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Published in: Drugs 2/2000

01-02-2000 | Leading Article

Drug-Resistant Tuberculosis

What Do We Do Now?

Authors: Dr Amalio Telenti, Michael Iseman

Published in: Drugs | Issue 2/2000

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Abstract

Drug-resistant tuberculosis (TB) represents a threat to TB control programmes. Erratic and inappropriate use of currently available medications, HIV-TB coinfection, and concern about transmission of drug-resistant strains in the general population all contribute to a worrying picture. What do we do now? In the last few years, there has been considerable progress in the understanding of mechanisms of action and resistance to antituberculosis agents, and in establishing the value of directly observed therapy in preventing treatment failure. However, a limited effort has been devoted to the development of new active compounds or of rapid diagnostic tests, and their relevance to global tuberculosis control has been questioned.
Literature
1.
go back to reference Pablos-Mendez A, Raviglione MC, Laszlo A, et al. Global surveillance for antituberculosis-drug resistance, 1994–1997. World Health Organization-International Union Against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance [published erratum appears in N Engl J Med 1998 Jul 9; 339 (2): 139]. N Engl J Med 1998; 338: 1641–9PubMedCrossRef Pablos-Mendez A, Raviglione MC, Laszlo A, et al. Global surveillance for antituberculosis-drug resistance, 1994–1997. World Health Organization-International Union Against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance [published erratum appears in N Engl J Med 1998 Jul 9; 339 (2): 139]. N Engl J Med 1998; 338: 1641–9PubMedCrossRef
2.
go back to reference World Health Organization. WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance. Anti-tuberculosis drug resistance in the world. Geneva: World Health Organization, 1997. Also available from: URL: http://www.who.int World Health Organization. WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance. Anti-tuberculosis drug resistance in the world. Geneva: World Health Organization, 1997. Also available from: URL: http://​www.​who.​int
3.
go back to reference David HL. Basis for lack of drug susceptibility of atypical mycobacteria. Rev Infect Dis 1981; 3: 878–84PubMedCrossRef David HL. Basis for lack of drug susceptibility of atypical mycobacteria. Rev Infect Dis 1981; 3: 878–84PubMedCrossRef
4.
go back to reference Cole ST, Brosch R, Parkhill J, et al. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature 1998; 393: 537–44PubMedCrossRef Cole ST, Brosch R, Parkhill J, et al. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature 1998; 393: 537–44PubMedCrossRef
5.
go back to reference Ainsa JA, Perez E, Pelicic V, et al. Aminoglycoside 2′-N-acetyltransferase genes are universally present in mycobacteria: characterization of the aac(2′)-Ic gene from Mycobacterium tuberculosis and the aac(2′)-Id gene from Mycobacterium smegmatis. Mol Microbiol 1997; 24: 431–41PubMedCrossRef Ainsa JA, Perez E, Pelicic V, et al. Aminoglycoside 2′-N-acetyltransferase genes are universally present in mycobacteria: characterization of the aac(2′)-Ic gene from Mycobacterium tuberculosis and the aac(2′)-Id gene from Mycobacterium smegmatis. Mol Microbiol 1997; 24: 431–41PubMedCrossRef
6.
go back to reference Kwon HH, Tomioka H, Saito H. Distribution and characterization of β-lactamases of mycobacteria and related organisms. Tuber Lung Dis 1995; 76: 141–8PubMedCrossRef Kwon HH, Tomioka H, Saito H. Distribution and characterization of β-lactamases of mycobacteria and related organisms. Tuber Lung Dis 1995; 76: 141–8PubMedCrossRef
7.
go back to reference Heym B, Honoré N, Truffot-Pernot C, et al. Implications of multidrug resistance for the future of short course chemotherapy of tuberculosis: a molecular study. Lancet 1994; 344: 293–8PubMedCrossRef Heym B, Honoré N, Truffot-Pernot C, et al. Implications of multidrug resistance for the future of short course chemotherapy of tuberculosis: a molecular study. Lancet 1994; 344: 293–8PubMedCrossRef
9.
go back to reference Ramaswamy S, Musser JM. Molecular genetic basis of antimicrobial agent resistance in Mycobacterium tuberculosis: 1998 update. Tuber Lung Dis 1998; 79: 3–29PubMedCrossRef Ramaswamy S, Musser JM. Molecular genetic basis of antimicrobial agent resistance in Mycobacterium tuberculosis: 1998 update. Tuber Lung Dis 1998; 79: 3–29PubMedCrossRef
10.
go back to reference Zhang Y, Telenti A. Genetics of drug resistance in Mycobacterium tuberculosis. In: Hatfull G, Jr Jacobs WR, editors. Molecular genetics of the mycobacteria. Washington: American Society for Microbiology, 2000. In press Zhang Y, Telenti A. Genetics of drug resistance in Mycobacterium tuberculosis. In: Hatfull G, Jr Jacobs WR, editors. Molecular genetics of the mycobacteria. Washington: American Society for Microbiology, 2000. In press
11.
go back to reference Telenti A, Persing DH. Novel strategies for the detection of drug resistance in Mycobacterium tuberculosis. Res Microbiol 1996; 147: 73–9PubMedCrossRef Telenti A, Persing DH. Novel strategies for the detection of drug resistance in Mycobacterium tuberculosis. Res Microbiol 1996; 147: 73–9PubMedCrossRef
12.
go back to reference Head SR, Parikh K, Rogers YH, et al. Solid-phase sequence scanning for drug resistance detection in tuberculosis. Mol Cell Probes 1999; 13: 81–7PubMedCrossRef Head SR, Parikh K, Rogers YH, et al. Solid-phase sequence scanning for drug resistance detection in tuberculosis. Mol Cell Probes 1999; 13: 81–7PubMedCrossRef
13.
go back to reference Troesch A, Nguyen H, Miyada CG, et al. Mycobacterium species identification and rifampin resistance testing with high-density DNA probe arrays. J Clin Microbiol 1999; 37: 49–55PubMed Troesch A, Nguyen H, Miyada CG, et al. Mycobacterium species identification and rifampin resistance testing with high-density DNA probe arrays. J Clin Microbiol 1999; 37: 49–55PubMed
14.
go back to reference Piatek AS, Tygi S, Pol AC, et al. Molecular beacon sequence analysis: a novel approach to the detection of drug resistance in Mycobacterium tuberculosis. Nature Biotech 1998. 16: 359–363CrossRef Piatek AS, Tygi S, Pol AC, et al. Molecular beacon sequence analysis: a novel approach to the detection of drug resistance in Mycobacterium tuberculosis. Nature Biotech 1998. 16: 359–363CrossRef
15.
go back to reference Telenti A, Imboden P, Marchesi F, et al. Detection of rifampicin-resistance mutations in Mycobacterium tuberculosis. Lancet 1993; 341: 647–50PubMedCrossRef Telenti A, Imboden P, Marchesi F, et al. Detection of rifampicin-resistance mutations in Mycobacterium tuberculosis. Lancet 1993; 341: 647–50PubMedCrossRef
16.
go back to reference Jacobs Jr WJ, Barletta RG, Udani R, et al. Rapid assessment of drug susceptibilities of Mycobacterium tuberculosis by means of luciferase reporter phages. Science 1993; 260: 819–22PubMedCrossRef Jacobs Jr WJ, Barletta RG, Udani R, et al. Rapid assessment of drug susceptibilities of Mycobacterium tuberculosis by means of luciferase reporter phages. Science 1993; 260: 819–22PubMedCrossRef
17.
go back to reference Wilson SM, Al-Suwaidi Z, McNerney R, et al. Evaluation of a new rapid bacteriophage-based method for the drug susceptibility testing of Mycobacterium tuberculosis. Nature Med 1997; 3: 465–8PubMedCrossRef Wilson SM, Al-Suwaidi Z, McNerney R, et al. Evaluation of a new rapid bacteriophage-based method for the drug susceptibility testing of Mycobacterium tuberculosis. Nature Med 1997; 3: 465–8PubMedCrossRef
18.
go back to reference Riska PF, Su Y, Bardarov S, et al. Rapid film-based determination of antibiotic susceptibilities of Mycobacterium tuberculosis strains by using a luciferase reporter phage and the Bronx Box. J Clin Microbiol 1999; 37: 1144–9PubMed Riska PF, Su Y, Bardarov S, et al. Rapid film-based determination of antibiotic susceptibilities of Mycobacterium tuberculosis strains by using a luciferase reporter phage and the Bronx Box. J Clin Microbiol 1999; 37: 1144–9PubMed
19.
go back to reference Sudre P, Cohn DL. Mycobacterium tuberculosis resistance: a call for action. Int J Tuberculosis Lung Dis 1998; 2: 609–11 Sudre P, Cohn DL. Mycobacterium tuberculosis resistance: a call for action. Int J Tuberculosis Lung Dis 1998; 2: 609–11
20.
go back to reference Lazlo A, Rahman M, Raviglione M, et al. Quality assurance programme for drug susceptibility testing for Mycobacterium tuberculosis in the WHO/IUTLD supranational laboratory network: first round of proficiency testing. Int J Tuberculosis Lung Dis 1997; 1: 231–8 Lazlo A, Rahman M, Raviglione M, et al. Quality assurance programme for drug susceptibility testing for Mycobacterium tuberculosis in the WHO/IUTLD supranational laboratory network: first round of proficiency testing. Int J Tuberculosis Lung Dis 1997; 1: 231–8
21.
go back to reference van Embden JDA. Molecular epidemiology of tuberculosis [lecture]. American Society of Microbiology (ASM) Conference on Tuberculosis: past, present and future; State of the Art: 1997 July; Coppermountain (CO) van Embden JDA. Molecular epidemiology of tuberculosis [lecture]. American Society of Microbiology (ASM) Conference on Tuberculosis: past, present and future; State of the Art: 1997 July; Coppermountain (CO)
22.
go back to reference Ordway DJ, Sonnenberg MG, Donahue SA, et al. Drug-resistant strains of Mycobacterium tuberculosis exhibit a range of virulence for mice. Infect Immun 1995; 63: 741–3PubMed Ordway DJ, Sonnenberg MG, Donahue SA, et al. Drug-resistant strains of Mycobacterium tuberculosis exhibit a range of virulence for mice. Infect Immun 1995; 63: 741–3PubMed
23.
go back to reference Meissner G. The bacteriology of the tubercle bacillus. In: Barry VC, editor. Chemotherapy of tuberculosis. London: Butter-worths, 1964 Meissner G. The bacteriology of the tubercle bacillus. In: Barry VC, editor. Chemotherapy of tuberculosis. London: Butter-worths, 1964
24.
go back to reference Wilson TM, de Lisle GW, Collins DM. Effect of inhA and katG on isoniazid resistance and virulence of Mycobacterium bovis. Mol Microbiol 1995; 15: 1009–15PubMedCrossRef Wilson TM, de Lisle GW, Collins DM. Effect of inhA and katG on isoniazid resistance and virulence of Mycobacterium bovis. Mol Microbiol 1995; 15: 1009–15PubMedCrossRef
25.
go back to reference Heym B, Stavropoulos E, Honore N, et al. Effects of over-expression of the alkyl hydroperoxide reductase AhpC on the virulence and isoniazid resistance of Mycobacterium tuberculosis. Infect Immun 1997; 65: 1395–1401PubMed Heym B, Stavropoulos E, Honore N, et al. Effects of over-expression of the alkyl hydroperoxide reductase AhpC on the virulence and isoniazid resistance of Mycobacterium tuberculosis. Infect Immun 1997; 65: 1395–1401PubMed
26.
go back to reference Billington O, McHugh T, Gillespie S. The physiological cost of rifampicin resistance induced in vitro in Mycobacterium tuberculosis. Antimicrob Agents Chemother 1999; 43: 1866–9PubMed Billington O, McHugh T, Gillespie S. The physiological cost of rifampicin resistance induced in vitro in Mycobacterium tuberculosis. Antimicrob Agents Chemother 1999; 43: 1866–9PubMed
27.
go back to reference Bifani PJ, Plikaytis BB, Kapur V, et al. Origin and interstate spread of a New York City multidrug-resistant Mycobacterium tuberculosis clone family. JAMA 1996; 275: 452–7PubMedCrossRef Bifani PJ, Plikaytis BB, Kapur V, et al. Origin and interstate spread of a New York City multidrug-resistant Mycobacterium tuberculosis clone family. JAMA 1996; 275: 452–7PubMedCrossRef
28.
go back to reference Agerton T, Valway SE, Blinkhorn RJ, et al. Spread of strain W, a highly drug-resistant strain of Mycobacterium tuberculosis, across the United States. Clin Infect Dis 1999; 29: 85–92PubMedCrossRef Agerton T, Valway SE, Blinkhorn RJ, et al. Spread of strain W, a highly drug-resistant strain of Mycobacterium tuberculosis, across the United States. Clin Infect Dis 1999; 29: 85–92PubMedCrossRef
29.
go back to reference Telzak EE, Fazal BA, Pollard CL, et al. Factors influencing time to sputum conversion among patients with smear positive pulmonary tuberculosis. Clin Infect Dis 1997; 25: 666–70PubMedCrossRef Telzak EE, Fazal BA, Pollard CL, et al. Factors influencing time to sputum conversion among patients with smear positive pulmonary tuberculosis. Clin Infect Dis 1997; 25: 666–70PubMedCrossRef
30.
go back to reference Mitchison D, Nunn P. Influence of initial drug resistance on the response to short-course chemotherapy of pulmonary tuberculosis. Am Rev Resp Dis 1986; 133: 423–30PubMed Mitchison D, Nunn P. Influence of initial drug resistance on the response to short-course chemotherapy of pulmonary tuberculosis. Am Rev Resp Dis 1986; 133: 423–30PubMed
31.
go back to reference Hong Kong Chest Service, British Medical Research Council. Controlled trial of 6-month and 9-month regimens of daily and intermittent streptomycin plus isoniazid plus pyrazinamide for pulmonary tuberculosis in Hong Kong. Am Rev Respir Dis 1977; 115: 727–35 Hong Kong Chest Service, British Medical Research Council. Controlled trial of 6-month and 9-month regimens of daily and intermittent streptomycin plus isoniazid plus pyrazinamide for pulmonary tuberculosis in Hong Kong. Am Rev Respir Dis 1977; 115: 727–35
32.
go back to reference Crofton JO, Chaulet P, Maher D. Guidelines for the management of drug resistant tuberculosis. Geneva: World Health Organization, 1997. Also available from: URL: http://www.who.int Crofton JO, Chaulet P, Maher D. Guidelines for the management of drug resistant tuberculosis. Geneva: World Health Organization, 1997. Also available from: URL: http://​www.​who.​int
33.
34.
go back to reference Goble M, Iseman MD, Madsen LA, et al. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med 1993; 328: 527–32PubMedCrossRef Goble M, Iseman MD, Madsen LA, et al. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med 1993; 328: 527–32PubMedCrossRef
35.
go back to reference Alangaden GJ, Lerner SA. The clinical use of fluoroquinolones for the treatment of mycobacterial infections. Clin Infect Dis 1997; 25: 1213–21PubMedCrossRef Alangaden GJ, Lerner SA. The clinical use of fluoroquinolones for the treatment of mycobacterial infections. Clin Infect Dis 1997; 25: 1213–21PubMedCrossRef
36.
go back to reference Ji B, Lounis N, Maslo C, et al. In vitro and in vivo activities of moxifloxacin and clinafloxaxin against Mycobacterium tuberculosis. Antimicrob Agents Chemother 1998; 42: 2066–9PubMed Ji B, Lounis N, Maslo C, et al. In vitro and in vivo activities of moxifloxacin and clinafloxaxin against Mycobacterium tuberculosis. Antimicrob Agents Chemother 1998; 42: 2066–9PubMed
37.
go back to reference Herbert D, Paramasivan CN, Venkatesan P, et al. Bactericidal action of ofloxacin, sulbactam-ampicillin, rifampin, and isoniazid on logarithmic- and stationary-phase cultures of Mycobacterium tuberculosis. Antimicrob Agents Chemother 1996; 40: 2296–9PubMed Herbert D, Paramasivan CN, Venkatesan P, et al. Bactericidal action of ofloxacin, sulbactam-ampicillin, rifampin, and isoniazid on logarithmic- and stationary-phase cultures of Mycobacterium tuberculosis. Antimicrob Agents Chemother 1996; 40: 2296–9PubMed
38.
go back to reference Hackbarth CJ, Unsal I, Chambers HF. Cloning and sequence analysis of a class A beta-lactamase from Mycobacterium tuberculosis. Antimicrob Agents Chemother 1997; 41: 1182–5PubMed Hackbarth CJ, Unsal I, Chambers HF. Cloning and sequence analysis of a class A beta-lactamase from Mycobacterium tuberculosis. Antimicrob Agents Chemother 1997; 41: 1182–5PubMed
39.
go back to reference Chambers HF, Kocagoz S, Sipit T, et al. Activity of amoxicillin-clavulanate in patients with tuberculosis. Clin Infect Dis 1998; 26: 874–7PubMedCrossRef Chambers HF, Kocagoz S, Sipit T, et al. Activity of amoxicillin-clavulanate in patients with tuberculosis. Clin Infect Dis 1998; 26: 874–7PubMedCrossRef
40.
go back to reference Segura C, Salvado M, Collado I, et al. Contribution of beta-lactam susceptibilities of susceptible and multidrug-resistant M tuberculosis clinical isolates. Antimicrob Agents Chemother 1998; 42: 1524–6PubMed Segura C, Salvado M, Collado I, et al. Contribution of beta-lactam susceptibilities of susceptible and multidrug-resistant M tuberculosis clinical isolates. Antimicrob Agents Chemother 1998; 42: 1524–6PubMed
41.
go back to reference Chambers HF, Moreau D, Yajko D, et al. Can penicillins and other beta-lactam antibiotics be used to treat tuberculosis? Antimicrob Agents Chemother 1995; 39: 2620–4PubMedCrossRef Chambers HF, Moreau D, Yajko D, et al. Can penicillins and other beta-lactam antibiotics be used to treat tuberculosis? Antimicrob Agents Chemother 1995; 39: 2620–4PubMedCrossRef
42.
go back to reference Barbachyn MR, Hutchinson DK, Brickner SJ, et al. Identification of a novel oxazolidinone (U-100480) with potent anti-mycobacterial activity. J Med Chem 1996; 39: 680–5PubMedCrossRef Barbachyn MR, Hutchinson DK, Brickner SJ, et al. Identification of a novel oxazolidinone (U-100480) with potent anti-mycobacterial activity. J Med Chem 1996; 39: 680–5PubMedCrossRef
43.
go back to reference Zurenko GE, Yagi BH, Schaadt RD, et al. In vitro activities of U-100592 and U-100766, novel osazolidinone antibacterial agents. Antimicrob Agents Chemother 1996; 40: 839–45PubMed Zurenko GE, Yagi BH, Schaadt RD, et al. In vitro activities of U-100592 and U-100766, novel osazolidinone antibacterial agents. Antimicrob Agents Chemother 1996; 40: 839–45PubMed
44.
go back to reference Eustice DC, Feldmann GM, Zajac I, et al. Mechanism of action of DuP 721: inhibition of an early event during initiation of protein synthesis. Antimicrob Agents Chemother 1988; 32: 1218–22PubMedCrossRef Eustice DC, Feldmann GM, Zajac I, et al. Mechanism of action of DuP 721: inhibition of an early event during initiation of protein synthesis. Antimicrob Agents Chemother 1988; 32: 1218–22PubMedCrossRef
45.
go back to reference Cynamon M, Klemens SP, Sharpe CA, et al. Activities of several novel oxazolidinones against Mycobacterium tuberculosis in a murine model. Antimicrob Agents Chemother 1999; 43: 1189–91PubMed Cynamon M, Klemens SP, Sharpe CA, et al. Activities of several novel oxazolidinones against Mycobacterium tuberculosis in a murine model. Antimicrob Agents Chemother 1999; 43: 1189–91PubMed
46.
47.
go back to reference Slayden RA, Lee RE, Armour JW, et al. Antimycobacterial action of thiolactomycin: an inhibitor of fatty acid and mycolic acid synthesis. Antimicrob Agents Chemother 1996; 40: 2813–19PubMed Slayden RA, Lee RE, Armour JW, et al. Antimycobacterial action of thiolactomycin: an inhibitor of fatty acid and mycolic acid synthesis. Antimicrob Agents Chemother 1996; 40: 2813–19PubMed
48.
go back to reference Phetsuksiri B, Baulard AR, Cooper AM, et al. Antimycobacterial activities of isoxyl and new derivatives through the inhibition of mycolic acid synthesis. Antimicrob Agents Chemother 1999; 43: 1042–51PubMed Phetsuksiri B, Baulard AR, Cooper AM, et al. Antimycobacterial activities of isoxyl and new derivatives through the inhibition of mycolic acid synthesis. Antimicrob Agents Chemother 1999; 43: 1042–51PubMed
49.
go back to reference Rastogi N, Seng Goh K, David HL. Enhancement of drug susceptibility of Mycobacterium avium by inhibitors of cell envelope synthesis. Antimicrob Agents Chemother 1990; 34: 759–64PubMedCrossRef Rastogi N, Seng Goh K, David HL. Enhancement of drug susceptibility of Mycobacterium avium by inhibitors of cell envelope synthesis. Antimicrob Agents Chemother 1990; 34: 759–64PubMedCrossRef
50.
go back to reference Khoo KH, Douglas E, Azadi P, et al. Truncated structural variants of lipoarabinomannan in ethambutol drug-resistant strains of Mycobacterium smegmatis: inhibition of arabinan biosynthesis by ethambutol. J Biol Chem 1996; 271: 28682–90PubMedCrossRef Khoo KH, Douglas E, Azadi P, et al. Truncated structural variants of lipoarabinomannan in ethambutol drug-resistant strains of Mycobacterium smegmatis: inhibition of arabinan biosynthesis by ethambutol. J Biol Chem 1996; 271: 28682–90PubMedCrossRef
51.
go back to reference Bodmer T, Zürcher G, Imboden I, et al. Molecular basis of rifabutin susceptibility in rifampicin resistant M tuberculosis. J Antimicrob Chemother 1995; 35: 345–8PubMedCrossRef Bodmer T, Zürcher G, Imboden I, et al. Molecular basis of rifabutin susceptibility in rifampicin resistant M tuberculosis. J Antimicrob Chemother 1995; 35: 345–8PubMedCrossRef
52.
go back to reference Moghazeh SL, Pan X, Arain T, et al. Comparative antimycobacterial activities of rifampin, rifapentine, and KRM-1648 against a collection of rifampin-resistant Mycobacterium tuberculosis isolates with known rpoB mutations. Antimicrob Agents Chemother 1996; 40: 2655–7PubMed Moghazeh SL, Pan X, Arain T, et al. Comparative antimycobacterial activities of rifampin, rifapentine, and KRM-1648 against a collection of rifampin-resistant Mycobacterium tuberculosis isolates with known rpoB mutations. Antimicrob Agents Chemother 1996; 40: 2655–7PubMed
53.
go back to reference World Health Organization (WHO). Global tuberculosis control: WHO report. Geneva: WHO, 1999 World Health Organization (WHO). Global tuberculosis control: WHO report. Geneva: WHO, 1999
55.
go back to reference Iseman MD. MDR-TB and the developing world — a problem no longer to be ignored: the WHO announces DOTS-plus strategy. Int J Tuberculosis Lung Dis 1998; 2: 867 Iseman MD. MDR-TB and the developing world — a problem no longer to be ignored: the WHO announces DOTS-plus strategy. Int J Tuberculosis Lung Dis 1998; 2: 867
56.
go back to reference Frieden TR, Sherman DR, Maw K, et al. A multi-institutional outbreak of highly resistant tuberculosis: epidemiology and clinical outcomes. JAMA 1996; 276: 1229–35PubMedCrossRef Frieden TR, Sherman DR, Maw K, et al. A multi-institutional outbreak of highly resistant tuberculosis: epidemiology and clinical outcomes. JAMA 1996; 276: 1229–35PubMedCrossRef
57.
go back to reference Fennelly K, Nardell E. The relative efficacy of respirators and room ventilation in preventing occupational tuberculosis. Inf Control Hosp Epidemiol 1998; 19: 754–9CrossRef Fennelly K, Nardell E. The relative efficacy of respirators and room ventilation in preventing occupational tuberculosis. Inf Control Hosp Epidemiol 1998; 19: 754–9CrossRef
58.
go back to reference Rose DN. Short course prophylaxis against tuberculosis in HIV-infected persons: a decision and cost-effective analysis. Ann Intern Med 1998; 129: 779–86PubMed Rose DN. Short course prophylaxis against tuberculosis in HIV-infected persons: a decision and cost-effective analysis. Ann Intern Med 1998; 129: 779–86PubMed
59.
go back to reference Fang Z, Doig C, Rayner A, et al. Molecular evidence for heterogeneity of the multiple-drug-resistant Mycobacterium tuberculosis population in Scotland (1990 to 1997). J Clin Microbiol 1999; 37: 998–1003PubMed Fang Z, Doig C, Rayner A, et al. Molecular evidence for heterogeneity of the multiple-drug-resistant Mycobacterium tuberculosis population in Scotland (1990 to 1997). J Clin Microbiol 1999; 37: 998–1003PubMed
Metadata
Title
Drug-Resistant Tuberculosis
What Do We Do Now?
Authors
Dr Amalio Telenti
Michael Iseman
Publication date
01-02-2000
Publisher
Springer International Publishing
Published in
Drugs / Issue 2/2000
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200059020-00002

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