ERS/WHO Tuberculosis Consilium: reporting of the initial 10 cases

Abstract

To the Editor: As part of the 2012–2013 European Respiratory Society (ERS) Presidential plan, the ERS/World Health Organization (WHO) Tuberculosis (TB) Consilium was implemented as a novel high priority initiative to face the growing global multidrug-resistant (MDR) TB pandemic, which is also very much a European problem [1–3]. This priority is largely due to the alarming rates of MDR-TB ( i.e . active TB cases infected by Mycobacterium tuberculosis strains that are resistant to isoniazid and rifampicin) and extensively drug-resistant (XDR) TB ( i.e . TB caused by strains that are resistant to at least one fluoroquinolone and one injectable second-line anti-TB drug, in addition to isoniazid and rifampicin) [4–7]. MDR/XDR-TB are considered serious threats for TB control and elimination in Europe as their clinical outcomes are largely suboptimal, as the regimens are very toxic and expensive and taken for much longer [6–9]. The largest available meta-analysis, assessing 9153 MDR-TB cases, has shown treatment success as low as 54% (with 15% dying, 8% failing/relapsing and 23% defaulting). In cases whose disease is caused by M. tuberculosis strains with resistance patterns beyond XDR-TB the outcomes are much lower: treatment success ranges from 19% to 40%, failure/relapse from 15% to 54% and death from 15% to 35% [6, 7]. Due to the clinical complexity (frequent occurrence of adverse events, lack of clinical experience, limited availability of adequate diagnostics and second-line anti-TB drugs in some countries), the real risk for acquiring …