Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study

Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. TBNET is a pan-European clinica...

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Veröffentlicht in:Respiratory medicine Jg. 132; S. 68 - 75
Hauptverfasser: Bothamley, Graham H., Lange, Christoph, Albrecht, Dirk, Anibarro, Luis, Gomez, Neus Altet, Andersen, Aase Bengaard, Avsar, Korkut, Balasanyants, Goar, Belton, Moerida, García, Cristina Berastegui, Bogyi, Matthias, Bruchfeld, Judith, Caminero, Jose, Chesov, Dumitru, Chiappini, Elena, Confalonieri, Marco, Dedicoat, Martin, Luiza de Souza Galvao, Maria, Duarte, Raquel, Dudnyk, Andrii, Dyrhol-Riise, Anne Ma, Eisenhut, Michael, Esteban, Jaime, Fløe, Andreas, García-García, José-María, Giacomet, Vania, Gomez-Pastrana, David, Gyorfy, Zsuzsanna, Holmoka, Jiri, Jachym, Mathilde Fréchet, Janssens, Jean-Paul, Jonsson, Jerker, Kaluzhenina, Anna, Konstantynovska, Olha, Kruczak, Katarzyna, Ladeira, Inês, Kuksa, Liga, Kulcitkaia, Stela, Lillebæk, Troels, Magis-Escurra, Cecile, Manika, Katerina, Joan-Pau, Millet, Muylle, Inge, Palmieri, Fabrizio, Pesut, Dragica, Polanova, Monika, Pontali, Emanuele, Popa, Cristina, Ravn, Pernille, Sánchez-Montalvá, Adrian, Schoch, Otto, Selmeryd, Ingrid, Skrahina, Alena, Solovic, Ivan, Soriano-Arandes, Antoni, Thouvenin, Guillaume, Tiberi, Simon, Wagner, Dirk, van der Werf, Tjip, van Ingen, Jakko, Vicente, Diego, Volchenkov, Grigory, Woltmann, Gerrit
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Elsevier Ltd 01.11.2017
Elsevier Limited
Schlagworte:
Clinical trials
Decontamination
Drug resistance
Drug sensitivity testing
Drug therapy
Europe
Infection control
Mutation
Mycobacterium tuberculosis
PCR
Rifampin
Tuberculosis
Europe
Tuberculosis
Drug-resistance
Europe
PCR
Infection control
ISSN:0954-6111, 1532-3064, 1532-3064
Online-Zugang:Volltext
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Abstract Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop. •M/XDR-TB poses a serious threat to TB control in Europe.•Isolation rooms are insufficient for safe diagnosis.•Drug susceptibility testing results are frequently delayed.•A positive test for rifampicin resistance should lead automatically to tests for other first- and second-line drug resistance.
AbstractList Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.AIMEurope has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.METHODSTBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.RESULTS68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.CONCLUSIONInfection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.
Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.
Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop. •M/XDR-TB poses a serious threat to TB control in Europe.•Isolation rooms are insufficient for safe diagnosis.•Drug susceptibility testing results are frequently delayed.•A positive test for rifampicin resistance should lead automatically to tests for other first- and second-line drug resistance.
AimEurope has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.MethodsTBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.Results68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.ConclusionInfection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain ofMycobacterium tuberculosisare significantly delayed, allowing for further drug resistance to develop.
Author Wagner, Dirk
Balasanyants, Goar
Holmoka, Jiri
Avsar, Korkut
Soriano-Arandes, Antoni
Skrahina, Alena
Selmeryd, Ingrid
Duarte, Raquel
Ladeira, Inês
Kuksa, Liga
Tiberi, Simon
Lange, Christoph
Ravn, Pernille
Kaluzhenina, Anna
Jachym, Mathilde Fréchet
Bruchfeld, Judith
Solovic, Ivan
Volchenkov, Grigory
Joan-Pau, Millet
Bogyi, Matthias
Gomez-Pastrana, David
Gyorfy, Zsuzsanna
Andersen, Aase Bengaard
Kruczak, Katarzyna
Giacomet, Vania
Kulcitkaia, Stela
Esteban, Jaime
Anibarro, Luis
García-García, José-María
Muylle, Inge
Confalonieri, Marco
Thouvenin, Guillaume
Pontali, Emanuele
Belton, Moerida
van Ingen, Jakko
Lillebæk, Troels
Manika, Katerina
Luiza de Souza Galvao, Maria
Chesov, Dumitru
García, Cristina Berastegui
Dyrhol-Riise, Anne Ma
Magis-Escurra, Cecile
Dudnyk, Andrii
Dedicoat, Martin
Fløe, Andreas
Konstantynovska, Olha
Polanova, Monika
Janssens, Jean-Paul
Eisenhut, Michael
Sánchez-Montalvá, Adrian
Gomez, Neus Altet
van der Werf, Tjip
Jonsson, Jerker
Albrecht, Dirk
Palmieri, Fabrizio
Chiappini, Elena
Schoch, Otto
Pesut, Dragica
Vicente, Diego
Cam
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10.1183/09031936.00029311
10.1371/journal.pmed.0040068
10.3201/eid2103.141343
10.1183/09031936.00170411
10.2307/2983604
10.2471/BLT.12.104588
10.1183/13993003.01601-2016
10.1016/S2213-2600(15)00466-X
10.5588/ijtld.15.0327
10.5588/ijtld.16.0015
10.1186/1471-2334-14-333
10.1183/09031936.00124614
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Keywords Tuberculosis
Drug-resistance
Europe
PCR
Infection control
Language English
License This article is made available under the Elsevier license.
Copyright © 2017 Elsevier Ltd. All rights reserved.
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SubjectTerms Clinical trials
Decontamination
Drug resistance
Drug sensitivity testing
Drug therapy
Europe
Infection control
Mutation
Mycobacterium tuberculosis
PCR
Rifampin
Tuberculosis
Title Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study
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