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

Migliori, G. B.; Tiberi, S.; Zumla, A.; Petersen, E.; Chakaya, J. M.; Wejse, C.; Munoz Torrico, M.; Duarte, R.; Alffenaar, J. W.; Schaaf, H. S.; Marais, B. J.; Cirillo, D. M.; Alagna, R.; Rendon, A.; Pontali, E.; Piubello, A.; Figueroa, J.; Ferlazzo, G.; Garcia-Basteiro, A.; Centis, R.; Visca, D.; D'Ambrosio, L.; Sotgiu, G.; Arkub, T. A.; Akkerman, O. W.; Aleksa, A.; Belilovski, E.; Bernal, E.; Blanc, F. -X.; Boeree, M.; Borisov, S.; Bruchfeld, J.; Cadinanos Loidi, J.; Caminero, J. A.; Carvalho, A. C.; Cebrian Gallardo, J. J.; Charalampos,; Danila, E.; Davies Forsman, L.; Denholm, J.; Dheda, K.; Diel, R.; Diktanas, S.; Dobler, C.; Enwerem, M.; Esposito, S.; Escobar Salinas, N.; Filippov, A.; Formenti, B.; Garcia Garcia, J. M.; Goletti, D.; Gomez Rosso, R.; Gualano, G.; Isaakidis, P.; Kaluzhenina, A.; Koirala, S.; Kuksa, L.; Kunst, H.; Li, Y.; Magis-Escurra, C.; Manfrin, V.; Manga, S.; Manika, K.; Marchese, V.; Martinez Robles, E.; Maryandyshev, A.; Matteelli, A.; Mariani, A.; Mazza-Stalder, J.; Mello, F.; Mendoza, L.; Mesi, A.; Miliauskas, S.; Mustafa Hamdan, H.; Ndjeka, N.; Nieto Marcos, M.; Ottenhoff, T. H. M.; Palmero, D. J.; Palmieri, F.; Papavasileiou, A.; Payen, M. C.; Pontarelli, A.; Pretti Dalcolmo, M.; Quiros Fernandez, S.; Romero, R.; Rossato Silva, D.; Santos, A. P.; Seaworth, B.; Sinitsyn, M.; Skrahina, A.; Solovic, I.; Spanevello, A.; Tadolini, M.; Torres, C.; Udwadia, Z.; van den Boom, M.; Volchenkov, G. V.; Yedilbayev, A.; Zaleskis, R.; Zellweger, J. P.

doi:10.1016/j.ijid.2020.01.042

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.