MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network

Int J Infect Dis. 2020 Mar;92S:S15-S25. doi: 10.1016/j.ijid.2020.01.042. Epub 2020 Feb 4.

Abstract

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: Diagnosis; MDR-TB; Prevention; Rehabilitation of sequelae; Treatment; XDR-TB.

Publication types

  • Review

MeSH terms

  • Adult
  • Child
  • Child, Preschool
  • Contact Tracing
  • Extensively Drug-Resistant Tuberculosis / diagnosis*
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • Humans
  • Infection Control
  • Latent Tuberculosis / drug therapy
  • Practice Guidelines as Topic
  • Risk Factors
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / prevention & control