TY -的T1 -其失败的一个方案not predict MDR/XDR tuberculosis: is “blind” treatment dangerous? JF - European Respiratory Journal JO - Eur Respir J SP - 1283 LP - 1285 DO - 10.1183/09031936.00144710 VL - 37 IS - 5 AU - Badoum, G. AU - Saleri, N. AU - Dembélé, M.S. AU - Ouedraogo, M. AU - Pinsi, G. AU - Boncoungou, K. AU - Bonkoungou, V. AU - Birba, E. AU - Miotto, P. AU - Migliori, G.B. AU - Cirillo, D.M. AU - Matteelli, A. Y1 - 2011/05/01 UR - //www.qdcxjkg.com/content/37/5/1283.abstract N2 - To the Editors:Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) represent an emerging public health threat worldwide 1. The Stop TB Strategy has been revised to provide universal access to diagnosis and treatment for all patients with MDR-TB by 2015 2–4. This plan calls for accelerated access to culture for mycobacteria, species identification and drug susceptibility testing (DST) of Mycobacterium tuberculosis. However, in several countries, appropriate TB laboratory facilities are still largely unavailable. In the absence of culture and DST, TB patients failing a re-treatment regimen have been considered eligible for treatment regimens with second-line drugs, under the assumption that ≥80% of them would harbour MDR M. tuberculosis strains 5.In Burkina Faso, as in most low- and some middle-income settings, pulmonary TB cases failing a standard category II regimen are only identified by positive sputum smear microscopy at the end of the fifth month of treatment and are defined as “chronic” TB patients. The diagnosis of chronic TB has significant implications. National guidelines for the management of chronic TB cases in Burkina Faso recommend hospital admission and in-patient treatment for ≥6 months with a standardised category IV treatment regimen 6.Although the diagnosis of chronic TB is taken as a surrogate marker for the identification of MDR-TB, little evidence is available from the literature on its positive predictive value for MDR-TB diagnosis. We systematically performed microbiological investigations, which included both phenotypic and genotypic techniques, on all newly identified chronic TB cases diagnosed over a 2-yr period in Burkina Faso. Here, we report the results and discuss the implications that “blind” treatment with second-line drugs have at programmatic level.A prospective, country-wide investigation was performed to microbiologically characterise all consecutively registered chronic TB cases in Burkina Faso, defined on the basis of … ER -