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Case Reports
. 2018 Mar 22;51(3):1702490.
doi: 10.1183/13993003.02490-2017. Print 2018 Mar.

Cross border, highly individualised treatment of a patient with challenging extensively drug-resistant tuberculosis

Onno W Akkerman  1   2   3 , Floris Grasmeijer  4   3 , Wiel C M de Lange  5   2 , Huib A M Kerstjens  5 , Gerard de Vries  6   7 , Mathieu S Bolhuis  8 , Jan-Willem Alffenaar  8 , Henderik W Frijlink  4 , Grace Smith  9 , Roger Gajraj  10 , Rina de Zwaan  11 , Paul Hagedoorn  4 , Martin Dedicoat  12 , Dick van Soolingen  11   13 , Tjip S van der Werf  5   14
Affiliations
Case Reports

Cross border, highly individualised treatment of a patient with challenging extensively drug-resistant tuberculosis

Onno W Akkerman et al. Eur Respir J. .

Abstract

Crossing borders by treating a patient with difficult to treat XDR-TB; highly individualised but holistic approach http://ow.ly/JyjK30ielsD

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Conflict of interest statement

Conflict of interest: F. Grasmeijer reports part time employment by PureIMS BV, outside the submitted work. Conflict of interest: H.W. Frijlink has a patent for a breath actuated dry powder inhaler (number WO 2015/187025 A1) pending. Conflict of interest: P. Hagedoorn has a patent pending and is co-inventor of Twincer. Conflict of interest: T.S. van der Werf was principal investigator of the RUTI therapeutic vaccine trial, sponsored in part by Archivel, Badelona, Spain; and participated in a meeting organised and sponsored by TBVI in June, 2016, and in a meeting organised by TBVI and sponsored by Transgene−Institut Merieux France, in November 2017.

Figures

FIGURE 1
FIGURE 1
Timeline including the pharmaco-therapeutic treatment, sputum test results and results of drug susceptibility testing for the treatment in a) the UK and b) the Netherlands. #: disputed mutation encoding low level rifampicin resistance; : mixed wild-type/mutant; §: mixed second mutation in the rpoB gene encoding high level rifampicin resistance found after isolation of colonies on agar containing a high concentration of rifampicin or amikacin. S: susceptible; R: resistant; I: intermediate resistant; +: positive; −: negative; DPI: dry powder inhalation; DOT: directly observed therapy.
See this image and copyright information in PMC

References

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    1. Sotgiu G, Centis R, D'Ambrosio L, et al. . Linezolid to treat extensively drug-resistant TB: retrospective data are confirmed by experimental evidence. Eur Respir J 2013; 42: 288–290. - PubMed
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    1. van Klingeren B, Dessens-Kroon M, van der Laan T, et al. . Drug susceptibility testing of Mycobacterium tuberculosis complex by use of a high-throughput, reproducible, absolute concentration method. J Clin Microbiol 2007; 45: 2662–2668. - PMC - PubMed
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