Outbreak of pre- and extensively drug-resistant tuberculosis in northern Italy: urgency of cross-border, multidimensional, surveillance systems
Outbreak of pre- and extensively drug-resistant tuberculosis in northern Italy: urgency of cross-border, multidimensional, surveillance systems
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意大利北部爆发前耐药性和广泛耐药性结核病：跨境、多维监测系统的紧迫性
DOI：
10.1183/13993003.00839-2021
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发表时间：
2021
影响因子：
24.3
通讯作者：
L. Codecasa
中科院分区：
文献类型：
--
作者：
S. Villa;E. Tagliani;E. Borroni;P. Castellotti;M. Ferrarese;A. Ghodousi;A. Lamberti;S. Senatore;M. Faccini;D. Cirillo;L. Codecasa
耐多药结核病（MDR）和广泛耐药结核病（XDR）是一种主要的公共卫生威胁，因为治疗选择减少，患者预后不佳。近年来已经开发了新的抗菌剂和方案，但它们的有效性受到耐药菌株的增加和传播的阻碍。全基因组测序（WGS）已经成为一种能够彻底改变结核病监测和结核病临床管理的工具。目前，公共卫生机构在发现疫情和传播链方面广泛采用这种方法，从而支持制定循证卫生政策。此外，WGS可以预测结核分枝杆菌复合体（MTBC）菌株的药敏谱，通常与表型抗菌药物敏感性试验（AST）和最低抑菌浓度（MIC）测定相结合，为耐药结核bbb的最佳临床管理提供依据。利用全基因组测序和流行病学研究在意大利北部发现了一次（前）广泛耐药结核病的暴发。这一经验表明，应紧急采用综合和跨界监测系统。https://bit.ly/3wtQkBp
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are a major public health threat because of reduced treatment options and poor patient outcomes. New antimicrobials and regimens have been developed in recent years, but their effectiveness has been hampered by the rise and spread of drug-resistant strains. Whole genome sequencing (WGS) has emerged as a tool able to revolutionise TB surveillance and the clinical management of TB. This approach is now widely used by public health agencies in detecting outbreaks and transmission chains, thus supporting the formulation of evidence-based health policies. Moreover, WGS can predict the drug-susceptibility profile of Mycobacterium tuberculosis complex (MTBC) strains, often in combination with phenotypic antimicrobial susceptibility testing (AST) and minimum inhibitory concentration (MIC) determination for the optimal clinical management of drug-resistant TB [1]. An outbreak of (pre-)extensively drug-resistant tuberculosis was detected in Northern Italy using whole genome sequencing and epidemiological study. This experience suggests that integrated and cross-border surveillance systems should be urgently employed. https://bit.ly/3wtQkBp