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 ; Tiberi, Simon ; Zumla, Alimuddin ; Petersen, Eskild ; Chakaya, Jeremiah Muhwa ; Wejse, Christian ; Torrico, Marcela Munoz ; Duarte, Raquel ; Alffenaar, Jan Willem ; Schaaf, H. Simon ; Marais, Ben J. ; Cirillo, Daniela Maria ; Alagna, Riccardo ; Rendon, Adrian ; Pontali, Emanuele ; Piubello, Alberto ; Figueroa, Jose ; Ferlazzo, Gabriella ; García-Basteiro, Alberto ; Centis, Rosella ; Visca, Dina ; D’Ambrosio, Lia ; Sotgiu, Giovanni (2020-03-01)

CITATION: Migliori, G. B. et al. 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. doi:10.1016/j.ijid.2020.01.042

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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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