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    Jan 19, 2021
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    Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, Malawi.

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    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
    Affiliation
    Médecins sans Frontières-Luxembourg, Thyolo District, Malawi. zachariah@internet.lu
    Issue Date
    2008-01-31T15:06:04Z
    
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    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.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/17237
    PubMed ID
    12055816
    Additional Links
    http://www.sciencedirect.com/science/journal/00359203
    Language
    en
    ISSN
    0035-9203
    Collections
    TB

    entitlement

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