The Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
The Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia.
J Infect. 2017 Jun;74 Suppl 1:S128-S135. doi: 10.1016/S0163-4453(17)30203-7.
The DOTS strategy assisted global tuberculosis (TB) control, but was unable to prevent the emergence and spread of drug-resistant strains. Genomic evidence confirms the transmission of drug-resistant Mycobacterium tuberculosis strains in many different settings, indicative of epidemic spread. These findings emphasise the need for enhanced infection control measures in health care and congregate settings. Young children in TB endemic areas are particularly vulnerable. Although advances in TB drug and vaccine development are urgently needed, improved access to currently available preventive therapy and treatment for drug resistant TB could reduce the disease burden and adverse outcomes experienced by children. We review new insights into the transmission dynamics of drug resistant TB, the estimated disease burden in children and optimal management strategies to consider.
DOTS 策略协助了全球结核病 (TB) 控制，但未能阻止耐药菌株的出现和传播。基因组证据证实了耐药结核分枝杆菌菌株在许多不同环境中的传播，表明存在流行传播。这些发现强调了需要在医疗保健和聚集场所加强感染控制措施。结核病流行地区的幼儿尤其脆弱。尽管迫切需要在结核病药物和疫苗开发方面取得进展，但增加获得现有耐药结核病预防性治疗和治疗的机会，可以减轻儿童的疾病负担和不良后果。我们回顾了耐药结核病传播动态、儿童疾病负担和最佳管理策略方面的新见解。
