title: Management of emerging multidrug-resistant tuberculosis in a low-prevalence setting.
abstract: Multidrug-resistant (MDR) tuberculosis (TB) is an emerging concern in communities with a low TB prevalence and a high standard of public health. Twenty-three consecutive adult MDR TB patients who were treated at our institution between 2007 and 2013 were reviewed for demographic characteristics and anti-TB treatment management, which included surgical procedures and long-term patient follow-up. This report of our experience emphasizes the need for an individualized approach as MDR TB brings mycobacterial disease management to a higher level of expertise, and for a balance to be found between international current guidelines and patient-tailored treatment strategies.
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Service de Pneumologie et Allergologie Pédiatriques, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France.
authors.forename: G
authors.initials: G
authors.lastname: Catho
authors.affiliation: Service de Pneumologie et Oncologie Thoracique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: S
authors.initials: S
authors.lastname: Couraud
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Grard
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bouaziz
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Sénéchal
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Valour
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: T
authors.initials: T
authors.lastname: Perpoint
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Braun
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Biron
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Inserm U1111 CIRI, Université Claude Bernard Lyon I, Lyon, France.
authors.forename: T
authors.initials: T
authors.lastname: Ferry
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Chidiac
authors.affiliation: Service de Pneumologie et Oncologie Thoracique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: N
authors.initials: N
authors.lastname: Freymond
authors.affiliation: Service de Pneumologie et Oncologie Thoracique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: E
authors.initials: E
authors.lastname: Perrot
authors.affiliation: Service de Pneumologie et Oncologie Thoracique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: P-J
authors.initials: PJ
authors.lastname: Souquet
authors.affiliation: Departement de Chirurgie Thoracique, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Maury
authors.affiliation: Departement de Chirurgie Thoracique, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.
authors.forename: F
authors.initials: F
authors.lastname: Tronc
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de Bactériologie-Hygiène, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France; UPMC, INSERM, Centre d'Immunologie et des Maladies Infectieuses, E13, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Veziris
authors.affiliation: Inserm U1111 CIRI, Université Claude Bernard Lyon I, Lyon, France; Laboratoire de Microbiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: G
authors.initials: G
authors.lastname: Lina
authors.affiliation: Inserm U1111 CIRI, Université Claude Bernard Lyon I, Lyon, France; Laboratoire de Microbiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.
authors.forename: O
authors.initials: O
authors.lastname: Dumitrescu
authors.affiliation: Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Inserm U1111 CIRI, Université Claude Bernard Lyon I, Lyon, France. Electronic address: florence.ader@chu-lyon.fr.
authors.forename: F
authors.initials: F
authors.lastname: Ader
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D019090:Case Management / Q000458:organization & administration*; D021821:Communicable Diseases, Emerging / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D057285:Precision Medicine / Q000379:methods; D015995:Prevalence; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents
keywords: Bedaquiline; MDR TB surgery; Mycobacterium tuberculosis; multidrug-resistant tuberculosis; negative-pressure ventilation room