (OFX), which was 2.2% (6/270) overall and 5.1% (2/39) among MDR patients. Isolates from four non-MDR patients who had never received anti-tuberculosis treatment were found to be resistant to OFX. Resistance to kanamycin and capreomycin occurred simultaneously only among MDR patients and was observed in 17/39 cases (43.6%). High rates of resistance to > or =2 second-line drugs (18/39, 46.2%) and > or =3 second-line drugs (10/39, 25.6%) were observed among all MDR-TB patients, reaching respectively 59.3% and 29.6% among previously treated MDR-TB cases. Only one patient was found to be resis...
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
Our multidisciplinary project on TB control in the Free State, South Africa, is targeting two dim... more Our multidisciplinary project on TB control in the Free State, South Africa, is targeting two dimensions for intervention: firstly, patients, to facilitate compliance and improve quality of care; secondly, the health care system, to identify weaknesses that require remedying and best practices to promote better TB control. This communication illustrates how social scientists can contribute towards the implementation of interventions related to their research, thus influencing TB policy, programme planning and practice more directly.
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2004
Greater Mymensingh District, Bangladesh. To determine changes in prevalence of drug resistance of... more Greater Mymensingh District, Bangladesh. To determine changes in prevalence of drug resistance of Mycobacterium tuberculosis under DOTS. Drug susceptibility testing of systematic samples of M. tuberculosis isolated from all sputum smear-positive cases newly registered in sentinel centres during 1995 and 2001. Continuous monitoring of retreatment registrations and resistance of strains from relapse and failure cases. Of 942 strains from the new cases in 2001, 10.8% showed resistance to any drug, 6.2% to isoniazid, 0.4% to rifampicin (all of them multidrug-resistant, MDR), 7.1% to streptomycin, and 1.0% to ethambutol. Corresponding rates for 99 strains from previously treated cases were 32%, 20%, 3%, 20% and 2%, respectively. Although most rates of resistance had decreased since 1995, increased streptomycin resistance was the only significant change when new and previously treated cases were considered separately. However, combined resistance for any drug, isoniazid, rifampicin and MD...
INNO-LiPA Mycobacteria (LiPA; Innogenetics, Zwijnaarde, Belgium) is a kit for the simultaneous de... more INNO-LiPA Mycobacteria (LiPA; Innogenetics, Zwijnaarde, Belgium) is a kit for the simultaneous detection and identification of Mycobacterium species in culture and identifies the Mycobacterium tuberculosis complex, the M. avium complex (MAC), and the following Mycobacterium species: M. kansasii , M. avium , M. intracellulare , M. scrofulaceum , M. gordonae , M. xenopi , and the M. chelonae-M. abscessus complex. The assay, which targets the 16S-23S rRNA spacer region, was evaluated on 157 mycobacterial strains that had been identified by conventional techniques and PCR-restriction enzyme analysis of the hsp65 gene (PRA). Forty-seven reference strains consisting of 37 different species and 110 human clinical isolates were submitted to the test, and all were hybridized with the Mycobacterium genus probe (MYC) on the LiPA strip (100% sensitivity). Ninety-four isolates hybridized to their corresponding species- or complex-specific probes; only one isolate phenotypically identified as M. ...
Childhood tuberculosis (TB) represents an important part of the disease burden, yet its diagnosis... more Childhood tuberculosis (TB) represents an important part of the disease burden, yet its diagnosis remains challenging. This review summarizes the clinical, radiological, and bacteriological approaches to diagnose TB infection and disease in children. Fever (possibly intermittent or low grade), weight loss or failure to thrive, and a persistent cough for >2 weeks are the most important clinical signs for pulmonary tuberculosis. Extra-pulmonary TB, which might occur in over 40% of the patients, can have in addition some specific clinical symptoms or signs. Chest radiographs provide important information in many patients and advanced imaging can be applied in case of (and should be restricted to) inconclusive diagnosis. The Mantoux test is positive in up to 70% of non-immunocompromised TB patients, whereas HIV co-infection or malnourishment results in a lower reactivity. Evidence of an adult TB index case is clue for diagnosis of childhood TB in low-endemic countries. Bacteriological confirmation remains difficult and is useful for doubtful cases or when drug resistance is suspected.
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Papers by L. Rigouts