Lange C, Grobusch M P, Wagner D
Klinische Infektiologie, Medizinische Klinik, Forschungszentrum Borstel.
Dtsch Med Wochenschr. 2008 Feb;133(8):374-6. doi: 10.1055/s-2008-1046724.
Recently an increasing number of antibiotic-resistant MYCOBACTERIUM TUBERCULOSIS (MTB) strains have been described worldwide. The term XDR- (extensively drug-resistant) tuberculosis (TB) has been introduced by the World Health Organisation (WHO) to characterize multi-drug-resistant MTB strains that are in vitro resistant against fluorochinolones and one of the injectible substances amikacin, capreomycin or kanamycin in addition to isoniazid and rifampin. Strains of XDR-MTB are currently increasingly seen in HIV-seropositive individuals with tuberculosis in southern Africa, where these strains are passed by person-to person contact. XDR-TB has become a serious problem for the health administrations in this region. In contrast, cases of XDR-TB are only rarely seen in Germany so far, mainly among the population of pre-treated migrants from eastern Europe. The development of rapid diagnostic tests for resistance testing and new drugs for the treatment of tuberculosis has lacked support for several decades. The sudden emergence of XDR-MTB strains now warrants immediate action for the development of such tests and new classes of antibiotics to give all patients with TB a chance for a successful treatment.
近年来，全球范围内出现了越来越多具有抗生素耐药性的结核分枝杆菌（MTB）菌株。世界卫生组织（WHO）引入了“广泛耐药（XDR）结核病”这一术语，用于描述对氟喹诺酮类药物以及注射用药物阿米卡星、卷曲霉素或卡那霉素中的一种呈现体外耐药性，同时对异烟肼和利福平也耐药的多重耐药MTB菌株。目前，在非洲南部感染结核病的HIV血清阳性个体中，XDR-MTB菌株越来越常见，且通过人际接触传播。XDR-TB已成为该地区卫生管理部门面临的一个严重问题。相比之下，到目前为止，德国仅偶尔出现XDR-TB病例，主要集中在来自东欧的接受过治疗的移民群体中。几十年来，用于耐药性检测的快速诊断测试以及治疗结核病的新药研发一直缺乏支持。如今，XDR-MTB菌株的突然出现促使人们立即采取行动，开发此类检测方法和新型抗生素，以使所有结核病患者都有机会获得成功治疗。
