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

Migliori G.B.; Tiberi S.; Zumla A.; Petersen E.; Chakaya J.M.; Wejse C.; Torrico M.M.; Duarte R.; Alffenaar J.W.; Schaaf H.S.; Marais B.J.; Cirillo D.M.; Alagna R.; Rendon A.; Pontali E.; Piubello A.; Figueroa J.; Ferlazzo G.; García-Basteiro A.; Centis R.; Visca D.; D’Ambrosio L.; Sotgiu G.; Abu Arkub T.; Akkerman O.W.; Aleksa A.; Belilovski E.; Bernal E.; Blanc F.-X.; Boeree M.; Borisov S.; Bruchfeld J.; Cadiñanos Loidi J.; Caminero J.A.; Carvalho A.C.; Cebrian Gallardo J.J.; Charalampos M.; Danila E.; Davies Forsman L.; Denholm J.; Dheda K.; Diel R.; Diktanas S.; Dobler C.; Enwerem M.; Esposito S.; Escobar Salinas N.; Filippov A.; Formenti B.; García García J.M.; Goletti D.; Gomez Rosso R.; Gualano G.; Isaakidis P.; Kaluzhenina A.; Koirala S.; Kuksa L.; Kunst H.; Li Y.; Magis-Escurra C.; Manfrin V.; Manga S.; Manika K.; Marchese V.; Martínez Robles E.; Maryandyshev A.; Matteelli A.; Mariani A.; Mazza-Stalder J.; Mello F.; Mendoza L.; Mesi A.; Miliauskas S.; Mustafa Hamdan H.; Ndjeka N.; Nieto Marcos M.; Ottenhoff T.H.M.; Palmero D.J.; Palmieri F.; Papavasileiou A.; Payen M.C.; Pontarelli A.; Pretti Dalcolmo M.; Quirós Fernandez S.; Romero R.; Rossato Silva D.; Santos A.P.; Seaworth B.; Sinitsyn M.; Skrahina A.; Solovic I.; Spanevello A.; Tadolini M.; Torres C.; Udwadia Z.; van den Boom M.; Volchenkov G.V.; Yedilbayev A.; Zaleskis R.; Zellweger J.P. · International Journal of Infectious Diseases (2020) · DOI: 10.1016/j.ijid.2020.01.042

Resumen

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.