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

Migliori, Giovanni Battista y Tiberi, Simon y Zumla, Alimuddin y Petersen, Eskild y Chakaya, Jeremiah Muhwa y Wejse, Christian y Muñoz Torrico, Marcela y Duarte, Raquel y Alffenaar, Jan Willem y Schaaf, H. Simon y Marais, Ben J. y Cirillo, Daniela Maria y Alagna, Riccardo y Rendón, Adrián y Pontali, Emanuele y Piubello, Alberto y Figueroa, José y Ferlazzo, Gabriella y García Basteiro, Alberto y Centis, Rosella y Visca, Dina y D’Ambrosio, Lia y Sotgiu, Giovanni (2020) MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network. International Journal of Infectious Diseases, 92. S15-S25. ISSN 1201-9712

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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

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