广谱耐药性结核病治疗计划(2009年版)-英文版
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department of health and human services
Centers for Disease Control and PreventionRecommendations and Reports February 13, 2009 / Vol. 58 / No. RR-3
Morbidity and Mortality Weekly Report
www.cdc.gov/mmwr
Plan to Combat Extensively Drug-Resistant Tuberculosis
Recommendations of the Federal Tuberculosis Task Force MMWR
Editorial Board
William L. Roper, MD, MPH, Chapel Hill, NC, ChairmanVirginia A. Caine, MD, Indianapolis, INDavid W. Fleming, MD, Seattle, WAWilliam E. Halperin, MD, DrPH, MPH, Newark, NJMargaret A. Hamburg, MD, Washington, DCKing K. Holmes, MD, PhD, Seattle, WADeborah Holtzman, PhD, Atlanta, GAJohn K. Iglehart, Bethesda, MDDennis G. Maki, MD, Madison, WISue Mallonee, MPH, Oklahoma City, OKPatricia Quinlisk, MD, MPH, Des Moines, IAPatrick L. Remington, MD, MPH, Madison, WIBarbara K. Rimer, DrPH, Chapel Hill, NCJohn V. Rullan, MD, MPH, San Juan, PRWilliam Schaffner, MD, Nashville, TNAnne Schuchat, MD, Atlanta, GADixie E. Snider, MD, MPH, Atlanta, GAJohn W. Ward, MD, Atlanta, GAThe MMWR series of publications is published by the Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2009;58(No. RR-#):[inclusive page numbers].
Centers for Disease Control and Prevention
Richard E. Besser, MD(Acting) DirectorTanja Popovic, MD, PhDChief Science OfficerJames W. Stephens, PhDAssociate Director for ScienceSteven L. Solomon, MDDirector, Coordinating Center for Health Information and ServiceJay M. Bernhardt, PhD, MPHDirector, National Center for Health MarketingKatherine L. Daniel, PhDDeputy Director, National Center for Health Marketing
Editorial and Production Staff
Frederic E. Shaw, MD, JDEditor, MMWR SeriesSusan F. Davis, MD(Acting) Assistant Editor, MMWR SeriesRobert A. Gunn, MD, MPHAssociate Editor, MMWR SeriesTeresa F. RutledgeManaging Editor, MMWR SeriesDavid C. Johnson(Acting) Lead Technical Writer-EditorJeffrey D. Sokolow, MAProject EditorMartha F. BoydLead Visual Information SpecialistMalbea A. LaPeteStephen R. SpriggsVisual Information SpecialistsKim L. Bright, MBAQuang M. Doan, MBAPhyllis H. KingInformation Technology SpecialistsConTEnTS
Introduction ..............................................................................2
Recommendations to Combat Extensively
Drug-Resistant Tuberculosis ......................................................5
Action Plan to Combat Extensively Drug-Resistant Tuberculosis ......6
Conclusion ..............................................................................39
References ..............................................................................39
Appendix ...............................................................................41
Disclosure of Relationship
CDC, our planners, and our content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Presentations will not include any discussion of the unlabeled use of a product or a product under investigational use.Vol. 58 / RR-3 Recommendations and Reports 1
Plan to Combat Extensively Drug-Resistant Tuberculosis
Recommendations of the Federal Tuberculosis Task Force
Reported byPhilip LoBue, MD1Christine Sizemore, PhD2Kenneth G. Castro, MD11Division of TB Elimination, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC2Division of Microbiology and Infectious Diseases, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
Summary
An estimated one third of the world’s population is infected with Mycobacterium tuberculosis, and nearly 9 million persons
develop disease caused by M. tuberculosis each year. Although tuberculosis (TB) occurs predominantly in resource-limited coun-
tries, it also occurs in the United States.
During 1985–1992, the United States was confronted with an unprecedented TB resurgence. This resurgence was accompa-
nied by a rise in multidrug-resistant TB (MDR TB), which is defined as TB that is resistant to the two most effective first-line
therapeutic drugs, isoniazid and rifampin. In addition, virtually untreatable strains of M. tuberculosis are emerging globally.
Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic
drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB
