title: Beyond multidrug-resistant tuberculosis in Europe: a TBNET study.
abstract: The emergence of drug-resistant tuberculosis (TB) is a challenge to TB control in Europe. We evaluated second-line drug susceptibility testing in Mycobacterium tuberculosis isolates from patients with multidrug-resistant, pre-extensively drug-resistant (pre-XDR-TB) and XDR-TB at 23 TBNET sites in 16 European countries. Over 30% of bacilli from patients with pre-XDR-TB showed resistance to any fluoroquinolone and almost 70% to any second-line injectable drug. Respectively >90% and >80% of the XDR-TB strains tested showed phenotypic resistance to pyrazinamide and ethambutol. Resistance to prothionamide/ethionamide was high in bacilli from pre-XDR-TB patients (43%) and XDR-TB patients (49%).
authors.affiliation: Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Borstel, Germany; Department of Medicine, University of Namibia School of Medicine, Windhoek, Namibia.
authors.forename: G
authors.initials: G
authors.lastname: Günther
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van Leth
authors.affiliation: Hospital Universitari Vall d'Hebron, Barcelona, Spain; Investigació i Recerca en Atenció Primària Jordi Gol, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Altet
authors.affiliation: Heart of England Foundation Trust, Birmingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Dedicoat
authors.affiliation: Centro Hospitalar de Vila Nova Gaia/Espinho, Vila Nova Gaia, Portugal; EpiUnit, Institute of Public Health, Medical School Porto University, Porto, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Duarte
authors.affiliation: L Spallanzani National Institute for Infectious Diseases, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gualano
authors.affiliation: Heart of England Foundation Trust, Birmingham, UK; Queen Mary University, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Kunst
authors.affiliation: St Pieter University Medical Centre, Brussels, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Muylle
authors.affiliation: Marius-Nasta-Institut, Bucharest, Romania.
authors.forename: V
authors.initials: V
authors.lastname: Spinu
authors.affiliation: Azienda Ospedaliera di Valtellina e Valchiavenna E Morelli Hospital, Reference Hospital for MDR and HIV-TB, Sondalo, Italy; Department of Infection, Barts Health NHS Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tiberi
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: P
authors.initials: P
authors.lastname: Viiklepp
authors.affiliation: Division of Clinical Infectious Diseases and German Center for Infection Research Tuberculosis Unit, Research Center Borstel, Borstel, Germany; Department of Medicine, University of Namibia School of Medicine, Windhoek, Namibia; Department of Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Lange
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004977:Ethambutol / Q000627:therapeutic use; D005000:Ethionamide / Q000627:therapeutic use; D005060:Europe; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011718:Pyrazinamide / Q000627:therapeutic use
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones; D011718:Pyrazinamide; D004977:Ethambutol; D005000:Ethionamide