Multidrug-resistant and extensively drug-resistant tuberculosis in the West. Europe and United States: epidemiology, surveillance, and control.
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.
Migliori
Giovanni Battista
GB
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
D'Arcy Richardson
Morgan
M
Sotgiu
Giovanni
G
Lange
Christoph
C
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
D000995:Antitubercular Agents