Tuberculosis
- Topics
- Basic TB Facts
- Treatment
- Testing & Diagnosis
- TB & HIV Coinfection
- Infection Control & Prevention
- Drug-Resistant TB
- TB in Specific Populations
- African-American Community
- Correctional Facility Staff & Inmates
- Table of Contents
- Introduction
- Strengthen TB Information Systems and Program Assessment
- Strengthen TB Environmental Controls and Isolation Practices
- Provide More Comprehensive and Timely Screening and Diagnostic Evaluations
- Develop and Strengthen Contact Investigation Protocols
- Increase HIV Counseling and Testing
- Increase Staff Training
- Strengthen Collaboration Between Health Departments and Jails
- International Travelers
- Pregnancy
- Vaccines & Immunizations
- Laboratory Information
- Drug Susceptibility Testing
- High Performance Liquid Chromatography (HPLC)
- The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TB
- Rapid Molecular Testing to Detect Drug-Resistant TB in the US
- Executive Summary
- Introduction
- Background on Tests for Molecular Detection of DR
- General Considerations and Principles for a Molecular DR Testing Service�
- Possible Scenarios and Scope of Testing for a Molecular DR Testing Service
- Research Needs
- General Recommendations of the Expert Panel
- Communication Plan for the Report
- Recommendations
- References
- Panel Members and CDC Participants
- Appendix 1
- Appendix 2
- Appendix 3
- Interim Laboratory Biosafety Guidance for XDR Mycobacterium tuberculosis strains
- Research
- TB Epidemiologic Studies Consortium
- Background
- Infrastructure
- Research Projects
- Publications
- Meetings
- Directory
- TBESC Committee Members
- Contact TBESC
- Prospective Evaluation of Immunogenetic and Immunologic Markers for Susceptibility to Tuberculosis Infection and Progression from M. Tuberculosisinfection to active TB
- Zero Tolerance for Pediatric TB
- Models for Incorporating HIV Counseling, Testing, and Referral into Tuberculosis Contact Investigations
- Prevalence of Latent TB Infection Among High Risk Populations in the United States
- Regional Capacity-Building in Low-Incidence Areas
- Use of Network Analysis Methods to Characterize M. tuberculosis Transmission Patterns Among Women and Other High-Risk Populations
- An Analysis of Molecular Epidemiology of Multi-Drug Resistant M. tuberculosisin the United States
- Missed Opportunities for TB Prevention in Foreign-Born Population in the United States and Canada
- New Model for Assessing TB Surveillance and Action Performance and Cost
- Addressing TB Among African Americans in the Southeast: Identifying and Overcoming Barriers to Treatment Adherence for Latent TB Infection and TB Disease
- Assessing the TB Knowledge, Attitudes, Beliefs, and Practices Among Private Providers Serving Foreign-born Populations at Risk for TB
- Factors Associated with Acceptance of, Adherence to and Toxicity From Treatment for Latent TB Infection and Pilot Study of Treatment for Latent TB Infection Effectiveness
- Culturally Appropriate TB Educational Materials for Leaders and Staff of Hispanic Service Organizations
- Enhancing TB Programs� Capacity for Self-Evaluation: Testing New Tools and Developing an Evaluation Toolkit
- African Refugee Women�s Health Improvement Project
- Evaluation of the TK Medium: A New Rapid Solid Culture System for Tuberculosis
- Evaluation of New Interferon-y Release Assays in the Diagnosis of Latent TB Infection in Health Care Workers
- TB Trials Consortium
- Behavioral & Social Science Research
- TB Epidemiologic Studies Consortium
- Data & Statistics
- Education & Training
- Resources for TB Programs
- Publications & Products
- Fact Sheets
- General
- Fact sheets - Spanish
- TB - General Information
- The Difference Between Latent TB Infection and Active TB Disease
- A Global Perspective on TB
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Tuberculosis Information for International Travelers
- TB Can Be Treated
- Exposure to TB
- TB and HIV/AIDS
- You Can Prevent TB
- Testing for TB
- Tuberculosis: informaci�n general
- Diferencia entre la infecci�n de tuberculosis latente y enfermedad de tuberculosis activa
- Informaci�n sobre la tuberculosis para los viajeros internacionales
- Exposición a la tuberculosis
- Usted puede prevenir la tuberculosis
- La tuberculosis puede ser tratada
- Tuberculosis y VIH/SIDA
- Usted puede prevenir la tuberculosis
- Pruebas para detectar la tuberculosis
- Data & Statistics
- A Global Perspective on TB
- Trends in Tuberculosis – United States
- The Revised Report of Verified Case of Tuberculosis
- The National Tuberculosis Indicators Project (NTIP)
- National Tuberculosis Indicators Project (NTIP): Frequently Asked Questions
- TB Genotyping
- TB Genotyping Information Management System (TB-GIMS)
- Drug-Resistant TB
- Multidrug-Resistant Tuberculosis (MDR TB)
- Extensively Drug-Resistant Tuberculosis (XDR TB)
- CDC’s Role in Preventing Extensively Drug-Resistant Tuberculosis (XDR TB)
- Tuberculosis multirresistente (MDR)
- Tuberculosis extremadamente resistente (XDR)
- El papel de los CDC en la prevenci�n de la tuberculosis extremadamente resistente (XDR)
- Infection Control & Prevention
- TB in Specific Populations
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Tuberculosis in Minorities
- Tuberculosis Information for International Travelers
- TB and HIV/AIDS
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tuberculosis in Blacks
- Tuberculosis and Pregnancy
- Tuberculosis y embarazo
- Treatment
- TB Can Be Treated
- Treatment of Latent TB Infection
- Treatment of Latent Tuberculosis Infection: Maximizing Adherence
- Treatment Options for Latent Tuberculosis Infection
- Treatment of Drug-Resistant Tuberculosis
- Treatment of Drug-Susceptible Tuberculosis Disease in Persons Not Infected with HIV
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tratamiento de la infecci�n de tuberculosis latente
- Testing & Diagnosis
- TB Can Be Treated
- Testing for TB
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- QuantiFERON®-TB Gold Test
- Tuberculin Skin Testing
- Diagnosis of Tuberculosis Disease
- Targeted Tuberculin Testing and Interpreting Tuberculin Skin Test Results
- Prueba de QuantiFERON�-TB Gold
- Prueba cutánea de la tuberculina
- Diagnóstico de la tuberculosis activa
- Vaccines & Immunizations
- General
- Guidelines
- Guides & Toolkits
- Newsletters
- Pamphlets, Brochures, Booklets
- PDA Application
- Posters
- Reports & Articles
- Morbidity and Mortality Weekly Reports (MMWRs)
- Contact Investigations
- Control and Elimination
- Data & Statistics
- Drug-Resistant Tuberculosis
- Infection Control & Prevention
- Laboratory
- TB in Specific Populations
- Foreign-Born
- High-Risk Settings
- Homeless
- International
- Occupational Groups
- Travel
- TB & HIV
- Testing & Diagnosis
- Treatment
- LTBI Updates
- Vaccines & Immunizations
- World TB Day
- DTBE Authored Journal Articles
- Morbidity and Mortality Weekly Reports (MMWRs)
- Slide Sets
- Guidelines for Preventing the Transmission of M. TB in Health care Settings
- Investigation of Contacts of Persons with Infectious TB
- Text-Only version
- Introduction
- Decisions to Initiate a Contact Investigation
- Investigating the Index Patient and Sites of Transmission
- Assigning Priorities to Contacts
- Diagnostic and Public Health Evaluation of Contacts
- Medical Treatment for Contacts with LTBI
- When to Expand a Contact Investigation
- Communicating Through the News Media
- Data Management and Evaluation of Contact Investigations
- Confidentiality and Consent in Contact Investigations
- Staff Training for Contact Investigations
- Contact Investigations in Special Circumstances
- Source-Case Investigations
- Cultural Competency and Social Network Analysis
- Resources
- Epidemiology of Pediatric Tuberculosis in the United States
- Text-Only version
- Introduction
- Pediatric TB Cases by Age and Race
- Pediatric TB Cases by Origin of Birth
- Pediatric Cases, Percentages and Rates by States
- Pediatric TB Cases by Case Verification Criterion and Site of Disease
- Pediatric TB Cases in Specific Groups
- Pediatric TB Cases Case Completion
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- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Treatment of TB
- Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection
- Videos, DVDs, CD Roms
- Podcasts
- Web-Based Courses & Webinars
- Fact Sheets
- Events
- Links
- About Us
- Mission Statement and Activities
- Organization Chart
- Advisory Groups
- Federal TB Task Force
- Table of Contents
- Executive Summary
- Introduction
- Chronology in the Development of This Report
- Strategies for Maintaining Control of TB
- Strategies for Accelerating the Decline of TB
- Activities for Developing New Tools
- Global U.S. Actions
- Assessing the Impact of Actions Taken
- Federal TB Task Force Members and Others Involved in the Development of This Report
- Glossary
- References
- Federal TB Task Force Roster
- Table of Contents
- Executive Summary
- Introduction
- How to Eliminate TB? – The IOM Report
- Why Eliminate TB? – Rationale for Elimination
- Who Will Lead? – CDC's Response
- Goal I: Maintain control of TB
- Goal II: Accelerate the decline
- Goal III: Create new tools
- Goal IV: Reduce the global burden of TB
- Goal V: Summon and sustain support
- Goal VI: Track progress
- References
- Federal TB Task Force
- Funding
Multidrug-Resistant Tuberculosis (MDR TB)
and Extensively-Drug Resistant (XDR) TB
Text for PowerPoint Slides
Welcome and Overview
Slide 2: Welcome and Introduction
Slide 3: Collaboration
Slide 4: TB Regional Training and Medical Consultation Centers
Slide 5: Learning Objectives
Slide 6: Agenda
Slide 7: Continuing Education Credits
Slide 8: Continuing Education Disclaimer Statement
MDR/XDR TB: Global Problem, Domestic Implications
Slide 9: MDR/XDR TB: Global Problem, Domestic Implications
L. Masae Kawamura, MD
Slide 12: Global Drug-Resistant TB: How Bad Is It?
Slide 13: 2006 Global Distribution of MDR TB among New Cases
Slide 14: WHO Map – Countries with XDR TB Confirmed Cases to Date
Slide 15: Global Drug-Resistant TB: MDR/XDR TB Fuel
Slide 16: Primary MDR TB, United States, 1993–2005
Slide 17: Primary MDR TB in U.S.-born vs. Foreign-born Persons, United States, 1993–2005
Slide 18: XDR TB in the US: 1993-2007*
Slide 19: XDR TB Cases in the United States (Initial DST), 1993–2007*
Slide 20: Primary U.S. XDR TB Counted Cases as Defined on Initial DST by Year, 1993–2007*
Slide 21: XDR TB Pie Chart and Table
Slide 22: Outcomes of XDR TB Counted Cases Defined on Initial DST, 1993–2007*
Slide 23: Death of XDR TB Counted Cases Defined on Initial DST, 1993–2007
Slide 24: Have germs, will travel…
Laboratory Aspects of Drug-Resistant Tuberculosis
Slide 25: Laboratory Aspects of Drug-Resistant Tuberculosis
Thomas M. Shinnick, Ph.D.
Slide 26: Spontaneous mutations develop as bacilli proliferate to
>108
Slide 27: Drug-resistant mutants
Slide 28: Drug-resistant mutants (cont.)
Slide 29: Role of the Laboratory
Slide 30: Drug Susceptibility Testing
Slide 31: Agar Proportion Method
Slide 32: Critical Concentration
Slide 33: Critical Concentrations
Slide 34: Critical Concentration
Slide 35: Reasons for Discordant DST Results
Slide 36: Problem Drugs
Slide 37: Difficult Strains
Slide 38: Summary
Averting Disaster: Principles in Preventing and Managing Drug Resistant TB
Slide 39: Averting Disaster: Principles in Preventing and Managing Drug-Resistant TB
Slide 42: Treatment History (cont.)
Slide 43: Treatment History (cont.)
Slide 44: Drug-O-Gram: Initial Regimens
Slide 45: Poor Patient Outcome with Failure to Follow Principles
of Care
Slide 46: Ten Years Later…Patient History (cont.)
Slide 48: Drug Susceptibility Testing from Commercial Lab
Slide 49: Retreatment Course
Slide 50: Treatment Failure
Slide 51: Discussion of Retreatment: Appropriate Management Decisions
Slide 52: Approach to Treatment of MDR TB: Errors in Management
Slide 53: Approach to Treatment of MDR TB: Errors in Management
(cont.)
Slide 54: Building a Treatment Regimen
Slide 55: Building a Treatment Regimen (cont)
Slide 56: Building a Treatment Regimen (cont)
Slide 57: Retreatment Course Continued
Slide 58: Drug Susceptibility Test Results from National Reference Lab
Slide 60: Drug-O-Gram: Retreatment
Slide 61: Approach to Treatment of MDR TB: Errors in Management
Slide 62: Principles for Managing MDR TB
Slide 63: Principles for Managing MDR TB (cont.)
Management of Contacts to Cases of MDR/XDR
Slide 64: Management of Contacts to Cases of MDR and XDR
Slide 65: Transmission of Tuberculosis
Slide 66: Challenges to an Evidence-Based Approach to Management of
Contacts to MDR and XDR TB
Slide 67: Are drug-resistant strains as transmissible as
drug-susceptible strains?
Slide 68: Are drug-resistant strains likely to progress to active
disease once infection is established?
Slide 69: Secondary Case Rate Ratio (SR) of Drug-Resistant (DR)
Strains, by (HIV) Serostatus and Place of Birth
Slide 70: Are drug-resistant strains likely to progress to active
disease once infection is established?
Slide 71: Conflicting Data
Slide 72: Are drug-resistant strains likely to progress to active
disease once infection is established?
Slide 73: Are drug-resistant strains as likely to progress to active
disease?
Slide 74: Are all MDR and XDR strains equally virulent?
Slide 75: Should we treat or follow contacts to MDR/XDR?
Slide 76: Practical Points in Treating MDR/XDR Contacts
Slide 77: Treatment Outcomes of MDR Contacts
Slide 78: Treatment Outcomes of MDR Contacts (cont.)
Slide 79: Summary
Lessons and Resources
Slide 80: MDR and XDR TB: Lessons & Resources
Slide 81: Lessons from US Traveler with XDR/MDR TB
Slide 82: Lessons from US Traveler with XDR/MDR TB (cont.)
Slide 83: Consultation
Slide 84: Regional Training and Medical Consultation Centers
Slide 85: Regional Training and Medical Consultation Centers
Slide 86: RTMCC Training
Slide 87: RTMCC Educational Products & Resources for XDR/MDR
Slide 88: Additional XDR and MDR TB Educational Resources
Slide 89: CDC’s Extensively Drug-Resistant Tuberculosis (XDR TB)
Webpage
Slide 90: CDC’s Extensively Drug-Resistant Tuberculosis (XDR TB)
Webpage
Slide 91: CDC’s XDR TB Webpage (cont.)
Slide 92: Acknowledgements
Slide 93: CDC and Regional Training and Medical Consultation Centers
Slide 94: Panel Discussion
Contact Us:
- Centers for Disease Control and Prevention
Division of Tuberculosis Elimination (DTBE)
1600 Clifton Rd., NE
MS E10
Atlanta, GA 30333 - 800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348
24 Hours/Every Day - cdcinfo@cdc.gov