Drug resistant TB – latest developments in epidemiology, diagnostics and management

•DR- and MDR-TB are more frequent in contacts and patients previously treated.•Whole genome sequencing, rapid, consistent and sensitive, is very useful in outbreaks•RR/MDR-TB requires treatment with ≥4 drugs for 6–24 months.•An all oral shorter WHO course is now recommended for the treatment of RR-T...

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Vydané v:	International journal of infectious diseases Ročník 124; s. S20 - S25
Hlavní autori:	Tiberi, Simon, Utjesanovic, Natasa, Galvin, Jessica, Centis, Rosella, D'Ambrosio, Lia, van den Boom, Martin, Zumla, Alimuddin, Migliori, Giovanni Battista
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Canada Elsevier Ltd 01.11.2022 Elsevier
Predmet:	Active TB drug safety monitoring (aDSM) Adherence Antitubercular Agents - pharmacology Antitubercular Agents - therapeutic use BPaL Drug susceptibility testing (DST) Drug-resistant TB (DR-TB) Extensively Drug-Resistant Tuberculosis - diagnosis Extensively Drug-Resistant Tuberculosis - drug therapy Extensively Drug-Resistant Tuberculosis - epidemiology Humans Isoniazid - therapeutic use Mycobacterium tuberculosis - genetics Rehabilitation Rifampin - therapeutic use Treatment Guidelines Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Video Observed Therapy (VOT) WHO shorter oral regimen Adherence Treatment Guidelines BPaL Video Observed Therapy (VOT) WHO shorter oral regimen Rehabilitation Drug-resistant TB (DR-TB) Drug susceptibility testing (DST) Active TB drug safety monitoring (aDSM)
ISSN:	1201-9712, 1878-3511, 1878-3511
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Abstract	•DR- and MDR-TB are more frequent in contacts and patients previously treated.•Whole genome sequencing, rapid, consistent and sensitive, is very useful in outbreaks•RR/MDR-TB requires treatment with ≥4 drugs for 6–24 months.•An all oral shorter WHO course is now recommended for the treatment of RR-TB.•Pulmonary rehabilitation is useful for patients with sequelae. The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Drug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually. Recently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance. The availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB. Despite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly.
AbstractList	The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Drug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually. Recently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance. The availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB. Despite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly. •DR- and MDR-TB are more frequent in contacts and patients previously treated.•Whole genome sequencing, rapid, consistent and sensitive, is very useful in outbreaks•RR/MDR-TB requires treatment with ≥4 drugs for 6–24 months.•An all oral shorter WHO course is now recommended for the treatment of RR-TB.•Pulmonary rehabilitation is useful for patients with sequelae. The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Drug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually. Recently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance. The availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB. Despite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly. The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management.AIMThe aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management.Drug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually.EPIDEMIOLOGYDrug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually.Recently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance.DIAGNOSTICSRecently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance.The availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB.TREATMENTThe availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB.Despite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly.CONCLUSIONDespite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly. Aim: The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Epidemiology: Drug-resistant Tuberculosis (DR-TB) continues to be a current global health threat, and is defined by higher morbidity and mortality, sequelae, higher cost and complexity. The WHO classifies drug-resistant TB into 5 categories: isoniazid-resistant TB, rifampicin resistant (RR)-TB and MDR-TB, (TB resistant to isoniazid and rifampicin), pre-extensively drug-resistant TB (pre-XDR-TB) which is MDR-TB with resistance to a fluoroquinolone and finally XDR-TB that is TB resistant to rifampicin, plus any fluoroquinolone, plus at least one further priority A drug (bedaquiline or linezolid). Of 500,000 estimated new cases of RR-TB in 2020, only 157 903 cases are notified. Only about a third of cases are detected and treated annually. Diagnostics: Recently newer rapid diagnostic methods like the GeneXpert, whole genome sequencing and Myc-TB offer solutions for rapid detection of resistance. Treatment: The availability of new TB drugs and shorter treatment regimens have been recommended for the management of DR-TB. Conclusion: Despite advances in diagnostics and treatments we still have to find and treat two thirds of the drug resistant cases that go undetected and therefore go untreated each year. Control of TB and elimination will only occur if cases are detected, diagnosed and treated promptly.
Author	van den Boom, Martin Tiberi, Simon Centis, Rosella D'Ambrosio, Lia Utjesanovic, Natasa Galvin, Jessica Migliori, Giovanni Battista Zumla, Alimuddin
Author_xml	– sequence: 1 givenname: Simon surname: Tiberi fullname: Tiberi, Simon email: s.tiberi@qmul.ac.uk organization: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London. Department of Infection, Royal London Hospital, Barts Health NHS Trust, London UK – sequence: 2 givenname: Natasa surname: Utjesanovic fullname: Utjesanovic, Natasa organization: Department of Clinical Virology, University College London Hospital, UCL Hospitals NHS Foundation Trust, London UK – sequence: 3 givenname: Jessica surname: Galvin fullname: Galvin, Jessica organization: Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London. Department of Infection, Royal London Hospital, Barts Health NHS Trust, London UK – sequence: 4 givenname: Rosella orcidid: 0000-0002-8551-3598 surname: Centis fullname: Centis, Rosella organization: Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy – sequence: 5 givenname: Lia orcidid: 0000-0002-7000-5777 surname: D'Ambrosio fullname: D'Ambrosio, Lia organization: Public Health Consulting Group, Lugano, Switzerland – sequence: 6 givenname: Martin orcidid: 0000-0002-6417-6668 surname: van den Boom fullname: van den Boom, Martin organization: WHO Regional Office for the Eastern Mediterranean Region, Cairo, Egypt – sequence: 7 givenname: Alimuddin orcidid: 0000-0002-5111-5735 surname: Zumla fullname: Zumla, Alimuddin organization: Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, and National Institute for Health Research Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK – sequence: 8 givenname: Giovanni Battista orcidid: 0000-0002-2597-574X surname: Migliori fullname: Migliori, Giovanni Battista organization: Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/35342000$$D View this record in MEDLINE/PubMed
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Snippet	•DR- and MDR-TB are more frequent in contacts and patients previously treated.•Whole genome sequencing, rapid, consistent and sensitive, is very useful in... The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Drug-resistant Tuberculosis (DR-TB)... The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management.AIMThe aim of this review is to inform... Aim: The aim of this review is to inform the reader on the latest developments in epidemiology, diagnostics and management. Epidemiology: Drug-resistant...
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SubjectTerms	Active TB drug safety monitoring (aDSM) Adherence Antitubercular Agents - pharmacology Antitubercular Agents - therapeutic use BPaL Drug susceptibility testing (DST) Drug-resistant TB (DR-TB) Extensively Drug-Resistant Tuberculosis - diagnosis Extensively Drug-Resistant Tuberculosis - drug therapy Extensively Drug-Resistant Tuberculosis - epidemiology Humans Isoniazid - therapeutic use Mycobacterium tuberculosis - genetics Rehabilitation Rifampin - therapeutic use Treatment Guidelines Tuberculosis, Multidrug-Resistant - diagnosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Video Observed Therapy (VOT) WHO shorter oral regimen
Title	Drug resistant TB – latest developments in epidemiology, diagnostics and management
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