Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study

Graham H. Bothamley, Christoph Lange, Dirk Albrecht, Luis Anibarro, Neus Altet Gomez, Aase Bengaard Andersen, Korkut Avsar, Goar Balasanyants, Moerida Belton, Cristina Berastegui García, Matthias Bogyi, Judith Bruchfeld, Jose Caminero, Dumitru Chesov, Elena Chiappini, Marco Confalonieri, Martin Dedicoat, Maria Luiza de Souza Galvao, Raquel Duarte, Andrii DudnykAnne Ma Dyrhol-Riise, Michael Eisenhut, Jaime Esteban, Andreas Fløe, José María García-García, Vania Giacomet, David Gomez-Pastrana, Zsuzsanna Gyorfy, Jiri Holmoka, Mathilde Fréchet Jachym, Jean Paul Janssens, Jerker Jonsson, Anna Kaluzhenina, Olha Konstantynovska, Katarzyna Kruczak, Inês Ladeira, Liga Kuksa, Stela Kulcitkaia, Troels Lillebæk, Cecile Magis-Escurra, Katerina Manika, Millet Joan-Pau, Inge Muylle, Fabrizio Palmieri, Dragica Pesut, Monika Polanova, Emanuele Pontali, Cristina Popa, Pernille Ravn, Adrian Sánchez-Montalvá, TBNET

Research output: Contribution to journalArticle

Abstract

Aim Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented. Methods TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing. Results 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months. Conclusion Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.

Original languageEnglish
Pages (from-to)68-75
Number of pages8
JournalRespiratory Medicine
Volume132
DOIs
Publication statusPublished - Nov 1 2017

Keywords

  • Drug-resistance
  • Europe
  • Infection control
  • PCR
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Bothamley, G. H., Lange, C., Albrecht, D., Anibarro, L., Gomez, N. A., Andersen, A. B., Avsar, K., Balasanyants, G., Belton, M., García, C. B., Bogyi, M., Bruchfeld, J., Caminero, J., Chesov, D., Chiappini, E., Confalonieri, M., Dedicoat, M., Luiza de Souza Galvao, M., Duarte, R., ... TBNET (2017). Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study. Respiratory Medicine, 132, 68-75. https://doi.org/10.1016/j.rmed.2017.09.007