Frontiers in Public Health (Sep 2022)
Case report: A 9-year systematic treatment failure of a pulmonary tuberculosis patient
- Hui Jiang,
- Hui Jiang,
- Chendi Zhu,
- Chendi Zhu,
- Chendi Zhu,
- Liyi Qin,
- Liyi Qin,
- Liyi Qin,
- Xiaoguang Wu,
- Xiaoguang Wu,
- Jinfeng Yin,
- Jinfeng Yin,
- Jinfeng Yin,
- Yijia Guo,
- Yijia Guo,
- Yijia Guo,
- Huan Ma,
- Junnan Jia,
- Junnan Jia,
- Junnan Jia,
- Fengmin Huo,
- Fengmin Huo,
- Fengmin Huo,
- Yi Xue,
- Yi Xue,
- Yi Xue,
- Mengqiu Gao,
- Mengqiu Gao,
- Weimin Li,
- Weimin Li,
- Weimin Li
Affiliations
- Hui Jiang
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Hui Jiang
- Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Chendi Zhu
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Chendi Zhu
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Chendi Zhu
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Liyi Qin
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Liyi Qin
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Liyi Qin
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Xiaoguang Wu
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Xiaoguang Wu
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Jinfeng Yin
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Jinfeng Yin
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Jinfeng Yin
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Yijia Guo
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Yijia Guo
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Yijia Guo
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Huan Ma
- School of Public Health, Wenzhou Medical University, Wenzhou, China
- Junnan Jia
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Junnan Jia
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Junnan Jia
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Fengmin Huo
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Fengmin Huo
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Fengmin Huo
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Yi Xue
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Yi Xue
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Yi Xue
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- Mengqiu Gao
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Mengqiu Gao
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China
- Weimin Li
- Beijing Chest Hospital, Capital Medical University, Beijing, China
- Weimin Li
- National Tuberculosis Clinical Laboratory, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
- Weimin Li
- Beijing Key Laboratory for Drug Resistant Tuberculosis, Beijing, China
- DOI
- https://doi.org/10.3389/fpubh.2022.966891
- Journal volume & issue
-
Vol. 10
Abstract
ObjectiveTo explore the reasons of failure in a case of pulmonary tuberculosis (PTB) after 9 years systematic treatment.MethodsWe extracted the patients' treatment history, drug susceptibility testing (DST), Computed tomography (CT) images, and sequenced the isolated strains by whole gene sequencing (WGS).ResultsAlthough most results of the phenotypical DSTs were consistent with the genotype DST, the occurrence of gene resistance to amikacin (AMK), capreomycin (CAP), moxifloxacin (MFX) was earlier than the phenotypical DST. Based on the continuously reversed results of phenotypical DSTs, CT images in different stages and WGS, it can be confirmed that the patient was infected with two different strains of Mycobacterium tuberculosis (M.TB). Moreover, severe cavities may be another factor leading to treatment failure.ConclusionGiven the suggestive effect of genotype DST is earlier than the phenotypical DST, so genotype DST can play a better guiding role in patients with MDR-TB. Additionally, for patients who have not been cured for a long time, medication should be more cautious and the role of WGS in drug resistance surveillance should be fully utilized.
Keywords
- tuberculosis
- treatment failure
- whole genome sequencing
- multidrug resistance
- computed tomography-three dimensional
