Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi.

Hdl Handle:
http://hdl.handle.net/10144/17237
Title:
Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi.
Authors:
Zachariah, R; Harries, A D; Spielmann M P; Arendt, V; Nchingula, D; Mwenda, R; Courteille, O; Kirpach, P; Mwale, B; Salaniponi, F M L
Journal:
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abstract:
In Thyolo district, Malawi, an operational research study is being conducted on the efficacy and feasibility of co-trimoxazole prophylaxis in preventing deaths in HIV-positive patients with tuberculosis (TB). A series of cross-sectional studies were carried out in 1999 and 2001 to determine (i) whether faecal Escherichia coli resistance to co-trimoxazole in TB patients changed with time, and (ii) whether the resistance pattern was different in HIV-positive TB patients who were taking co-trimoxazole prophylaxis. Co-trimoxazole resistance among E. coli isolates in TB patients at the time of registration was 60% in 1999 and 77% in 2001 (P < 0.01). Resistance was 89% among HIV-infected TB patients (receiving cotrimoxazole), while in HIV-negative patients (receiving anti-TB therapy alone) it was 62% (P < 0.001). The study shows a significant increase of E. coli resistance to co-trimoxazole in TB patients which is particularly prominent in HIV-infected patients on co-trimoxazole prophylaxis. Since a high degree of plasmid-mediated transfer of resistance exists between E. coli and the Salmonella species, these findings could herald limitations on the short- and long-term benefits to be expected from the use of co-trimoxazole prophylaxis in preventing non-typhoid Salmonella bacteraemia and enteritis in HIV-infected TB patients in Malawi.
Affiliation:
Médecins sans Frontières-Luxembourg, Thyolo District, Malawi. zachariah@internet.lu
Publisher:
Elsevier
Issue Date:
31-Jan-2008
URI:
http://hdl.handle.net/10144/17237
PubMed ID:
12055816
Additional Links:
http://www.sciencedirect.com/science/journal/00359203
Language:
en
ISSN:
0035-9203
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorZachariah, R-
dc.contributor.authorHarries, A D-
dc.contributor.authorSpielmann M P-
dc.contributor.authorArendt, V-
dc.contributor.authorNchingula, D-
dc.contributor.authorMwenda, R-
dc.contributor.authorCourteille, O-
dc.contributor.authorKirpach, P-
dc.contributor.authorMwale, B-
dc.contributor.authorSalaniponi, F M L-
dc.date.accessioned2008-01-31T15:06:04Z-
dc.date.available2008-01-31T15:06:04Z-
dc.date.issued2008-01-31T15:06:04Z-
dc.identifier.citationChanges in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi., 96 (2):202-4 Trans. R. Soc. Trop. Med. Hyg.en
dc.identifier.issn0035-9203-
dc.identifier.pmid12055816-
dc.identifier.urihttp://hdl.handle.net/10144/17237-
dc.description.abstractIn Thyolo district, Malawi, an operational research study is being conducted on the efficacy and feasibility of co-trimoxazole prophylaxis in preventing deaths in HIV-positive patients with tuberculosis (TB). A series of cross-sectional studies were carried out in 1999 and 2001 to determine (i) whether faecal Escherichia coli resistance to co-trimoxazole in TB patients changed with time, and (ii) whether the resistance pattern was different in HIV-positive TB patients who were taking co-trimoxazole prophylaxis. Co-trimoxazole resistance among E. coli isolates in TB patients at the time of registration was 60% in 1999 and 77% in 2001 (P < 0.01). Resistance was 89% among HIV-infected TB patients (receiving cotrimoxazole), while in HIV-negative patients (receiving anti-TB therapy alone) it was 62% (P < 0.001). The study shows a significant increase of E. coli resistance to co-trimoxazole in TB patients which is particularly prominent in HIV-infected patients on co-trimoxazole prophylaxis. Since a high degree of plasmid-mediated transfer of resistance exists between E. coli and the Salmonella species, these findings could herald limitations on the short- and long-term benefits to be expected from the use of co-trimoxazole prophylaxis in preventing non-typhoid Salmonella bacteraemia and enteritis in HIV-infected TB patients in Malawi.en
dc.language.isoenen
dc.publisherElsevier-
dc.relation.urlhttp://www.sciencedirect.com/science/journal/00359203-
dc.rightsArchived on this site with the kind permission of Elsevier Ltd. and the Royal Society of Tropical Medicine and Hygiene, http://www.rstmh.org/transactions.aspen
dc.subject.meshAIDS-Related Opportunistic Infectionsen
dc.subject.meshAdulten
dc.subject.meshAnti-Bacterial Agentsen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDrug Resistance, Bacterialen
dc.subject.meshEscherichia colien
dc.subject.meshEscherichia coli Infectionsen
dc.subject.meshFecesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshTrimethoprim-Sulfamethoxazole Combinationen
dc.subject.meshTuberculosisen
dc.titleChanges in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi.en
dc.contributor.departmentMédecins sans Frontières-Luxembourg, Thyolo District, Malawi. zachariah@internet.luen
dc.identifier.journalTransactions of the Royal Society of Tropical Medicine and Hygieneen

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.