Extensively drug-resistant tuberculosis

Research output: Contribution to journalArticle

Abstract

Extensively drug-resistant (XDR) tuberculosis is defined as disease caused by Mycobacterium tuberculosis with resistance to at least isoniazid and rifampicin, any fluoroquinolone, and at least one of three injectable second-line drugs (amikacin, capreomycin, or kanamycin). The definition has applicable clinical value and has allowed for more uniform surveillance in varied international settings. Recent surveillance data have indicated that the prevalence of tuberculosis drug resistance has risen to the highest rate ever recorded. The gold standard for drug-susceptibility testing has been the agar proportion method; however, this technique requires several weeks for results to be determined. More sensitive and specific diagnostic tests are still unavailable in resource-limited settings. Clinical manifestations, although variable in different settings and among different strains, have in general shown that XDR tuberculosis is associated with greater morbidity and mortality than non-XDR tuberculosis. The treatment of XDR tuberculosis should include agents to which the organism is susceptible, and should continue for a minimum of 18-24 months. However, treatment continues to be limited in tuberculosis-endemic countries largely because of weaknesses in national tuberculosis health-care models. The ultimate strategy to control drug-resistant tuberculosis is one that implements a comprehensive approach incorporating innovation from the political, social, economic, and scientific realms.

Original languageEnglish (US)
Pages (from-to)19-30
Number of pages12
JournalLancet Infectious Diseases
Volume9
Issue number1
DOIs
StatePublished - Jan 2009

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Extensively Drug-Resistant Tuberculosis
Tuberculosis
Capreomycin
Multidrug-Resistant Tuberculosis
Kanamycin
Amikacin
Fluoroquinolones
Isoniazid
Rifampin
Mycobacterium tuberculosis
Routine Diagnostic Tests
Drug Resistance
Pharmaceutical Preparations
Agar
Economics
Morbidity
Delivery of Health Care
Injections
Mortality
Therapeutics

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Extensively drug-resistant tuberculosis. / Jassal, Mandeep S; Bishai, William Ramses.

In: Lancet Infectious Diseases, Vol. 9, No. 1, 01.2009, p. 19-30.

Research output: Contribution to journalArticle

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