Multidrug- and Extensively Drug-Resistant Tuberculosis, Germany

sociated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004– 2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identifi ed as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the former Soviet Union. In patients with XDR TB, hospitalization was longer (mean ± SD 202 ± 130 vs. 123 ± 81 days; p = 0.015) and resistance to all fi rst-line drugs was more frequent (36% vs. 86%; p = 0.013) than in patients with MDR TB. Seventyfour (40%) of these 184 patients received treatment with linezolid. Treatment success rates ranged from 59% for the entire cohort (59% for MDR TB and 57% for XDR TB) to 87% for those with a defi nitive outcome (n = 125; 89% for MDR TB and 80% for XDR TB). Extensive drug susceptibility testing and availability of secondand third-line drugs under inpatient management conditions permit relatively high treatment success rates in MDR and XDR TB.

[1]  D. Ashkin.  Treatment/Outcomes in MDR and XDR TB , 2016 .

[2]  K. Kliiman,et al.  Fluoroquinolones: are they essential to treat multidrug-resistant tuberculosis? , 2008, European Respiratory Journal.

[3]  K. Kliiman,et al.  Extensively drug-resistant tuberculosis is worse than multidrug-resistant tuberculosis: different methodology and settings, same results. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  J. Yim,et al.  Impact of extensive drug resistance on treatment outcomes in non-HIV-infected patients with multidrug-resistant tuberculosis. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  S. Rüsch-Gerdes,et al.  Multidrug-Resistant Tuberculosis Treatment Outcomes in Karakalpakstan, Uzbekistan: Treatment Complexity and XDR-TB among Treatment Failures , 2007, PloS one.

[6]  K. Kliiman,et al.  Clinical and operational value of the extensively drug-resistant tuberculosis definition , 2007, European Respiratory Journal.

[7]  A. Gori,et al.  Extensively Drug-resistant Tuberculosis, Italy and Germany , 2007, Emerging infectious diseases.

[8]  G. Bai,et al.  Worldwide Emergence of Extensively Drug-resistant Tuberculosis , 2007, Emerging infectious diseases.

[9]  S. Rüsch-Gerdes,et al.  First Linezolid-Resistant Clinical Isolates of Mycobacterium tuberculosis , 2007, Antimicrobial Agents and Chemotherapy.

[10]  Paul Nunn,et al.  Epidemiology of antituberculosis drug resistance (the Global Project on Anti-tuberculosis Drug Resistance Surveillance): an updated analysis , 2006, The Lancet.

[11]  Neel R Gandhi,et al.  Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa , 2006, The Lancet.

[12]  S. Cannas,et al.  In vitro efficacy of Linezolid on clinical strains of Mycobacterium tuberculosis and other mycobacteria. , 2006, The new microbiologica.

[13]  Mehran Hosseini,et al.  Global incidence of multidrug-resistant tuberculosis. , 2006, The Journal of infectious diseases.

[14]  F. Baquero,et al.  In vitro activity of linezolid against Mycobacterium tuberculosis complex, including multidrug-resistant Mycobacterium bovis isolates. , 2006, International journal of antimicrobial agents.

[15]  T. Holtz,et al.  Clinical outcome of individualised treatment of multidrug-resistant tuberculosis in Latvia: a retrospective cohort study , 2005, The Lancet.

[16]  S. Kyle,et al.  Mycobacterium chelonae infection successfully treated with oral clarithromycin and linezolid , 2004, The British journal of dermatology.

[17]  E. Bouza,et al.  In Vitro Activities of Linezolid against Clinical Isolates of Mycobacterium tuberculosis That Are Susceptible or Resistant to First-Line Antituberculous Drugs , 2003, Antimicrobial Agents and Chemotherapy.

[18]  Mohammad Mustafizur Rahman,et al.  Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994-1998. , 2002, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[19]  Ronald N. Jones,et al.  Oxazolidinone antibiotics , 2001, The Lancet.

[20]  R. Wallace,,et al.  Successful treatment of disseminated Mycobacterium chelonae infection with linezolid. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[21]  N. Binkin,et al.  Determinants of drug-resistant tuberculosis: analysis of 11 countries. , 2001, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[22]  M. Raviglione,et al.  Tuberculosis control in Europe and international migration. , 1994, The European respiratory journal.

[23]  G. Schecter,et al.  Linezolid in the treatment of multidrug-resistant tuberculosis. , 2010, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[24]  M. Raviglione,et al.  Patients with previously treated tuberculosis no longer neglected. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[25]  H L Rieder,et al.  Global trends in resistance to antituberculosis drugs. World Health Organization-International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance. , 2001, The New England journal of medicine.