Tuberc Respir Dis.  2014 Oct;77(4):161-166. 10.4046/trd.2014.77.4.161.

Respiratory Review of 2014: Tuberculosis and Nontuberculous Mycobacterial Pulmonary Disease

• Park CK
• Kwon YS

• KMID: 2320572
• DOI: http://doi.org/10.4046/trd.2014.77.4.161

Abstract

Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.

Keyword

Tuberculosis; Nontuberculous Mycobacteria; Tuberculosis, Multidrug-Resistant; Diagnosis; Antitubercular Agents

MeSH Terms

Adrenal Cortex Hormones
Antitubercular Agents
Compliance
Diagnosis
Disease Progression
Drug Resistance
Fluoroquinolones
Genome
Humans
Incidence
Levofloxacin
Lung Diseases*
Mortality
Mycobacterium
Mycobacterium avium Complex
Nontuberculous Mycobacteria
Phenotype
Recurrence
Rifampin
Steroids
Treatment Failure
Treatment Outcome
Tuberculosis*
Tuberculosis, Multidrug-Resistant
Linezolid
Adrenal Cortex Hormones
Antitubercular Agents
Fluoroquinolones
Rifampin
Steroids

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