{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:41:00Z","timestamp":1773855660680,"version":"3.50.1"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the reasons of failure in a case of pulmonary tuberculosis (PTB) after 9 years systematic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We extracted the patients' treatment history, drug susceptibility testing (DST), Computed tomography (CT) images, and sequenced the isolated strains by whole gene sequencing (WGS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although most results of the phenotypical DSTs were consistent with the genotype DST, the occurrence of gene resistance to amikacin (AMK), capreomycin (CAP), moxifloxacin (MFX) was earlier than the phenotypical DST. Based on the continuously reversed results of phenotypical DSTs, CT images in different stages and WGS, it can be confirmed that the patient was infected with two different strains of Mycobacterium tuberculosis (M.TB). Moreover, severe cavities may be another factor leading to treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Given the suggestive effect of genotype DST is earlier than the phenotypical DST, so genotype DST can play a better guiding role in patients with MDR-TB. Additionally, for patients who have not been cured for a long time, medication should be more cautious and the role of WGS in drug resistance surveillance should be fully utilized.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.966891","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T15:24:00Z","timestamp":1662477840000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case report: A 9-year systematic treatment failure of a pulmonary tuberculosis patient"],"prefix":"10.3389","volume":"10","author":[{"given":"Hui","family":"Jiang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chendi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liyi","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoguang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfeng","family":"Yin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yijia","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junnan","family":"Jia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengmin","family":"Huo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Xue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengqiu","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weimin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"eaba4901","DOI":"10.1126\/sciadv.aba4901","article-title":"Mycobacterium tuberculosis clinical isolates carry mutational signatures of host immune environments","volume":"6","author":"Liu","year":"2020","journal-title":"Sci Adv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1111\/eva.12654","article-title":"Insights into the processes that drive the evolution of drug resistance in Mycobacterium tuberculosis","volume":"11","author":"Nguyen","year":"2018","journal-title":"Evol Appl"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e3391","DOI":"10.1093\/cid\/ciaa1002","article-title":"Reduced susceptibility of Mycobacterium tuberculosis to Bedaquiline during antituberculosis treatment and its correlation with clinical outcomes in China","volume":"73","author":"Liu","year":"2021","journal-title":"Clin Infect Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e117","DOI":"10.1016\/S1473-3099(20)30148-1","article-title":"Cavitary tuberculosis: the gateway of disease transmission","volume":"20","author":"Urbanowski","year":"2020","journal-title":"Lancet Infect Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e00159","DOI":"10.1128\/CMR.00159-19","article-title":"Caseum: a niche for Mycobacterium tuberculosis drug-tolerant persisters","volume":"33","author":"Sarathy","year":"2020","journal-title":"Clin Microbiol Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e1002773","DOI":"10.1371\/journal.pmed.1002773","article-title":"Tuberculosis drugs' distribution and emergence of resistance in patient's lung lesions: a mechanistic model and tool for regimen and dose optimization","volume":"16","author":"Strydom","year":"2019","journal-title":"PLoS Med."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.966891\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T15:24:03Z","timestamp":1662477843000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.966891\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,6]]},"references-count":6,"alternative-id":["10.3389\/fpubh.2022.966891"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.966891","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,6]]},"article-number":"966891"}}