title: Multidrug-resistant and extensively drug-resistant tuberculosis in the West. Europe and United States: epidemiology, surveillance, and control.
abstract: The emergence of multidrug-resistant (MDR) and, more recently, of extensively drug resistant (XDR) strains of Mycobacterium tuberculosis is a real threat to achieve tuberculosis (TB) control and elimination globally. More than 510,000 new cases of MDR-TB occur each year and XDR-TB cases are recognized in every setting where there has been the capacity to detect them, particularly in Eastern Europe. MDR- and XDR-TB control in Europe and the United States are heavily affected by what happens globally, as the majority of cases occurring in these countries originate in high TB-burden areas of the world. Scaling-up of culture- and drug susceptibility testing capacities and the expanded use of high-technology assays for rapid determination of resistance represent the prerequisites to achieve better control of MDR- and XDR-TB. Most cases with MDR- and XDR-TB in Europe and the United States can be treated successfully if well-designed regimens based on available second- and third-line anti-TB drugs are used and surgical options are carefully considered. Nevertheless, the development of new (more effective and less toxic) drugs to treat patients infected by MDR- and XDR-TB strains with or without active disease are urgently needed. Adherence to internationally agreed standards of care and control practices is imperative to achieve TB control.
authors.affiliation: WHO Collaborating Centre for TB and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute/TBNET Secretariat (TuBerculosis Network European Trialsgroup)/Stop TB Italy, Via Roncaccio 16, 21049, Tradate, Italy. giovannibattista.migliori@fsm.it
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Migliori
authors.forename: Morgan
authors.initials: M
authors.lastname: D'Arcy Richardson
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sotgiu
authors.forename: Christoph
authors.initials: C
authors.lastname: Lange
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D014481:United States / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents