Extensively drug-resistant tuberculosis: new strains, new challenges.

Author(s): Banerjee R, Schecter GF, Flood J, Porco TC

Affiliation(s): Division of Infectious Disease, Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143-0136, USA. banerjeer@peds.ucsf.edu

Publication date & source: 2008-10, Expert Rev Anti Infect Ther., 6(5):713-24.

Publication type: Review

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.