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Extensively Drug-Resistant Tuberculosis

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Tuberculosis resistant to ISONIAZID and RIFAMPIN and at least three of the six main classes of second-line drugs (AMINOGLYCOSIDES; polypeptide agents; FLUOROQUINOLONES; THIOAMIDES; CYCLOSERINE; and PARA-AMINOSALICYLIC ACID) as defined by the CDC.

Also Known As:

Extremely Drug-Resistant Tuberculosis; Tuberculosis, Extremely Drug-Resistant; XDR-TB; Drug-Resistant Tuberculoses, Extensively; Drug-Resistant Tuberculoses, Extremely; Drug-Resistant Tuberculosis, Extensively; Drug-Resistant Tuberculosis, Extremely; Extensively Drug Resistant Tuberculosis; Extensively Drug-Resistant Tuberculoses; Extremely Drug Resistant Tuberculosis; Extremely Drug-Resistant Tuberculoses; Tuberculoses, Extensively Drug-Resistant; Tuberculoses, Extremely Drug-Resistant; Tuberculosis, Extensively Drug Resistant; Tuberculosis, Extremely Drug Resistant; Tuberculosis, Extensively Drug-Resistant

Networked: 69 relevant articles (4 outcomes, 3 trials/studies) for this Disease, Comments

Relationship Network

Disease Context: Research Results

Bacterial Infections and Mycoses
- Bacterial Infections: 6809
  - Gram-Positive Bacterial Infections: 94
    - Actinomycetales Infections: 2
      - Mycobacterium Infections: 22
        Tuberculosis: 20541
        Multidrug-Resistant Tuberculosis: 389
        Extensively Drug-Resistant Tuberculosis: 69

Related Diseases

1.	Tuberculosis
2.	Extensively Drug-Resistant Tuberculosis
3.	Infection
4.	Multidrug-Resistant Tuberculosis (Drug-Resistant Tuberculosis)
5.	Latent Tuberculosis

Experts

1.	Lange, C: 5 articles (08/2009 - 10/2007)
2.	Warren, R M: 4 articles (11/2009 - 01/2008)
3.	Migliori, G B: 4 articles (08/2009 - 10/2007)
4.	van Helden, P D: 3 articles (11/2009 - 04/2008)
5.	Sotgiu, G: 3 articles (08/2009 - 06/2008)
6.	Richardson, M D: 3 articles (08/2009 - 06/2008)
7.	Centis, R: 3 articles (08/2009 - 06/2008)
8.	Victor, T C: 3 articles (05/2009 - 01/2008)
9.	Spanevello, A: 3 articles (04/2009 - 10/2007)
10.	Wares, F: 2 articles (02/2010 - 09/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Extensively Drug-Resistant Tuberculosis:

1.	linezolid (Zyvox)FDA Link 08/01/2009 - "We describe a young child with pulmonary XDR-TB who did not respond to an aggressive multidrug-resistant TB treatment regimen, but was cured with linezolid in combination with other reserve antituberculous drugs. " 05/01/2009 - "Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB." 04/01/2010 - "Methods We retrospectively reviewed public health and medical records of 16 MDR TB patients, including 10 patients with XDR TB, who were treated with linezolid in New York City between January 2000 and December 2006, to determine treatment outcomes and describe the incidence, management and predictors of adverse events. " 04/01/2010 - "Linezolid use for treatment of multidrug-resistant and extensively drug-resistant tuberculosis, New York City, 2000-06." 11/01/2009 - "Daily 300 mg dose of linezolid for the treatment of intractable multidrug-resistant and extensively drug-resistant tuberculosis--authors' response." Order ALL the reference details at left...
2.	DNA (Deoxyribonucleic Acid)IBA 05/26/2009 - "These data indicate that our novel DNA vaccine might be useful against Mycobacterium tuberculosis including XDR-TB and MDR-TB for human therapeutic clinical trials." Order ALL the reference details at left...
3.	1- methyl- 2- ((4- aminophenyl)sulfonyl)amino- 5- nitroimidazole (MASAN)IBA 05/01/2009 - "DESIGN: Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. " Order ALL the reference details at left...
4.	Rifampin (Rifampicin)FDA LinkGeneric 02/01/2009 - "OBJECTIVES: Since the emergence of multidrug-resistant and extensively drug-resistant tuberculosis, there has been a call for a rapid assay to detect rifampicin-resistant strains that can be implemented into a routine service to analyse all strains in a specific geographical location. " 04/01/2008 - "This method, named "FAST-Rif" ("fluorometric assay for susceptibility testing of rifampin"), allowed the rapid, reliable, and easy detection of genotypic rifampin resistance as a marker for MDR-TB and XDR-TB." 03/18/2008 - "The analysis of the survey led to the following recommendations for strengthening TB laboratory services: (1) implementing of the published European standards for TB laboratory services with respect to infrastructure, national reference functions, biosafety, human resources, quality assurance, operational research (including evaluation of new medical diagnostics), accuracy and speed, appropriately trained staff; (2) ensuring that laboratories only perform activities for which they have demonstrated proficiency; (3) implement validated and standardised second-line drug susceptibility testing (DST), including drugs used to define extensively drug-resistant tuberculosis (XDR TB); (4) aiming to identify Mycobacterium tuberculosis complex (MTBC) and rifampicin (RIF) resistance in over 90% of cultures and cases from smear-positive sputum directly within one to two working days. " 04/01/2008 - "The association between rifampin resistance and MDR-TB or XDR-TB makes it an important genetic marker for genotypic drug susceptibility testing. " 03/01/2009 - "CONCLUSION: Resectional lung surgery combined with isoniazid- and rifampin-based anti-tuberculous chemotherapy can be an effective treatment strategy for patients with well-localized, cavitary pulmonary MDR-TB and XDR-TB." Order ALL the reference details at left...
5.	Isoniazid (Ftivazide)FDA LinkGeneric 05/01/2009 - "Specific mutations detected by the Hain GenoType MTBDRplus test, recently approved by the World Health Organization (WHO) for rapid TB diagnosis and drug resistance testing, could inform the decision of whether to include high dose isoniazid (INH) when treating patients with INH mono-resistant TB, MDR-TB or XDR-TB. " 11/01/2008 - "Relationship between the isoniazid-resistant mutation katGS315T and the prevalence of MDR-/XDR-TB in Osaka, Japan." 03/01/2009 - "CONCLUSION: Resectional lung surgery combined with isoniazid- and rifampin-based anti-tuberculous chemotherapy can be an effective treatment strategy for patients with well-localized, cavitary pulmonary MDR-TB and XDR-TB." 03/01/2009 - "Pulmonary resection combined with isoniazid- and rifampin-based drug therapy for patients with multidrug-resistant and extensively drug-resistant tuberculosis." 08/15/2008 - "Pre-XDR TB was defined as TB with resistance to isoniazid and rifampin and either a fluoroquinolone or second-line injectable agent but not both. " Order ALL the reference details at left...
6.	Kanamycin FDA Link 01/01/2008 - "RESULTS: Of the 699 MDR-TB isolates submitted for testing between June 2005 and December 2006, 101 (17%) patients had a culture that was resistant to either ofloxacin or kanamycin, and 41 (6%) were resistant to both drugs (XDR-TB). " 02/01/2010 - "Of 1498 (53%) identified as having multidrug-resistant TB (MDR-TB), 671 (44.8%) were resistant to > or =1 second-line drugs (SLDs): 490 (32.7%) to ethionamide, 245 (16.4%) to ofloxacin and 169 (11.3%) to kanamycin; 69 (4.6%) were extensively drug-resistant TB (XDR-TB). " 01/01/2008 - "Patients with XDR TB were more likely to not respond to therapy, and successful conversion of sputum culture results to negative was correlated with initial susceptibility to both fluoroquinolones and kanamycin but not to streptomycin." 02/13/2009 - "Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB (amikacin, kanamycin, or capreomycin). " 11/01/2008 - "INTRODUCTION: Extensively drug-resistant tuberculosis (XDR-TB) is defined as a form of multidrug-resistant tuberculosis (MDR-TB) with additional resistance to fluoroquinolones and at least one of the injectable drugs used in tuberculosis treatment: amikacin, kanamycin and capreomycin. " Order ALL the reference details at left...
7.	Capreomycin (Capastat)FDA Link 06/01/2008 - "Among MDR- and XDR-TB cases, capreomycin resistance yielded a higher proportion of failure and death than capreomycin-susceptible cases. " 06/01/2008 - "In the treatment of patients with multidrug-resistant and extensively drug-resistant tuberculosis, resistance to the injectable drug capreomycin was an independent predictor for therapy failure in this cohort. " 02/13/2009 - "Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB (amikacin, kanamycin, or capreomycin). " 11/01/2008 - "INTRODUCTION: Extensively drug-resistant tuberculosis (XDR-TB) is defined as a form of multidrug-resistant tuberculosis (MDR-TB) with additional resistance to fluoroquinolones and at least one of the injectable drugs used in tuberculosis treatment: amikacin, kanamycin and capreomycin. " 10/01/2008 - "Extensively drug-resistant (XDR)-TB, defined as TB with resistance to at least isoniazid, rifampin, a fluoroquinolone and either amikacin, kanamycin or capreomycin, is a stark setback for global TB control. " Order ALL the reference details at left...
8.	Amikacin (A.M.K)FDA LinkGeneric 02/13/2009 - "Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB (amikacin, kanamycin, or capreomycin). " 11/01/2008 - "INTRODUCTION: Extensively drug-resistant tuberculosis (XDR-TB) is defined as a form of multidrug-resistant tuberculosis (MDR-TB) with additional resistance to fluoroquinolones and at least one of the injectable drugs used in tuberculosis treatment: amikacin, kanamycin and capreomycin. " 10/01/2008 - "Extensively drug-resistant (XDR)-TB, defined as TB with resistance to at least isoniazid, rifampin, a fluoroquinolone and either amikacin, kanamycin or capreomycin, is a stark setback for global TB control. " 10/01/2009 - "XDR-TB was defined as TB caused by bacilli showing resistance to rifampicin and isoniazid in addition to any fluoroquinolone and to at least one of the three following injectable drugs: capreomycin, kanamycin, and amikacin. " 04/01/2009 - "RECENT FINDINGS: XDR TB is defined as the occurrence of TB in persons whose Mycobacterium tuberculosis isolates are resistant to isoniazid and rifampin and to any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). " Order ALL the reference details at left...
9.	FluoroquinolonesIBA 01/01/2008 - "The emergence of extensively drug-resistant tuberculosis (XDR-TB), that is, MDR-TB with additional bacillary resistance to the fluoroquinolones and injectables, has provided a very alarming challenge to global health, as the disease currently has a low cure rate and high mortality. " 09/15/2007 - "Extensively drug resistant tuberculosis (XDR) is also resistant to more than 3 of the 6 classes of second line drugs including fluoroquinolones and aminoglycosides. " 12/15/2007 - "Moreover, cases of extensively drug-resistant tuberculosis (XDR-TB) with additional resistance to fluoroquinolones and aminoglycosides are also emerging. " 01/01/2008 - "Patients with XDR TB were more likely to not respond to therapy, and successful conversion of sputum culture results to negative was correlated with initial susceptibility to both fluoroquinolones and kanamycin but not to streptomycin." 02/13/2009 - "Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB (amikacin, kanamycin, or capreomycin). " Order ALL the reference details at left...
10.	Carbon MonoxideIBA 04/01/2009 - "Data show that XDR-TB can be successfully treated in up to 65% of patients, particularly those who are not co-infected with HIV. " 12/01/2008 - "HIV co-infection, multi- and extensively-drug resistant (MDR/XDR) TB contribute to the challenges. " 11/01/2008 - "CONCLUSIONS: The variables with predictive value for the diagnosis of XDR-TB vs. Not XDR-TB were presence of HIV co-infection (odds ratio [OR] for XDRTB 2.5; 95% confidence interval [CI], 1.24 - 5.05) and increased average duration of previous treatments ([OR] for XDR-TB 1.2; 95% [CI], 1.11 - 2.30)." 11/04/2006 - "Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa." 11/01/2008 - "Statistically significant differences were observed in the following variables: race (black race was associated with XDRTB in 74% of cases versus 46% of the Caucasian race); WHO classification (patients with retreatment for therapeutic failure, stopping treatment or relapse were 69.5% of XDR-TB cases versus 44.5% of Not XDR-TB cases; average duration of previous treatments (4.2 months for XDR-TB cases versus 2.8 months for Not XDR-TB cases); HIV co-infection (patients with HIV co-infection constituted 65.2% of XDR-TB cases versus 42.9% of Not XDR-TB cases), mortality (33.3% in patients with XDR-TB versus 14.3% in Not XDR-TB patients). " Order ALL the reference details at left...

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 12/01/2008 - "Pulmonary resection under cover of state-of-the-art chemotherapy is safe and effective for patients with localized extensively drug-resistant tuberculosis." 12/01/2009 - "Further development and evaluation of existing immunotherapeutic agents is required to identify an effective agent that can be used adjunctively with chemotherapy to improve treatment outcomes for drug-susceptible TB, MDR-TB, and XDR-TB. " 11/01/2008 - "Nevertheless, the emergence of extensively drug-resistant tuberculosis (XDR TB), for which chemotherapy is ineffective, has again made cytokine-based therapy attractive as one of the last available options. " 03/01/2009 - "CONCLUSION: Resectional lung surgery combined with isoniazid- and rifampin-based anti-tuberculous chemotherapy can be an effective treatment strategy for patients with well-localized, cavitary pulmonary MDR-TB and XDR-TB." 03/01/2009 - "Pulmonary resection combined with isoniazid- and rifampin-based drug therapy for patients with multidrug-resistant and extensively drug-resistant tuberculosis." Order ALL the reference details at left...
2.	Injections 03/01/2009 - "Neither combinations of first-line drugs nor those of injectable drugs were associated with increased odds for adverse treatment outcomes in non-XDR MDR-TB patients or XDR-TB patients. " 03/01/2009 - "None of the resistance to additional first-line or injectable drugs was associated with higher odds for adverse treatment outcome in 155 MDR but nonextensively drug-resistant (non-XDR) TB patients. " 06/01/2008 - "Resistance to second-line injectables and treatment outcomes in multidrug-resistant and extensively drug-resistant tuberculosis cases." 11/01/2008 - "In addition, new cases of extensively drug-resistant tuberculosis (XDR-TB), defined as MDR-TB with resistance to a fluoroquinolone and at least one second line injectable agent, have been reported in 45 countries in all five continents. " 09/01/2007 - "In addition to MDR-Tb, XDR-Tb (extensively drug-resistant tuberculosis) is resistant to any fluoroquinolone, and at least one of three injectable drugs, in addition to MDR-Tb. " Order ALL the reference details at left...
3.	Directly Observed Therapy 08/15/2008 - "CONCLUSIONS: XDR TB and pre-XDR TB cases comprise a substantial fraction of MDR TB cases in California, indicating the need for interventions that improve surveillance, directly observed therapy, and rapid drug susceptibility testing and reporting." 10/01/2008 - "Inadequate global tuberculosis control through the directly observed therapy short course strategy alone and the growing threat of multidrug-resistant and extensively drug-resistant tuberculosis has driven recent development of new commercial and noncommercial tests, which are most desperately needed in resource-limited, high-burden settings. " 07/01/2008 - "Seven patients with confirmed MDR-TB or XDR-TB who were still culture positive despite appropriate directly observed therapy were treated with a regimen containing linezolid and at least one other active agent. " Order ALL the reference details at left...
4.	Therapeutics 10/01/2008 - "To prevent an epidemic of untreatable XDR-TB, improvements in XDR-TB surveillance, increased laboratory capacity for rapid detection of drug-resistant strains, better infection control and the development of new therapeutics are urgently needed." 04/01/2008 - "The TB laboratory of the future: macrophage-based selection of XDR-TB therapeutics." Order ALL the reference details at left...
5.	Highly Active Antiretroviral Therapy (HAART) 07/01/2009 - "OBJECTIVE: To present treatment outcomes of patients with extensively drug-resistant tuberculosis (XDR-TB) patients and human immunodeficiency virus (HIV) coinfection with and without highly active antiretroviral therapy. " Order ALL the reference details at left...

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