extensively drug-resistant tuberculosis (XDR-TB)
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Etiology
- strains of Mycobacterium tuberculosisthat resistant to isoniazid, rifampicin, any fluoroquinolone, & either bedaquiline or linezolid (or both)[5]
- formerly strains of Mycobacterium tuberculosis resistant to isoniazid, rifampin, & quinolones...plus amikacin, kanamycin, or capreomycin
- risk factors:
- previous treatment of tuberculosis (RR = 11)
- HIV infection (RR = 3)
- homelessness (RR = 3)
- alcohol abuse (RR = 2)
Epidemiology
- case of a woman who flew from India to Chicago in April 2015, then traveled within the U.S.[3]
Management
- harder to treat & more lethal than drug-sensitive tuberculosis
- lung surgery to remove source of infection
- second line agents for treating multidrug-resistant tuberculosis
More general terms
References
- ↑ Prescriber's Letter 14(7): 2007 Extensively Drug-Resistant Tuberculosis (XDR TB) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230704&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Kliiman K and Altraja A. Predictors of extensively drug-resistant pulmonary tuberculosis. Ann Intern Med 2009 Jun 2; 150:766. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19487711
- ↑ 3.0 3.1 Orciari Herman A, Fairchild DG Extensively Drug-Resistant TB Diagnosed in Traveler, Officials Seek Contacts. Physician's First Watch, June 10, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ 5.0 5.1 World Health Organization (WHO) WHO announces updated definitions of extensively drug-resistant tuberculosis. WHO News Release. Jan 27, 2021 https://www.who.int/news/item/27-01-2021-who-announces-updated-definitions-of-extensively-drug-resistant-tuberculosis