4.) pleural cavity. ) *PDPI: Persatuan Dokter Paru Indonesia **N.. TB paru untuk awam Download as PPT, PDF, TXT or read online from Scribd. Flag for. Keywords 6 minutes walking test B-lines Brinkman index CAT scores CO concentration Destroyed lung Ginseng extract Nebulizer Post TB Pulmonary. OAT yang efektif persediaannya terbatas, sehingga epidemi MDR-TB akan mengancam Program . Di Jawa Barat angka prevalensi TB paru BTA (+) pada tahun / untuk semua golongan .. Konas VIII PDPI, Malang, Juli
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Pengaturan Strategi Nasional Pengendalian Tuberkulosis Tahun bertujuan .. Persentase kasus baru TB paru (BTA positif) yang ditemukan. This guideline module is for use in caring for patients with TB disease and Tuberculosis infection control in the era of expanding HIV care and. Divisi Respirologi dan Penyakit Kritis Paru, Departemen Ilmu Penyakit Dalam FK UGM/RSUP DR Pasien TB paru terdiagnosis klinis; Pasien TB ekstra paru.
DM is one of the most important factors that influence the occurrence worsening TB. Cahyadi A. Bretzel, M. J Respir Indo 16 1: Gonzaga, C. Multidrug resistance MDR to isoniazid and rifampicin with or without resistance to other drugs was found in 43
Bossink A. Extrapulmonary tuberculosis.
Palange P, Simonds AK, editors. Respiratory Medicine. ERS Handbook: Diagnosis and treatmnet of tuberculous pleural effusion in Chest ; Frank W. Tuberculous pleural effusion. Tuberculosis - current issues in diagnosis and management [Internet]. Available from: British Thoracic Society. BTS pleural disease guideline A quick reference guide. British Thoracic Society Report.
Diagnosis of pleural effusion: A systematic approach. American Journal Of Critical Care ;20 2: Gui X, Xiao H. Diagnosis of tuberculosis pleurisy with adenosine deaminase ADA: A systematic review and meta-analysis. Int J Clin Exp Med. Early effective drainage in treatment of loculated tuberculous pleurisy. Eur Respir J.
Kamholz SL. Pleural tuberculosis. Perhimpunan Dokter Paru Indonesia. Tidak dibedakan antara resistensi sekunder atau primer. Tabel 8. Tabel 9. Diagnosis TB Resisten. Indikator klinis yang mencurigakan seseorang menderita DR-TB adalah 1: Karena itu anamnesis riwayat penyakit dan pengobatan sangat penting. Pemeriksaan biakan dan kepekaan M.
TB harus dikerjakan. Cara konvensional memakan waktu 8 minggu. Di masa depan dengan cara PCR atau sistim luciferin-luciferase lama pemeriksaan hanya beberapa hari.
Pengobatan TB Resisten.
M DR-TB dengan data biakan dan kepekaan. Tabel Resisten terhadap. Lama terapi bln. Pertimbangkan pembedahan. Pembedahan dilakukan pada bulan ketiga terapi OAT optimal berupa reseksi lobektomi, pneumonektomi bagian paru yang rusak setelah mempertimbangkan faal paru dan keadaan umum penderita.
Efek samping cukup tinggi dan efektifitasnya belum diketahui. Kelompok risiko tinggi immunocompromised, HIV perlu mendapat regimen preventif alternatif selama 12 bulan sedangkan kelompok resiko rendah hanya berdasarkan permintaan sendiri selama 6 bulan atau cukup follow up klinis.
Pola resistensi sekunder dan primer pada pusat rujukan di Indonesia memperlihatkan angka yang tinggi tetapi di masyarakat angka prevalensi M DR-TB tidak diketahui, mungkin lebih rendah. Lambregts-van Weezenbeek, CSB.: Drug-resistant tuberculosis. In Wilson, R.
European Respiratory Monograph. Pedoman Penyakit Tuberkulosis dan Penanggulangannya. Departemen Kesehatan Republik Indonesia, Twenty five years trend of resistence to antituberculosis drugs in Japan. IUAT, , 61 3: Aditama, TY et al.: Pola Resistensi Kuman Tuberkulosis di Indonesia.
Perhimpunan Dokter Paru Indonesia, Aditama, TY.: Diagnosis, terapi dan masalahnya. Aditama TY, Wijanarko P: J Respir Indo 16 1: Jawa Barat: September Santoso, DK. Paru, , 4: Data dari BP-4 Bandung, Bretzel, M. Aziz, U. Wendl-Richter, F. Adatu, T. Aisu, A. To determine the prevalence of primary and acquired anti-tuberculosis drug resistance in Uganda. A representative random sampling of individual patients was chosen as sampling procedure.
Altogether smear-positive TB patients new cases and 49 previously treated cases were included in the survey. For primary resistance the results were as follows: According to these data the NTLP Uganda has been effective in preventing high levels of primary drug resistance.
Kenyon, M. J Mwasekaga, R.
Huebner, D. Rumisha, N. Binkin, E. Int J Tuberc Lung Dis ; 3 1: To determine prevalence of and risk factors for drug-resistant tuberculosis in an epidemic setting.
Systematic national random survey of newly diagnosed pulmonary TB and all patients with TB requiring retreatment during Interviews were conducted, human immunodeficiency virus HIV testing was offered, and drug susceptibility testing was performed for isoniazid, rifampicin, streptomycin and ethambutol. Resistance to at least one drug was identified in 16 3. One 0. Of patients tested for HIV, Drug susceptibility of Mycobacterium tuberculosis in a rural area of Bangladesh and its relevance to the national treatment regimens.
Van Deun, K. Aung, S. Chowdhury, S. Saha, A. Pankaj, A. Ashraf, L. Rigouts, K. Fissette, F. Int J Tuberc Lung Dis ; 3 2: To determine the prevalence of initial and acquired drug resistance of Mycobacterium tuberculosis , and to assess the appropriateness of the NTP's standard regimens. 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. Initial resistance to isoniazid H was 5.
Acquired H and R resistance were The prevalence of drug resistance is surprisingly low in Bangladesh, but could rise with improving economic conditions. The NTP regimens for smear-positive cases are appropriate, all the more so since the human immunodeficiency virus is virtually absent. Indications for the retreatment regimen should be extended to include all patients treated for at least one month with any drug. Drug-resistant strains of Mycobacterium tuberculosis isolated in Russia.
Stepanshina, E. Panfertsev, O.
Korobova, I. Shemyakin, Yu G. Stepanshin, I. Medvedeva, I. To analyze drug-resistant clinical isolates of Mycobacterium tuberculosis obtained from patients referred to the institute from different parts of Russia, and to study the mechanisms of their rifampicin resistance.
Fifty clinical isolates of M. Polymerase chain reaction PCR and sequencing were used to study the mechanisms of rifampicin resistance in 25 isolates. Among cultures isolated from 50 patients, drug resistance was detected in Most of the isolates were resistant to rifampicin 25 isolates , isoniazid 14 isolates , and streptomycin seven isolates.
Susceptible isolates were derived from 17 patients. A number of previously unrecognised genetic modifications in the rpoB region were found in rifampicin-resistant strains isolated from patients from different parts of Russia. Outbreak of multiple drug-resistant tuberculosis in Lisbon: Portugal, M. Covas, L. Brum, M. Viveiros, P. Ferrinho, J. Moniz-Pereira, H. Detection of transmission of MDR-TB strains and epidemic outbreaks in several hospital units in the city of Lisbon, including a prison hospital.
Use of restriction fragment length polymorphism RFLP to fingerprint isolates of Mycobacterium tuberculosis resistant to isoniazid, rifampicin, and one other drug. Strains from this cluster were resistant to isoniazid, rifampicin, streptomycin, and sometimes ethambutol. A retrospective epidemiological investigation was conducted with respect to all patients in cluster A, and epidemiological links were established between them.
Moreover, the predominant MDR-TB clustered strains were not confined to HIV-infected individuals, as they were also isolated in some immunocompetent patients. Phase II trial of recombinant interferon- a 2b in patients with advanced intractable multidrug-resistant pulmonary tuberculosis: Palmero, K. Eiguchi, P. Rendo, L.
Castro Zorrilla, E. Abbate, L. Multidrug-resistant tuberculosis patients without human immunodeficiency virus HIV infection, with Mycobacterium tuberculosis resistant to almost all of the available drugs. Limited phase II trial with recombinant interferon- a 2b in five chronic multidrug-resistant tuberculosis patients.
Three million units of r-IFN- a 2b were administered subcutaneously every week for 12 weeks. Before and after treatment, and during a month follow-up period, the patients underwent clinical and radiological examination, together with bacteriological, immunological and routine laboratory testing.
Two of the five patients became long-term sputum smear and culture negative after r-IFN- a 2b therapy; one of the patients showed clinical improvement and negative smear after therapy, but remained culture positive. The other two patients showed no response. The results of this trial suggest that r-IFN a 2b should be evaluated further in multidrug-resistant tuberculosis in prospective controlled trials.
The prevalence of Mycobacterium tuberculosis drug resistance in New Caledonia, P. Duval, H. Levenes, F. Study of the susceptibility to anti-tuberculosis drugs of Mycobacterium tuberculosis strains isolated in New Caledonia, a French South Pacific Territory, where tuberculosis continues to be a public health problem.
To assess the stability of this susceptibility in order to justify both non-systematic susceptibility testing and the implementation of simplified chemotherapy regimens. Over a period of nearly 2 years , every new case of tuberculosis confirmed by the laboratory was included in the study. A total of strains were tested against five anti-tuberculosis drugs: No primary drug resistance was detected for the main drugs.
One strain with acquired resistance to isoniazid and streptomycin was isolated from one of the 12 patients suffering a relapse of the disease. The results of this exhaustive study justify the non-systematic approach to susceptibility testing for new patients.
However, for strains isolated from patients suffering from relapse or therapeutic failure, or who belong to a high risk population, drug susceptibility testing should be performed.
This kind of management will aid in the detection of possible isoniazid and streptomycin resistance, thus avoiding the selection and possible emergence of strains resistant to rifampicin. The results of the study argue for the use of a fixed dose regimen using triple combination tablets of isoniazid, rifampicin and pyrazinamide HRZ for 2 months, followed by dual drug therapy HR for 4 months.
In adequacy of the current WHO re-treatment regimen in a central Siberian prison: Kimerling, H. Kluge, N. Vezhnina, T. Iacovazzi, T. Demeulenaere, F. Portaels, F. Among patients December - March , initial resistance to isoniazid and rifampin is Such a rate is a warning call to reconsider prison control strategies, and importantly, to address the treatment regimens necessary to combat an institutional epidemic of MDR-TB.
Mendoza, A. Gonzaga, C.
Roa, M. Velmonte, M. Jorge, J. Montoya, T. Torres, M. Ong, M. Barez, C. To determine the nature of drug resistance among patients with pulmonary tuberculosis PTB , and to establish clinical predictors of drug-resistant tuberculosis.
Descriptive, prospective study. Patients with positive culture for Mycobacterium tuberculosis were interviewed regarding past history of anti-tuberculosis treatment, BCG vaccination, chest X-ray and family contact. Pyrazinamide PZA susceptibility test was done with standard laboratory powder in 7H10 media.
Of the M. The chance of developing MDR-TB was significantly increased when inadequate prior treatment was given for more than 3 months. Moss, D. Alland, E. Telzak, D. Hewlett Jr. Sharp, P. Chiliade, V. LaBombardi, D. Kabus, B. Hanna, L. Palumbo, K. Brudney, A. Weltman, K. Stoeckle, K. Chirgwin, M. Simberkoff, S. Moghazeh, W. Eisner, M. Lutfey, B. Incident patients with active tuberculosis TB resistant to two or more drugs in New York City hospitals in We also compared strain W with other strains frequently observed in New York.
Blinded retrospective sutdy of stored M. We found cultures with the strain W fingerprint and 8 variants in 21 hospitals among incident patients hospitalized in Almost all isolates were resistant to four first-line drugs and kanamycin. The cluster is the most drug-ressitant cluster identified in New York and the largest IS fingerprint cluster identified anywhere to date.
Because recommended four-drug therapy will not sterilise this very resistant strain, there was a city-wide nosocomial outbreak of W-strain TB in the early s among New York AIDS patients.
Other frequently seen strains were either also very resistant, or, surprisingly, pansusceptible. Viskum, A. All bacteriologically confirmed new cases of tuberculosis and treatment relapses in Denmark are examined for drug resistance. In the years , nine cases of multidrug-resistant tuberculosis MDR TB , all acquired outside Denmark, were identified among cases of tuberculosis.
To examine incidence, treatment and prognosis for patients with tuberculosis due to MDR Mycobacterium tuberculosis. Retrospective evaluation of routine data. Multidrug resistance was present in less than one percent of patients with tuberculosis.
One patient died from tuberculosis without revision of treatment, and eight patients responded favourably to a regimen of pyrazinamide, streptomycin or amikacin, ofloxacin and cycloserine.
In two patients, this regimen was supplemented with para-aminosalicylic acid and thiacetazone respectively. All patients needed prolonged hospitalization and had observed treatment.
It is possible to cure such patients, but it is a lengthy and expensive process. It is expected that similar cases will be imported into the country and that they will occur within Denmark in the future. Kim, G.