Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement

被引：212

作者：

Lange, Christoph ^{[1
]}

Abubakar, Ibrahim ^{[2
]}

Alffenaar, Jan-Willem C. ^{[3
,4
]}

Bothamley, Graham ^{[5
]}

Caminero, Jose A. ^{[6
]}

Carvalho, Anna Cristina C. ^{[7
,8
,9
]}

Chang, Kwok-Chiu ^{[10
,11
]}

Codecasa, Luigi ^{[12
]}

Correia, Ana ^{[13
]}

Crudu, Valeriu ^{[14
]}

Davies, Peter ^{[15
]}

Dedicoat, Martin ^{[16
]}

Drobniewski, Francis ^{[17
,18
]}

Duarte, Raquel ^{[19
,20
]}

Ehlers, Cordula ^{[21
,22
]}

Erkens, Connie ^{[23
]}

Goletti, Delia ^{[24
]}

Guenther, Gunar ^{[25
]}

Ibraim, Elmira ^{[26
,27
]}

Kampmann, Beate ^{[28
]}

Kuksa, Liga ^{[29
,30
]}

de lange, Wiel ^{[31
]}

van Leth, Frank ^{[32
]}

van Lunzen, Jan ^{[33
,34
]}

Matteelli, Alberto ^{[35
]}

Menzies, Dick ^{[36
]}

Monedero, Ignacio ^{[37
]}

Richter, Elvira ^{[38
,39
]}

Ruesch-Gerdes, Sabine ^{[40
]}

Sandgren, Andreas ^{[40
]}

Scardigli, Anna ^{[41
]}

Skrahina, Alena ^{[38
]}

Tortoli, Enrico ^{[42
]}

Volchenkov, Grigory ^{[43
]}

Wagner, Dirk ^{[44
]}

van der Werf, Marieke J. ^{[45
,46
]}

Williams, Bhanu ^{[47
]}

Yew, Wing-Wai ^{[48
]}

Zellweger, Jean-Pierre ^{[49
]}

Cirillo, Daniela Maria ^{[50
]}

机构：

[1] Res Ctr Borstel, Med Clin, German Ctr Infect Res DZIF, Div Clin Infect Dis, D-23845 Borstel, Germany

[2] Univ Namibia, Sch Med, Dept Med, Windhoek, Namibia

[3] UCL, Res Dept Infect & Populat Hlth, London, England

[4] UCL, MRC Clin Trials Unit, London, England

[5] Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands

[6] Homerton Univ Hosp, London, England

[7] Univ Hosp Gran Canaria Dr Negrin, Dept Pneumol, Las Palmas Gran Canaria, Spain

[8] Int Union TB & Lung Dis Union, Multidrug Resistant TB Unit, Paris, France

[9] Int Union TB & Lung Dis Union, TB & HIV Dept, Paris, France

[10] Univ Brescia, Clin Infect & Trop Dis, WHO, Collaborating Ctr TB HIV Coinfect, Brescia, Italy

[11] Inst Oswaldo Cruz, Lab Innovat Therapies Educ & Bioprod, BR-20001 Rio De Janeiro, Brazil

[12] TB & Chest Serv, Dept Hlth, Hong Kong, Hong Kong, Peoples R China

[13] Osped Niguarda Ca Granda, Reg TB Reference Ctr, Villa Marelli Inst, Milan, Italy

[14] Portuguese Northern Hlth Adm, Dept Publ Hlth, Oporto, Portugal

[15] Phthisiopneumol Inst, Kishinev, Moldova

[16] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England

[17] Heart England Fdn Trust, Birmingham, W Midlands, England

[18] Univ Warwick, Coventry CV4 7AL, W Midlands, England

[19] Publ Hlth England Natl Mycobacterial Reference La, London, England

[20] Univ London Imperial Coll Sci Technol & Med, London, England

[21] Univ Porto, Ctr Hosp Vila Nova de Gaia Espinho, Portuguese Reference Ctr M XDR TB, P-4100 Oporto, Portugal

[22] Univ Porto, Inst Publ Hlth, Dept Clin Epidemiol Predict Med & Publ Hlth, P-4100 Oporto, Portugal

[23] Take That TB, Hamburg, Germany

[24] KNCV TB Fdn, The Hague, Netherlands

[25] L Spallanzani Natl Inst Infect Dis INMI, Translat Res Unit, Dept Epidemiol & Preclin Res, Rome, Italy

[26] German Ctr Infect Res, Med Clin, Res Ctr Borstel, Div Clin Infect Dis, Borstel, Germany

[27] Univ Namibia, Sch Med, Dept Med, Windhoek, Namibia

[28] Marius Nasta Inst Pulmonology, Bucharest, Romania

[29] Univ London Imperial Coll Sci Technol & Med, Dept Paediat, London, England

[30] MRC Unit, Serrekunda, Gambia

[31] Riga East Univ Hosp, TB & Lunge Dis Ctr, Riga, Latvia

[32] Univ Groningen, Univ Med Ctr Groningen, TB Ctr Beatrixoord, NL-9713 AV Groningen, Netherlands

[33] Univ Amsterdam, Acad Med Ctr, Dept Global Hlth, NL-1105 AZ Amsterdam, Netherlands

[34] Amsterdam Inst Global Hlth & Dev, Amsterdam, Netherlands

[35] Univ Med Ctr Hamburg, Infect Dis Unit, Hamburg, Germany

[36] Univ Brescia, Clin Infect & Trop Dis, WHO Collaborating Ctr TB HIV Coinfect, Brescia, Italy

[37] McGill Univ, Montreal Chest Inst, Montreal, PQ, Canada

[38] Multidrug Resistant TB Unit, TB & HIV Dept, Paris, France

[39] Hosp Serveis Clin, Barcelona, Spain

[40] Res Ctr Borstel, Natl Reference Ctr Mycobacteria, D-23845 Borstel, Germany

[41] European Ctr Dis Prevent & Control ECDC, Stockholm, Sweden

[42] Republican Res & Pract Ctr Pulmonol & TB, Minsk, BELARUS

[43] Ist Sci San Raffaele, Emerging Bacterial Pathogens Unit, I-20132 Milan, Italy

[44] Vladimir Reg TB Dispensary, Ctr Excellence TB Infect Control, Vladimir, Russia

[45] Univ Med Ctr Freiburg, Ctr Infect Dis, Freiburg, Germany

[46] Univ Med Ctr Freiburg, Ctr Chron Immunodeficiency, Freiburg, Germany

[47] ECDC, Stockholm, Sweden

[48] North West London Hosp NHS Trust, Dept Paediat, London, England

[49] Chinese Univ Hong Kong, Stanley Ho Ctr Emerging Infect Dis, Hong Kong, Hong Kong, Peoples R China

[50] Swiss Lung Assoc, Bern, Switzerland

来源：

EUROPEAN RESPIRATORY JOURNAL | 2014年 / 44卷 / 01期

基金：

英国医学研究理事会;

关键词：

EARLY BACTERICIDAL ACTIVITY; MULTICENTER LABORATORY VALIDATION; COMMUNITY-BASED THERAPY; OF-THE-ART; MYCOBACTERIUM-TUBERCULOSIS; PULMONARY TUBERCULOSIS; RISK-FACTORS; POPULATION PHARMACOKINETICS; IN-VITRO; ANTITUBERCULOSIS DRUGS;

D O I：

10.1183/09031936.00188313

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) substantially challenges TB control, especially in the European Region of the World Health Organization, where the highest prevalence of MDR/XDR cases is reported. The current management of patients with MDR/XDR-TB is extremely complex for medical, social and public health systems. The treatment with currently available anti-TB therapies to achieve relapse-free cure is long and undermined by a high frequency of adverse drug events, suboptimal treatment adherence, high costs and low treatment success rates. Availability of optimal management for patients with MDR/XDR-TB is limited even in the European Region. In the absence of a preventive vaccine, more effective diagnostic tools and novel therapeutic interventions the control of MDR/XDR-TB will be extremely difficult. Despite recent scientific advances in MDR/XDR-TB care, decisions for the management of patients with MDR/XDR-TB and their contacts often rely on expert opinions, rather than on clinical evidence. This document summarises the current knowledge on the prevention, diagnosis and treatment of adults and children with MDR/XDR-TB and their contacts, and provides expert consensus recommendations on questions where scientific evidence is still lacking.

引用

页码：23 / 63

页数：41

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