Pre-extensively Drug-Resistant Congenital Tuberculosis in an Extremely Premature Baby

Alison Boast; Jeu Ann How; Charis Lau; Arun Sett; Damien Gilby; Andrew Burke; Brett McWhinney; Connor Wright; Adrian Tramontana; Maria Globan; Justin Denholm; Stephen M Graham; Joshua Osowicki

doi:10.1093/cid/ciad540

Pre-extensively Drug-Resistant Congenital Tuberculosis in an Extremely Premature Baby

Clin Infect Dis. 2024 Jan 25;78(1):149-153. doi: 10.1093/cid/ciad540.

Authors

Alison Boast^{1

2

3}, Jeu Ann How⁴, Charis Lau^{4

5}, Arun Sett^{6

7

8}, Damien Gilby⁴, Andrew Burke^{9

10}, Brett McWhinney¹¹, Connor Wright¹², Adrian Tramontana¹², Maria Globan¹³, Justin Denholm^{14

15}, Stephen M Graham¹, Joshua Osowicki^{1

2

16}

Affiliations

¹ Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
² Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
³ Antimicrobials Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁴ Newborn Services, Joan Kirner Women's and Children's Hospital, St Albans, Victoria, Australia.
⁵ Pharmacy Department, Joan Kirner Women's and Children's Hospital, St Albans, Victoria, Australia.
⁶ Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.
⁷ Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.
⁸ Centre of Research Excellence in Newborn Medicine, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁹ Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
¹⁰ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
¹¹ Department of Chemical Pathology, Pathology Queensland, Queensland Health, Herston, Australia.
¹² Department of Infectious Diseases, Western Health, St Albans, Victoria, Australia.
¹³ Mycobacterium Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, at the Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia.
¹⁴ Victorian Tuberculosis Program, Melbourne Health, Parkville, Victoria, Australia.
¹⁵ Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
¹⁶ Tropical Diseases Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Abstract

We describe a case of congenital tuberculosis in an extremely premature baby, with rapid molecular detection of a pre-extensively drug-resistant (XDR) pattern of drug resistance. The baby was treated successfully with a regimen including bedaquline and delamanid, drugs not previously described in the treatment of congenital tuberculosis (TB).

Keywords: congenital tuberculosis; multidrug resistant; neonate; premature; therapeutic drug monitoring.

Publication types

Case Reports

MeSH terms

Antitubercular Agents / pharmacology
Antitubercular Agents / therapeutic use
Drug Resistance, Multiple, Bacterial
Extensively Drug-Resistant Tuberculosis* / drug therapy
Humans
Microbial Sensitivity Tests
Mycobacterium tuberculosis* / genetics
Tuberculosis, Multidrug-Resistant* / diagnosis
Tuberculosis, Multidrug-Resistant* / drug therapy
Tuberculosis, Pulmonary* / diagnosis
Tuberculosis, Pulmonary* / drug therapy

Substances

Antitubercular Agents