title: Management of young children in contact with an adult with drug-resistant tuberculosis, France, 2004-2008.
abstract: METHODS
  Drug-resistant tuberculosis (DR-TB) is increasing worldwide and may be a source of diagnostic and therapeutic problems in young exposed children. In France exposed children are systematically treated with 3-month isoniazid-rifampicin prophylaxis.
  
  
  OBJECTIVE
  To describe the characteristics and management of children aged <2 years in contact with an adult case of DR-TB in France over a 5-year period (2004-2008).
  
  
  METHODS
  Children were retrospectively identified by sending questionnaires to all the members of the Paediatric Infectious Diseases Group and the Paediatric Pulmonology Group of the French Paediatric Society.
  
  
  RESULTS
  Ten children, all infants, in contact with an adult case of DR-TB were identified: six cases of DR-TB (mean age 4.6 months), one case of TB infection and three cases of exposure (mean age 3.1 months). The children were mainly in contact with poly- or multidrug-resistant TB. Time to initiation of appropriate treatment was 39 days for TB disease and 58 days for TB infection or exposure. One child with TB infection developed TB disease due to failure to adapt prophylaxis. Treatment was variable and centre-dependent. Short-term follow-up showed complete recovery of all children.
  
  
  CONCLUSIONS
  Management of young children in contact with adult DR-TB requires rapid identification of the drug resistance profile. Molecular techniques should be used to reduce delays in initiating appropriate treatment.
authors.affiliation: Paediatric Unit, Centre Hospitalièr Universitaire Timone-Enfants, Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Tochon
authors.forename: E
authors.initials: E
authors.lastname: Bosdure
authors.forename: M
authors.initials: M
authors.lastname: Salles
authors.forename: C
authors.initials: C
authors.lastname: Beloncle
authors.forename: K
authors.initials: K
authors.lastname: Chadelat
authors.forename: M
authors.initials: M
authors.lastname: Dagorne
authors.forename: J
authors.initials: J
authors.lastname: Gaudelus
authors.forename: S
authors.initials: S
authors.lastname: Losi
authors.forename: M C
authors.initials: MC
authors.lastname: Renoux
authors.forename: N
authors.initials: N
authors.lastname: Veziris
authors.forename: J C
authors.initials: JC
authors.lastname: Dubus
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use*; D012189:Retrospective Studies; D012293:Rifampin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin