Abstract
Extensively drug-resistant (XDR)-TB, defined as TB with resistance to at least isoniazid, rifampin, a fluoroquinolone and either amikacin, kanamycin or capreomycin, is a stark setback for global TB control. Overburdened public-health systems with inadequate resources for case detection and management and high HIV coinfection rates in many regions have contributed to the emergence of XDR-TB. Patients with XDR-TB have poor outcomes, prolonged infectious periods and limited treatment options. To prevent an epidemic of untreatable XDR-TB, improvements in XDR-TB surveillance, increased laboratory capacity for rapid detection of drug-resistant strains, better infection control and the development of new therapeutics are urgently needed.
MeSH terms
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / epidemiology
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AIDS-Related Opportunistic Infections / microbiology
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Antitubercular Agents / pharmacology*
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Antitubercular Agents / therapeutic use
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Drug Resistance, Multiple, Bacterial / genetics
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Extensively Drug-Resistant Tuberculosis* / drug therapy
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Extensively Drug-Resistant Tuberculosis* / epidemiology
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Extensively Drug-Resistant Tuberculosis* / microbiology
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Global Health*
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HIV Infections / complications
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Humans
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Microbial Sensitivity Tests
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Mycobacterium tuberculosis / classification
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Mycobacterium tuberculosis / drug effects*
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Mycobacterium tuberculosis / genetics
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Tuberculosis, Multidrug-Resistant / drug therapy
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Tuberculosis, Multidrug-Resistant / epidemiology
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Tuberculosis, Multidrug-Resistant / microbiology
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Tuberculosis, Pulmonary / drug therapy
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Tuberculosis, Pulmonary / epidemiology
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Tuberculosis, Pulmonary / microbiology