PT - JOURNAL ARTICLE AU - Schäfer, Hannah AU - Barker, Michael AU - Follmann, Peter AU - Günther, Annette AU - Kaiser-Labusch, Petra AU - Kerzen, Sebastian AU - Schmidt, Christian AU - Schütz, Katharina AU - Stehling, Florian AU - Timmesfeld, Nina AU - Vöhringer, Paul AU - Brinkmann, Folke TI - Fate or missed opportunities - challenges in diagnosing paediatric drug resistant tuberculosis in Germany AID - 10.1183/13993003.congress-2021.PA3149 DP - 2021 Sep 05 TA - European Respiratory Journal PG - PA3149 VI - 58 IP - suppl 65 4099 - http://erj.ersjournals.com/content/58/suppl_65/PA3149.short 4100 - http://erj.ersjournals.com/content/58/suppl_65/PA3149.full SO - Eur Respir J2021 Sep 05; 58 AB - Background: Diagnosis and treatment of paediatric tuberculosis resistant to both isoniazid and rifampicin (MDR-pTB) remain challenging due to paucibacillary disease, low sensitivity and specificity of diagnostic tools and frequently changing guidelinesAims and objective: This study aimed to describe epidemiology, clinical characteristics and outcome of MDR-TB among children and adolescents in Germany.Methods: We collected all cases of MDR-pTB registered in Germany from 2010 to 2020 and compared their data to an adequate control sample with drug-sensitive TB.Results: 52 subjects with MDR-pTB (24 active MDR-TB, 28 MDR-LTBI) and 56 controls were included. The annual incidence of MDR-TB rose from two in 2010 to nine in 2020. Time to diagnosis was longer in MDR-pTB compared to drug-sensitive TB (43 vs. 8 days, p <0.001) and did not change during the observational period while the time to diagnose drug-sensitive TB decreased. Most children with MDR-TB were born in countries of the former Soviet Union (48% vs. 8%, p <0.001) and have an index with drug-resistant-TB (97.7% vs. 2.8%, p <0.001). Most patients (85%) recovered, but 20% of MDR patients suffered from long-term side effects.Conclusions: Early diagnosis, identification of potential MDR index, appropriate treatment and follow-up are essential in MDR-pTB. Therefore, better cooperation between clinics and public health care is required in Germany. In children with an MDR-TB index case or in those born in a MDR high-incidence country, bacteriological confirmation including PCR-based susceptibility testing should always be initiated. The individual drug regimen has to be adapted to the patients’ or index’ susceptibility testing results.FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3149.This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).