Document Detail


Extensively drug-resistant tuberculosis: epidemiology and management challenges.
MedLine Citation:
PMID:  20674800     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Widespread global use of rifampin for 2 decades preceded the emergence of clinically significant multidrug-resistant tuberculosis (MDR-TB) in the early 1990s. The prevalence of MDR-TB has gradually increased such that it accounts for approximately 5% of the global case burden of disease (approximately half a million cases in 2007). Eclipsing this worrying trend is the widespread emergence of extensively drug-resistant TB (XDR-TB). This article reviews the insights provided by clinical and molecular epidemiology regarding global trends and transmission dynamics of XDR-TB, and the challenges clinicians have to face in diagnosing and managing cases of XDR-TB. The ethical and management dilemmas posed by recurrent defaulters, XDR-TB treatment failures, and isolation of incurable patients are also discussed. Given the past global trends in MDR-TB, if aggressive preventive and management strategies are not implemented, XDR-TB has the potential to severely cripple global control efforts of TB.
Authors:
Keertan Dheda; Robin M Warren; Alimuddin Zumla; Martin P Grobusch
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Infectious disease clinics of North America     Volume:  24     ISSN:  1557-9824     ISO Abbreviation:  Infect. Dis. Clin. North Am.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-02     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804508     Medline TA:  Infect Dis Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  705-25     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Lung Infection and Immunity Unit, Division of Pulmonology and Clinical Immunology & UCT Lung Institute, Department of Medicine, University of Cape Town, Cape Town, South Africa. keertan.dheda@uct.ac.za
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Antitubercular Agents / pharmacology*,  therapeutic use
Bacterial Typing Techniques
DNA Fingerprinting
Disease Outbreaks*
Extensively Drug-Resistant Tuberculosis / diagnosis,  drug therapy*,  epidemiology*,  microbiology
Genotype
HIV Infections / complications
Humans
Mycobacterium tuberculosis / classification,  drug effects*,  genetics,  isolation & purification*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The convergence of the global smoking, COPD, tuberculosis, HIV, and respiratory infection epidemics.
Next Document:  Childhood Tuberculosis: An Emerging and Previously Neglected Problem.