Evidence map›Paper›PMID 39398438›Full record

ArticleIJTLD open2024

Impact of heteroresistance on treatment outcomes of people with drug-resistant TB.

R Crowder, M Kato-Maeda, B Schwem, A Dela Tonga, D M Geocaniga-Gaviola, E Lopez, C L Valdez, A R Lim, N Hunat, A G Sedusta and 20 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in IJTLD open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Heteroresistance inFrontiers in cellular and infection microbiology · 2026
    Review
  5. Observational
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

R CrowderDivision of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
M Kato-MaedaDivision of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
B SchwemUniversity of the Philippines, National Institutes of Health, Manila, Philippines.
A Dela TongaUniversity of the Philippines, National Institutes of Health, Manila, Philippines.
D M Geocaniga-GaviolaPhilippines Department of Health, Manila, Philippines.
E LopezPhilippines Department of Health, Manila, Philippines.
C L ValdezPhilippines Department of Health, Manila, Philippines.
A R LimPhilippines Department of Health, Manila, Philippines.
N HunatNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
A G SedustaNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
C A SacoponNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
G A M AtienzaNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
E BulagNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
D LimNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
J BascuñaNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
K ShahDivision of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
R P BasillioNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
C A BergerDivision of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
M C D P LopezUniversity of the Philippines, National Institutes of Health, Manila, Philippines.
S SenDepartment of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
C AllenderPathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA.
M FolkertsPathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA.
U KaraozEcology Department, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
E BrodieEcology Department, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
S MitaraiResearch Institute for Tuberculosis, Tokyo, Japan.
A M C GarfinPhilippines Department of Health, Manila, Philippines.
M C AmaNational Tuberculosis Reference Laboratory, Research Institute for Tropical Medicine, Muntinlupa, Philippines.
D M EngelthalerPathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, AZ, USA.
A CattamanchiDivision of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
R DesturaUniversity of the Philippines, National Institutes of Health, Manila, Philippines.

Funding

Improving the molecular diagnosis of drug resistant tuberculosisR01AI121144 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CATTAMANCHI, ADITHYA, KATO-MAEDA, MIDORI · 2016 to 2020
$3.6M
NIAID NIH HHS R01 AI121144
6 · The paper itself

Abstract

backgroundPoor treatment outcomes among people with drug-resistant TB (DR-TB) are a major concern. Heteroresistance (presence of susceptible and resistant

methodsWe used targeted deep sequencing to identify mutations associated with DR-TB and heteroresistance in culture samples of 624 people with DR-TB. We evaluated the association between heteroresistance and time to unfavorable treatment outcome using Cox proportional hazards regression.

resultsThe proportion of drug-resistant isolates with a known mutation conferring resistance was lower for streptomycin (45.2%) and second-line injectables (79.1%) than for fluoroquinolones (86.7%), isoniazid (93.2%) and rifampin (96.5%). Fifty-two (8.3%) had heteroresistance, and it was more common for fluoroquinolones (4.6%) than rifampin (2.2%), second-line injectables (1.4%), streptomycin (1.7%), or isoniazid (1.3%). There was no association between heteroresistance and time to unfavorable outcome among people with multidrug-resistant TB (adjusted hazard ratio [aHR] 1.74, 95% CI 0.39-7.72) or pre-extensively DR-TB (aHR 0.65, 95% CI 0.24-1.72).

conclusionsHeteroresistance was relatively common (8.3%) among people with DR-TB in the Philippines. However, we found insufficient evidence to demonstrate an impact on unfavorable treatment outcomes.

Indexed as

DR-TBDrug resistance-associated mutationstuberculosis

Identifiers

PMID39398438
PMCPMC11467852

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.