Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study

Graham H Bothamley; Christoph Lange; TBNET; Dirk Albrecht; Luis Anibarro; Neus Altet Gomez; Aase Bengaard Andersen; Andreas Fløe; Troels Lillebæk; Pernille Ravn; Diego Vicente; Grigory Volchenkov; Gerrit Woltmann

doi:10.1016/j.rmed.2017.09.007

Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study

Graham H Bothamley, Christoph Lange, TBNET, Dirk Albrecht, Luis Anibarro, Neus Altet Gomez, Aase Bengaard Andersen, Andreas Fløe, Troels Lillebæk, Pernille Ravn, Diego Vicente, Grigory Volchenkov, Gerrit Woltmann

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.

METHODS: TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.

RESULTS: 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.

CONCLUSION: Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.

Original language	English
Journal	Respiratory Medicine
Volume	132
Pages (from-to)	68-75
ISSN	0954-6111
DOIs	https://doi.org/10.1016/j.rmed.2017.09.007
Publication status	Published - Nov 2017

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Bothamley, G. H., Lange, C., TBNET, Albrecht, D., Anibarro, L., Gomez, N. A., Andersen, A. B., Fløe, A., Lillebæk, T., Ravn, P., Vicente, D., Volchenkov, G., & Woltmann, G. (2017). Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study. Respiratory Medicine, 132, 68-75. https://doi.org/10.1016/j.rmed.2017.09.007

Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe : A tuberculosis network European Trialsgroup (TBNET) study. / Bothamley, Graham H; Lange, Christoph; TBNET et al.

In: Respiratory Medicine, Vol. 132, 11.2017, p. 68-75.

Research output: Contribution to journal › Journal article › Research › peer-review

Bothamley, GH, Lange, C, TBNET, Albrecht, D, Anibarro, L, Gomez, NA, Andersen, AB, Fløe, A, Lillebæk, T, Ravn, P, Vicente, D, Volchenkov, G & Woltmann, G 2017, 'Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study', Respiratory Medicine, vol. 132, pp. 68-75. https://doi.org/10.1016/j.rmed.2017.09.007

Bothamley GH, Lange C, TBNET, Albrecht D, Anibarro L, Gomez NA et al. Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study. Respiratory Medicine. 2017 Nov;132:68-75. doi: 10.1016/j.rmed.2017.09.007

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title = "Infection control, genetic assessment of drug resistance and drug susceptibility testing in the current management of multidrug/extensively-resistant tuberculosis (M/XDR-TB) in Europe: A tuberculosis network European Trialsgroup (TBNET) study",

abstract = "AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.METHODS: TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.RESULTS: 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.CONCLUSION: Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.",

author = "Bothamley, {Graham H} and Christoph Lange and TBNET and Dirk Albrecht and Luis Anibarro and Gomez, {Neus Altet} and Andersen, {Aase Bengaard} and Andreas Fl{\o}e and Troels Lilleb{\ae}k and Pernille Ravn and Diego Vicente and Grigory Volchenkov and Gerrit Woltmann",

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T2 - A tuberculosis network European Trialsgroup (TBNET) study

AU - Bothamley, Graham H

AU - Lange, Christoph

AU - TBNET

AU - Albrecht, Dirk

AU - Anibarro, Luis

AU - Gomez, Neus Altet

AU - Andersen, Aase Bengaard

AU - Fløe, Andreas

AU - Lillebæk, Troels

AU - Ravn, Pernille

AU - Vicente, Diego

AU - Volchenkov, Grigory

AU - Woltmann, Gerrit

PY - 2017/11

Y1 - 2017/11

N2 - AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.METHODS: TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.RESULTS: 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.CONCLUSION: Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.

AB - AIM: Europe has the highest documented caseload and greatest increase in multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) of all World Health Organization (WHO) regions. This survey examines how recommendations for M/XDR-TB management are being implemented.METHODS: TBNET is a pan-European clinical research collaboration for tuberculosis. An email survey of TBNET members collected data in relation to infection control, access to molecular tests and basic microbiology with drug sensitivity testing.RESULTS: 68/105 responses gave valid information and were from countries within the WHO European Region. Inpatient beds matched demand, but single rooms with negative pressure were only available in low incidence countries; ultraviolet decontamination was used in 5 sites, all with >10 patients with M/XDR-TB per year. Molecular tests for mutations associated with rifampicin resistance were widely available (88%), even in lower income and especially in high incidence countries. Molecular tests for other first line and second line drugs were less accessible (76 and 52% respectively). A third of physicians considered that drug susceptibility results were delayed by > 2 months.CONCLUSION: Infection control for inpatients with M/XDR-TB remains a problem in high incidence countries. Rifampicin resistance is readily detected, but tests to plan regimens tailored to the drug susceptibilities of the strain of Mycobacterium tuberculosis are significantly delayed, allowing for further drug resistance to develop.

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