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Article ; Online: Reply to Upton et al.

Kempker, Russell R / Kipiani, Maia / Peloquin, Charles A

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2023 Volume 77, Issue 1, Page(s) 158–159

Language	English
Publishing date	2023-03-23
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciad188
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Article ; Online: Time to Review the Infectious Diseases Society of America Diabetic Foot Infection Classification System and Merge the Moderate and Severe Infection Categories?

Schechter, Marcos Coutinho / Kempker, Russell R

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2019 Volume 71, Issue 1, Page(s) 241

MeSH term(s)	Communicable Diseases ; Diabetes Mellitus ; Diabetic Foot ; Humans ; Osteomyelitis
Language	English
Publishing date	2019-10-22
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciz923
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Article ; Online: Brief Report: Financial Burden of Toxoplasmosis Encephalitis Treatment at a Safety Net Hospital.

Bogard, Sherri N / Lee, James T / Patel, Manish / Kempker, Russell R

Journal of acquired immune deficiency syndromes (1999)

2022 Volume 91, Issue 3, Page(s) 276–279

Abstract: Background: Although the price increase of pyrimethamine in 2015 received heavy media coverage, there are little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE).: ... ...

Abstract	Background: Although the price increase of pyrimethamine in 2015 received heavy media coverage, there are little data regarding specific implications to hospitals and the total costs of treating inpatients with toxoplasmosis encephalitis (TE). Methods: Using average drug wholesale costs, we estimated the inpatient drug costs of TE drugs 3 years prepyrimethamine and postpyrimethamine price increase in August 2015. The drug regimens and total doses were determined through retrospective chart review of patients living with HIV who received treatment for TE while inpatient during this period. Results: The 3-year pre-increase TE drug costs for 66 admissions were estimated at $50,310 compared with a total drug cost of $1,026,006 for 61 admissions postincrease. Pyrimethamine made up 98% of the drug costs postincrease, compared with 57% pre-increase. Pyrimethamine-based regimens were the most frequently used throughout the study period. Conclusions: The price increase of pyrimethamine in 2015 led to a substantial and unnecessary financial burden to hospitals. This required health care systems to shift valuable resources to continue to provide medications to a vulnerable patient population. There has been more focus on providing high-value care in recent years. Our study highlights the need for further examination of pharmaceutical companies' arbitrary determination of medication costs and how they contribute to patient care.
MeSH term(s)	Encephalitis ; Financial Stress ; HIV Infections/drug therapy ; Humans ; Pharmaceutical Preparations ; Pyrimethamine/therapeutic use ; Retrospective Studies ; Safety-net Providers ; Toxoplasmosis, Cerebral/chemically induced ; Toxoplasmosis, Cerebral/drug therapy
Chemical Substances	Pharmaceutical Preparations ; Pyrimethamine (Z3614QOX8W)
Language	English
Publishing date	2022-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000003054
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Article ; Online: Global Health and the Infectious Diseases Physician-Scientist Workforce.

Kempker, Russell R / Blumberg, Henry M

The Journal of infectious diseases

2018 Volume 219, Issue 6, Page(s) 1007–1008

MeSH term(s)	Biomedical Research ; Global Health ; Humans ; Physicians ; Workforce
Language	English
Publishing date	2018-10-03
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiy593
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Article ; Online: Minimum inhibitory concentrations of rifampin and isoniazid among multidrug and isoniazid resistant Mycobacterium tuberculosis in Ethiopia.

Getahun, Muluwork / Blumberg, Henry M / Ameni, Gobena / Beyene, Dereje / Kempker, Russell R

PloS one

2022 Volume 17, Issue 9, Page(s) e0274426

Abstract: Introduction: Traditionally, single critical concentrations of drugs are utilized for Mycobacterium tuberculosis (Mtb) drug susceptibility testing (DST); however, the level of drug resistance can impact treatment choices and outcomes. Mutations at the ... ...

Abstract	Introduction: Traditionally, single critical concentrations of drugs are utilized for Mycobacterium tuberculosis (Mtb) drug susceptibility testing (DST); however, the level of drug resistance can impact treatment choices and outcomes. Mutations at the katG gene are the major genetic mutations in multidrug resistant (MDR) Mtb and usually associated with high level resistance. We assessed the minimum inhibitory concentrations (MICs) of MDR or rifampin resistant (RR) and isoniazid (INH) resistant Mtb isolates to determine the quantification of drug resistance among key anti-tuberculosis drugs. Methods: The study was conducted on stored Mtb isolates collected as part of a national drug resistance survey in Ethiopia. MIC values were determined using Sensititre™ MYCOTB plates. A line probe assay (MTBDRplus) was also performed to identify genetic determinants of resistance for all isolates. Results: MIC testing was performed on 74 Mtb isolates including 46 MDR, 2 RR and 26 INH phenotypically resistant isolates as determined by the Löwenstein Jensen (LJ) method. Four (15%) INH resistant Mtb isolates were detected as borderline rifampin resistance (MIC = 1 μg/ml) using MYCOTB MIC plates and no rifampin resistance mutations were detected by LPA. Among the 48 MDR/RR TB cases, 9 (19%) were rifabutin susceptible (MIC was between ≤0.25 and 0.5μg/ml). Additionally, the MIC for isoniazid was between 2-4 μg/ml (moderate resistance) for 58% of MDR TB isolates and 95.6% (n = 25) of the isolates had mutations at the katG gene. Conclusion: Our findings suggest a role for rifabutin treatment in a subset of RR TB patients, thus potentially preserving an important drug class. The high proportion of moderate level INH resistant among MDR Mtb isolates indicates the potential benefit of high dose isoniazid treatment in a high proportion of katG gene harboring MDR Mtb isolates.
MeSH term(s)	Ethiopia ; Humans ; Isoniazid/pharmacology ; Isoniazid/therapeutic use ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; Rifabutin ; Rifampin/pharmacology ; Rifampin/therapeutic use ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/microbiology
Chemical Substances	Rifabutin (1W306TDA6S) ; Isoniazid (V83O1VOZ8L) ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2022-09-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0274426
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Article ; Online: Reply to Chang et al., "Pyrazinamide Is a Two-Edged Sword: Do WHO Guidelines Matter?"

Peloquin, Charles A / Kempker, Russell R

Antimicrobial agents and chemotherapy

2017 Volume 62, Issue 1

MeSH term(s)	Antitubercular Agents/therapeutic use ; Drug Resistance, Bacterial/drug effects ; Drug Resistance, Bacterial/genetics ; Humans ; Pyrazinamide/therapeutic use ; World Health Organization
Chemical Substances	Antitubercular Agents ; Pyrazinamide (2KNI5N06TI)
Language	English
Publishing date	2017-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.01937-17
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Einzelsignatur: Show issues

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Article ; Online: Updated considerations in the diagnosis and management of tuberculosis infection and disease: integrating the latest evidence-based strategies.

Graciaa, Daniel S / Schechter, Marcos Coutinho / Fetalvero, Krystle B / Cranmer, Lisa Marie / Kempker, Russell R / Castro, Kenneth G

Expert review of anti-infective therapy

2023 Volume 21, Issue 6, Page(s) 595–616

Abstract: Introduction: Tuberculosis (TB) is a leading infectious cause of global morbidity and mortality, affecting nearly a quarter of the human population and accounting for over 10 million deaths each year. Over the past several decades, TB incidence and ... ...

Abstract	Introduction: Tuberculosis (TB) is a leading infectious cause of global morbidity and mortality, affecting nearly a quarter of the human population and accounting for over 10 million deaths each year. Over the past several decades, TB incidence and mortality have gradually declined, but 2021 marked a threatening reversal of this trend highlighting the importance of accurate diagnosis and effective treatment of all forms of TB. Areas covered: This review summarizes advances in TB diagnostics, addresses the treatment of people with TB infection and TB disease including recent evidence for treatment regimens for drug-susceptible and drug-resistant TB, and draws attention to special considerations in children and during pregnancy. Expert opinion: Improvements in diagnosis and management of TB have expanded the available options for TB control. Molecular testing has enhanced the detection of TB disease, but better diagnostics are still needed, particularly for certain populations such as children. Novel treatment regimens have shortened treatment and improved outcomes for people with TB. However, important questions remain regarding the optimal management of TB. Work must continue to ensure the potential of the latest developments is realized for all people affected by TB.
MeSH term(s)	Child ; Humans ; Antitubercular Agents/therapeutic use ; Tuberculosis/epidemiology ; Tuberculosis, Multidrug-Resistant/drug therapy ; Latent Tuberculosis/drug therapy ; Antigens, Bacterial
Chemical Substances	Antitubercular Agents ; Antigens, Bacterial
Language	English
Publishing date	2023-05-08
Publishing country	England
Document type	Review ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2023.2207820
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Article ; Online: Hospital Onset Varicella Central Nervous System Vasculitis in a Patient with HIV Infection.

Harrington, Kristin R V / Rhyner, Patricia / Kempker, Russell R

AIDS research and human retroviruses

2019 Volume 35, Issue 4, Page(s) 357–358

MeSH term(s)	Adult ; Chickenpox/cerebrospinal fluid ; Chickenpox/complications ; Chickenpox/diagnosis ; HIV Infections/complications ; Hospitals ; Humans ; Magnetic Resonance Imaging ; Male ; Vasculitis, Central Nervous System/diagnostic imaging ; Vasculitis, Central Nervous System/virology
Language	English
Publishing date	2019-02-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	639130-8
ISSN	1931-8405 ; 0889-2229
ISSN (online)	1931-8405
ISSN	0889-2229
DOI	10.1089/aid.2018.0262
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Article ; Online: Diagnostic performance of the GenoType MTBDRplus VER 2.0 line probe assay for the detection of isoniazid resistant Mycobacterium tuberculosis in Ethiopia.

Moga, Shewki / Bobosha, Kidist / Fikadu, Dinka / Zerihun, Betselot / Diriba, Getu / Amare, Misikir / Kempker, Russell R / Blumberg, Henry M / Abebe, Tamrat

PloS one

2023 Volume 18, Issue 4, Page(s) e0284737

Abstract: Background: Isoniazid (INH) resistant Mycobacterium tuberculosis (Hr-TB) is the most common type of drug resistant TB, and is defined as M tuberculosis complex (MTBC) strains resistant to INH but susceptible to rifampicin (RIF). Resistance to INH ... ...

Abstract	Background: Isoniazid (INH) resistant Mycobacterium tuberculosis (Hr-TB) is the most common type of drug resistant TB, and is defined as M tuberculosis complex (MTBC) strains resistant to INH but susceptible to rifampicin (RIF). Resistance to INH precedes RIF resistance in almost all multidrug resistant TB (MDR-TB) cases, across all MTBC lineages and in all settings. Therefore, early detection of Hr-TB is critical to ensure rapid initiation of appropriate treatment, and to prevent progression to MDR-TB. We assessed the performance of the GenoType MTBDRplus VER 2.0 line probe assay (LPA) in detecting isoniazid resistance among MTBC clinical isolates. Methods: A retrospective study was conducted among M. tuberculosis complex (MTBC) clinical isolates obtained from the third-round Ethiopian national drug resistance survey (DRS) conducted between August 2017 and December 2019. The sensitivity, specificity, positive predictive value, and negative predictive value of the GenoType MTBDRplus VER 2.0 LPA in detecting INH resistance were assessed and compared to phenotypic drug susceptibility testing (DST) using the Mycobacteria Growth Indicator Tube (MGIT) system. Fisher's exact test was performed to compare the performance of LPA between Hr-TB and MDR-TB isolates. Results: A total of 137 MTBC isolates were included, of those 62 were Hr-TB, 35 were MDR-TB and 40 were INH susceptible. The sensitivity of the GenoType MTBDRplus VER 2.0 for detecting INH resistance was 77.4% (95% CI: 65.5-86.2) among Hr-TB isolates and 94.3% (95% CI: 80.4-99.4) among MDR-TB isolates (P = 0.04). The specificity of the GenoType MTBDRplus VER 2.0 for detecting INH resistance was 100% (95% CI: 89.6-100). The katG 315 mutation was observed in 71% (n = 44) of Hr-TB phenotypes and 94.3% (n = 33) of MDR-TB phenotypes. Mutation at position-15 of the inhA promoter region alone was detected in four (6.5%) Hr-TB isolates, and concomitantly with katG 315 mutation in one (2.9%) MDR-TB isolate. Conclusions: GenoType MTBDRplus VER 2.0 LPA demonstrated improved performance in detecting INH resistance among MDR-TB cases compared to Hr-TB cases. The katG315 mutation is the most common INH resistance conferring gene among Hr-TB and MDR-TB isolates. Additional INH resistance conferring mutations should be evaluated to improve the sensitivity of the GenoType MTBDRplus VER 2.0 for the detection of INH resistance among Hr-TB cases.
MeSH term(s)	Humans ; Isoniazid/pharmacology ; Isoniazid/therapeutic use ; Antitubercular Agents/pharmacology ; Antitubercular Agents/therapeutic use ; Mycobacterium tuberculosis/genetics ; Ethiopia/epidemiology ; Microbial Sensitivity Tests ; Retrospective Studies ; Tuberculosis, Multidrug-Resistant/diagnosis ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/microbiology ; Rifampin/pharmacology ; Rifampin/therapeutic use ; Genotype ; Mutation
Chemical Substances	Isoniazid (V83O1VOZ8L) ; Antitubercular Agents ; Rifampin (VJT6J7R4TR)
Language	English
Publishing date	2023-04-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0284737
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Article: HIV co-infection increases the risk of post-tuberculosis mortality among persons who initiated treatment for drug-resistant tuberculosis.

Salindri, Argita D / Kipiani, Maia / Lomtadze, Nino / Tukvadze, Nestani / Avaliani, Zaza / Blumberg, Henry M / Masyn, Katherine E / Rothenberg, Richard B / Kempker, Russell R / Magee, Matthew J

medRxiv : the preprint server for health sciences

2024

Abstract: Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) with post-TB mortality. We conducted a retrospective cohort ... ...

Abstract	Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) with post-TB mortality. We conducted a retrospective cohort study among persons who initiated treatment for rifampicin-resistant and multi/extensively drug-resistant (RR and M/XDR) TB reported to the country of Georgia's TB surveillance during 2009-2017. Exposures included HIV serologic status, diabetes, and HCV status. Our outcome was all-cause post-TB mortality determined by cross-validating vital status with Georgia's death registry through November 2019. We estimated adjusted hazard rate ratios (aHR) and 95% confidence intervals (CI) of post-TB mortality among participants with and without comorbidities using cause-specific hazard regressions. Among 1032 eligible participants, 34 (3.3%) died during treatment and 87 (8.7%) died post-TB treatment. Among those who died post-TB treatment, the median time to death was 21 months (interquartile range 7-39) post-TB treatment. After adjusting for confounders, the hazard rates of post-TB mortality were higher among participants with HIV co-infection (aHR=3.74, 95%CI 1.77-7.91) compared to those without HIV co-infection. In our cohort, post-TB mortality occurred most commonly in the first three years post-TB treatment. Linkage to care for common TB comorbidities post-treatment may reduce post-TB mortality rates.
Language	English
Publishing date	2024-03-26
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.05.19.23290190
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