Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK .
Lancet Infect Dis. 2012 Jun;12(6):469-79. doi: 10.1016/S1473-3099(11)70366-8. Epub 2012 Feb 27.
Children exposed to multidrug-resistant (MDR) Mycobacterium tuberculosis are at risk of developing MDR tuberculosis. Where treatment is available, it is lengthy, expensive, and associated with poor adherence and notable morbidity and mortality. Preventive treatment effectively lowers the risk of disease progression for contacts of individuals with drug-susceptible tuberculosis, but this strategy is poorly studied for contacts of people with MDR tuberculosis. In this Review we discuss the management of child contacts of source cases with MDR tuberculosis. We pay particular attention to assessment, existing international guidelines, possible preventive treatments, rationales for different management strategies, and the interaction with and implications of HIV infection.
儿童暴露于耐多药（MDR）结核分枝杆菌下，有发展为 MDR 结核的风险。如果有治疗方法，其疗程长、费用高，并且与较差的依从性以及显著的发病率和死亡率相关。预防治疗可有效降低对药物敏感型结核患者接触者发生疾病进展的风险，但对于 MDR 结核患者接触者，这种策略的研究较少。在这篇综述中，我们讨论了耐多药结核源病例的儿童接触者的管理。我们特别关注评估、现有的国际指南、可能的预防治疗方法、不同管理策略的原理，以及与 HIV 感染的相互作用和影响。
