This paper describes the results of second-line drug (SLD) susceptibility tests among multidrug-resistant tuberculosis (MDR TB) cases reported in 20 European countries aiming to identify extensively drug-resistant tuberculosis (XDR TB) cases. A project on molecular surveillance of MDR TB cases was conducted by EuroTB and the National Institute for Public Health and the Environment (RIVM) from 2...

CENTURIES AFTER THE FORMAL CREATION OF QUARantine, the practice continues to evoke concern when implemented to halt the spread of dangerous microbes. Witness the controversy generated by US citizen Andrew Speaker, whom the US Centers for Disease Control and Prevention (CDC) detained and isolated because he was diagnosed with pulmonary disease caused by extensively drug-resistant tuberculosis (X...

There are limited data on the temporal relationship between the regional introduction of multidrug-resistant tuberculosis (MDR-TB) treatment and the subsequent development of extensively drug-resistant TB (XDR-TB). The first XDR-TB case in the Western Cape province of South Africa was recorded in 1992, approximately 5 - 7 years after the regional introduction of MDR-TB-like treatment. Between 1...

RATIONALE The multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) epidemics are rapidly expanding in South Africa. Our initial report of HIV-associated XDR TB in South Africa revealed rapid and near complete mortality. Lower mortality has been described in the literature, but few of these patients have been HIV coinfected. OBJECTIVES To characterize mortality from...

We present the first fatal case of extensively drug-resistant tuberculosis (XDR-TB) in an injecting drug user (IDU) in Athens, Greece, co-infected with human immunodeficiency virus and hepatitis C virus and discuss the implications for public health. Despite immediate initiation of treatment, the patient's condition gradually deteriorated and he died 16 days after hospital admission because of ...

We investigated the activity of trimethoprim-sulfamethoxazole (SXT) against Mycobacterium tuberculosis, the pathogen that causes tuberculosis (TB). The MIC distribution of SXT was 0.125/2.4 to 2/38 mg/liter for the 100 isolates tested, including multi- and extensively drug-resistant isolates (MDR/XDR-TB), whereas the intracellular MIC90 of sulfamethoxazole (SMX) for the pansusceptible strain H3...

Bedaquiline, a diarylquinoline, improved cure rates when added to a multidrug-resistant tuberculosis (MDR-TB) treatment regimen in a previous placebo-controlled, phase 2 trial (TMC207-C208; NCT00449644). The current phase 2, multicenter, open-label, single-arm trial (TMC207-C209; NCT00910871) reported here was conducted to confirm the safety and efficacy of bedaquiline.Newly diagnosed or previo...

2014; 43: 1410–1420. 9 Esposito S, D’Ambrosio L, Tadolini M, et al. ERS/WHO Tuberculosis Consilium assistance with extensively drug-resistant tuberculosis management in a child: case study of compassionate delamanid use. Eur Respir J 2014; 44: 811–815. 10 Codecasa LR, Ciconali G, Mazzola E. Managing an XDR-TB outbreak: the public health face of the medal. Eur Respir J 2015; 45: 292–294. 11 Smit...

Ramalitse Sakoane It is only about 25 years since the abolition or abandonment of TB sanatoria in South Africa. It is likely that there are people in South Africa who are familiar with the idea of isolation of TB patients from the general public emanating from the era of TB sanatoria, and it is conceivable that they are likely to be understanding of the reasons that were used to keep patients t...