From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.

<h4>Background</h4>Emergence of extensively drug-resistant tuberculosis (XDR-TB) represents an enormous challenge to Public Health globally.<h4>Methods</h4>Progression towards XDR-TB was investigated in Belgium, a country with a typically low TB incidence, by analyzing the ma...

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Autores principales:	Karolien Stoffels, Caroline Allix-Béguec, Guido Groenen, Maryse Wanlin, Dirk Berkvens, Vanessa Mathys, Philip Supply, Maryse Fauville-Dufaux
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f268ea71d2944faaba5fb138c1d13918
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spelling	oai:doaj.org-article:f268ea71d2944faaba5fb138c1d139182021-11-18T07:46:12ZFrom multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.1932-620310.1371/journal.pone.0063128https://doaj.org/article/f268ea71d2944faaba5fb138c1d139182013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23671662/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Emergence of extensively drug-resistant tuberculosis (XDR-TB) represents an enormous challenge to Public Health globally.<h4>Methods</h4>Progression towards XDR-TB was investigated in Belgium, a country with a typically low TB incidence, by analyzing the magnitude, characteristics, and treatment success of multidrug-resistant tuberculosis (MDR-TB) through a population-based study from 1994 to 2008.<h4>Results</h4>Among the 174 MDR-TB patients, 81% were foreign-born, 48% of these being asylum seekers. Although the number of MDR-TB patients remained stable through the study period at around 15 new cases annually, frequencies of resistance of the patients' first MDR-TB isolate to second-line drugs increased, as well as the total number of antibiotics it was resistant to (p<0.001). XDR-TB cases were detected from 2002 onwards. For 24 patients, additional resistance to several second-line drugs was acquired during treatment. Molecular-guided investigations indicated little to no contribution of in-country clonal spread or exogenous re-infection. The increase of pre-XDR and XDR cases could be attributed to rising proportions of patients from Asia and Central and Eastern Europe (p<0.001) and an increase in the isolation of Beijing strains in these groups (p<0.001). Despite augmented resistance, the treatment success rate improved from 63.0% to 75.8% (p = 0.080) after implementation in 2005 of improved surveillance measures and therapeutic access.<h4>Conclusions</h4>Increasing severity in drug resistance patterns leading to more XDR- and "panresistant" TB cases in a country with a low TB incidence like Belgium represents a strong alert on worsening situations in other world regions and requires intense public health measures.Karolien StoffelsCaroline Allix-BéguecGuido GroenenMaryse WanlinDirk BerkvensVanessa MathysPhilip SupplyMaryse Fauville-DufauxPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e63128 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karolien Stoffels Caroline Allix-Béguec Guido Groenen Maryse Wanlin Dirk Berkvens Vanessa Mathys Philip Supply Maryse Fauville-Dufaux From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
description	<h4>Background</h4>Emergence of extensively drug-resistant tuberculosis (XDR-TB) represents an enormous challenge to Public Health globally.<h4>Methods</h4>Progression towards XDR-TB was investigated in Belgium, a country with a typically low TB incidence, by analyzing the magnitude, characteristics, and treatment success of multidrug-resistant tuberculosis (MDR-TB) through a population-based study from 1994 to 2008.<h4>Results</h4>Among the 174 MDR-TB patients, 81% were foreign-born, 48% of these being asylum seekers. Although the number of MDR-TB patients remained stable through the study period at around 15 new cases annually, frequencies of resistance of the patients' first MDR-TB isolate to second-line drugs increased, as well as the total number of antibiotics it was resistant to (p<0.001). XDR-TB cases were detected from 2002 onwards. For 24 patients, additional resistance to several second-line drugs was acquired during treatment. Molecular-guided investigations indicated little to no contribution of in-country clonal spread or exogenous re-infection. The increase of pre-XDR and XDR cases could be attributed to rising proportions of patients from Asia and Central and Eastern Europe (p<0.001) and an increase in the isolation of Beijing strains in these groups (p<0.001). Despite augmented resistance, the treatment success rate improved from 63.0% to 75.8% (p = 0.080) after implementation in 2005 of improved surveillance measures and therapeutic access.<h4>Conclusions</h4>Increasing severity in drug resistance patterns leading to more XDR- and "panresistant" TB cases in a country with a low TB incidence like Belgium represents a strong alert on worsening situations in other world regions and requires intense public health measures.
format	article
author	Karolien Stoffels Caroline Allix-Béguec Guido Groenen Maryse Wanlin Dirk Berkvens Vanessa Mathys Philip Supply Maryse Fauville-Dufaux
author_facet	Karolien Stoffels Caroline Allix-Béguec Guido Groenen Maryse Wanlin Dirk Berkvens Vanessa Mathys Philip Supply Maryse Fauville-Dufaux
author_sort	Karolien Stoffels
title	From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
title_short	From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
title_full	From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
title_fullStr	From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
title_full_unstemmed	From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
title_sort	from multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f268ea71d2944faaba5fb138c1d13918
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From multidrug- to extensively drug-resistant tuberculosis: upward trends as seen from a 15-year nationwide study.

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