The spread of drug-resistant tuberculosis in children: an Italian case series.
Drug-resistant paediatric tuberculosis (TB) is an overlooked global problem. In Italy, the epidemiology of TB has recently changed and data regarding drug-resistant forms in the paediatric setting is scanty. The aim of this case series was to report the cases of drug-resistant TB, diagnosed between June 2006 and July 2010 in four Italian tertiary centres for paediatric infectious diseases, in children and adolescents living in Italy. Twenty-two children were enrolled, of these 17 were resistant to one or more drugs and five had multidrug-resistant TB. All but one child were either foreign born or had at least one foreign parent. Twenty-one patients completed their treatment without clinical or radiological signs of activity at the end of treatment, and one patient was lost to follow up. The outcomes were good, with few adverse effects using second-line anti-TB drugs. Although this series is limited, it might already reflect the worrisome increase of drug-resistant TB, even in childhood.
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Mignone
TB Reference Centre/Villa Marelli Institute, Department of Pneumology, Niguarda Hospital, Milan,Italy.
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Codecasa
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Scolfaro
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Raffaldi
Paediatrics and Infectious Disease Unit, Ospedale Pediatrico Bambino Gesù, Rome,Italy.
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Lancella
TB Reference Centre/Villa Marelli Institute, Department of Pneumology, Niguarda Hospital, Milan,Italy.
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Ferrarese
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Garazzino
Paediatrics and Infectious Disease Unit, Ospedale Pediatrico Bambino Gesù, Rome,Italy.
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Marabotto
Department of Maternal and Paediatric Sciences,Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Milan,Italy.
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Esposito
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Gabiano
TB Reference Centre/Villa Marelli Institute, Department of Paediatrics, Niguarda Hospital, Milan,Italy.
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Lipreri
Department of Paediatrics, Infectious Diseases Unit,University of Turin,Regina Margherita Children's Hospital, Turin,Italy.
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Tovo
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission
D000995:Antitubercular Agents