MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network
•Updated clinical guidance on MDR-TB is needed.•Several new MDR-TB diagnostics have been recently approved by WHO to complement existing tools.•To design a regimen, 4–5 active drugs are needed with a treatment duration up to 24 months.•Post-treatment sequelae might require pulmonary rehabilitation.•...
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| Vydáno v: | International journal of infectious diseases Ročník 92; s. S15 - S25 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Canada
Elsevier Ltd
01.03.2020
Elsevier |
| Témata: | |
| ISSN: | 1201-9712, 1878-3511, 1878-3511 |
| On-line přístup: | Získat plný text |
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| Shrnutí: | •Updated clinical guidance on MDR-TB is needed.•Several new MDR-TB diagnostics have been recently approved by WHO to complement existing tools.•To design a regimen, 4–5 active drugs are needed with a treatment duration up to 24 months.•Post-treatment sequelae might require pulmonary rehabilitation.•LTBI management and infection control are core elements of the MDR-TB public health approach.
The continuous flow of new research articles on MDR-TB diagnosis, treatment, prevention and rehabilitation requires frequent update of existing guidelines. This review is aimed at providing clinicians and public health staff with an updated and easy-to-consult document arising from consensus of Global Tuberculosis Network (GTN) experts.
The core published documents and guidelines have been reviewed, including the recently published MDR-TB WHO rapid advice and ATS/CDC/ERS/IDSA guidelines.
After a rapid review of epidemiology and risk factors, the clinical priorities on MDR-TB diagnosis (including whole genome sequencing and drug-susceptibility testing interpretations) and treatment (treatment design and management, TB in children) are discussed. Furthermore, the review comprehensively describes the latest information on contact tracing and LTBI management in MDR-TB contacts, while providing guidance on post-treatment functional evaluation and rehabilitation of TB sequelae, infection control and other public health priorities. |
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| Bibliografie: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| ISSN: | 1201-9712 1878-3511 1878-3511 |
| DOI: | 10.1016/j.ijid.2020.01.042 |