title: Extensively drug-resistant tuberculosis.
abstract: Extensively drug-resistant tuberculosis (XDR-TB) is defined as Mycobacterium tuberculosis infection that is resistant to isoniazid, rifampin, any fluoroquinolone, and any injectable drug (amynoglicosides or polypetides). Although initially described in South Africa, it has emerged as a global threat, and cases have been reported from several countries, including the United States. XDR-TB has emerged mainly as a consequence of previous inadequate or poorly administered treatment, from failure of the public health infrastructure. As the diagnosis of this condition requires antibiotic susceptibility confirmation, a broad network of reference laboratories and the development of faster and more accurate tests for the identification of active cases of tuberculosis are urgently required. The treatment of XDR-TB is challenging and requires the use of multiple second-line drugs and, potentially, surgery. Infection control measures do not differ from those used for susceptible cases but may require more stringent application.
authors.affiliation: Section of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE 68198-8106, USA. mmadariaga@unmc.edu
authors.forename: Miguel G
authors.initials: MG
authors.lastname: Madariaga
authors.forename: Umesh G
authors.initials: UG
authors.lastname: Lalloo
authors.forename: Susan
authors.initials: S
authors.lastname: Swindells
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D054908:Extensively Drug-Resistant Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D038622:Internationality
chemical_list: D000995:Antitubercular Agents