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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| Veröffentlicht in: | International journal of infectious diseases Jg. 92; S. S15 - S25 |
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| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
Canada
Elsevier Ltd
01.03.2020
Elsevier |
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| ISSN: | 1201-9712, 1878-3511, 1878-3511 |
| Online-Zugang: | Volltext |
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| Abstract | •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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| AbstractList | 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. Keywords: MDR-TB, XDR-TB, Diagnosis, Treatment, Prevention, Rehabilitation of sequelae 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.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. •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. 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. |
| Author | Rendon, Adrian Diel, R. Li, Y. Manika, K. Nieto Marcos, M. Belilovski, E. Mustafa Hamdan, H. Martínez Robles, E. Ndjeka, N. Tiberi, Simon Payen, M.C. Boeree, M. Torres, C. Zaleskis, R. Wejse, Christian Filippov, A. D’Ambrosio, Lia Mazza-Stalder, J. Gomez Rosso, R. Manfrin, V. Mesi, A. Matteelli, A. Alagna, Riccardo Caminero, J.A. Isaakidis, P. van den Boom, M. Pontali, Emanuele Davies Forsman, L. Manga, S. Palmero, D.J. Chakaya, Jeremiah Muhwa Formenti, B. Skrahina, A. Gualano, G. Migliori, Giovanni Battista García-Basteiro, Alberto Spanevello, A. Mariani, A. Akkerman, O.W. Piubello, Alberto Dobler, C. Danila, E. Kuksa, L. Magis-Escurra, C. Santos, A.P. Marais, Ben J. Sinitsyn, M. Udwadia, Z. Borisov, S. Ferlazzo, Gabriella Arkub, T. Abu Carvalho, A.C. Centis, Rosella Pontarelli, A. Aleksa, A. Seaworth, B. Denholm, J. Tadolini, M. Sotgiu, Giovanni Duarte, Raquel Figueroa, José Visca, Dina Rossato Silva, D. Enwerem, M. Muñoz Torrico, Marcela Palmieri, F. Ottenhoff, T.H.M. Cirillo, Daniela Maria Maryandyshev, A. Kaluzhenina, A. Cebrian Gallardo, J.J. Bruchf |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32032752$$D View this record in MEDLINE/PubMed |
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| Copyright | 2020 The Authors Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved. |
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| Keywords | Prevention MDR-TB Treatment XDR-TB Diagnosis Rehabilitation of sequelae |
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