TY - JOUR T1 - Supporting TB clinicians managing difficult cases: the ERS/WHO Consilium JF - European Respiratory Journal JO - Eur Respir J SP - 491 LP - 494 DO - 10.1183/09031936.00196712 VL - 41 IS - 3 AU - Francesco Blasi AU - Masoud Dara AU - Marieke J. van der Werf AU - Giovanni Battista Migliori Y1 - 2013/03/01 UR - http://erj.ersjournals.com/content/41/3/491.abstract N2 - Multidrug-resistant tuberculosis (MDR-TB), defined as active TB cases infected by Mycobacterium tuberculosis strains that are resistant to isoniazid and rifampicin (the two most important anti-TB drugs currently in use), and extensively drug resistant tuberculosis (XDR-TB), defined as active TB cases caused by infection with strains that are resistant to at least one fluoroquinolone and one injectable second-line anti-TB drug in addition to resistance to isoniazid and rifampicin, attract interest at different levels [1–5]. In recent years the alarming rates of MDR- or XDR-TB in Eastern Europe and some other parts of the world, have resulted in strong expressions of concern from national and international partners, health authorities, and professional societies.At the media level, the key words MDR-TB and XDR-TB attract spikes of citations and consistent interest, as a simple Google search can testify (fig. 1).Figure 1– Web search interest for “MDR-TB”, “XDR-TB”, “totally drug resistant” and “resistant tuberculosis” worldwide from 2004 to present (source: Google Trends). On the y-axis the number 100 represents the peak search volume. From the public health point of view, MDR- and XDR-TB is considered a serious threat for TB control and elimination. Therefore, the international community and national governments prioritise monitoring and evaluating prevalence rates and trends of drug resistant TB at both the global and the regional level [2, 3].Recent evidence suggests that of the estimated 310,000 MDR-TB cases among notified TB patients with pulmonary TB in 2011, 60% occurred in India, China and the Russian Federation. XDR-TB is, at present, notified in 84 countries, although representative data on these difficult-to-treat cases are only available in 13 of them [2, 3].The proportion of MDR-TB cases harbouring XDR-TB strains of M. tuberculosis was highest in Azerbaijan, Belarus, Estonia, Latvia, Lithuania and Tajikistan. … ER -