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 Facilities
- 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
- Disaster Responders
- Children
- Vaccines & Immunizations
- Laboratory Information
- Drug Susceptibility Testing
- 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
- Molecular Detection of Drug Resistance (MDDR)
- Research
- TB Epidemiologic Studies Consortium
- Background
- Infrastructure
- Research Projects
- Publications
- Meetings
- Directory
- TBESC Committee Members
- Translating Research into Practice (TRIP)
- 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
- Request for Proposal
- 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
- Diferencia entre la infección de tuberculosis latente y enfermedad de tuberculosis activa
- A Global Perspective on TB
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Bovine Tuberculosis in Humans
- 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
- Interferon-Gamma Release Assays (IGRAs)
- Tuberculin Skin Testing
- Diagnosis of Tuberculosis Disease
- Targeted Tuberculin Testing and Interpreting Tuberculin Skin Test Results
- Prueba cutánea de la tuberculina
- Diagnóstico de la tuberculosis activa
- Vaccines & Immunizations
- General
- Guidelines
- Guides & Toolkits
- Core Curriculum
- Self-Study Modules
- Report of Verified Case of Tuberculosis (RVCT)
- Forging Partnerships to Eliminate TB
- Understanding the TB Cohort Review Process
- Latent Tuberculosis Infection: A Guide for Primary Health Care Providers
- Effective TB Interviewing for Contact Investigation
- Mantoux Tuberculin Skin Testing Products
- Ethnographic Guides
- Newsletters
- Pamphlets, Brochures, Booklets
- Posters
- Mantoux Tuberculin Skin Test Wall Chart
- World TB Day
- Afiches
- 2011 Poster (English)
- 2011 Poster (Spanish)
- 2010 Poster (English)
- 2010 Poster (Spanish)
- 2008 Poster (English)
- 2008 Poster (Spanish)
- 2006 Poster (English)
- 2004 Poster (English)
- 2004 Poster (Spanish)
- 2003 Poster (English)
- 2003 Poster (Spanish)
- 2003 Now is the Time Poster (English)
- 2003 Now is the Time Poster (Spanish)
- Think TB
- Stop TB
- 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
- Tuberculosis Laboratory Aggregate Reports
- Morbidity and Mortality Weekly Reports (MMWRs)
- Slide Sets
- Core Curriculum
- Self-Study Modules
- Prevention and Control of Tuberculosis in Correctional and Detention Facilities
- 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
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- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Treatment of TB
- Targeted Tuberculosis Testing and Treatment of Latent Tuberculosis Infection
- CD Roms
- Electronic Tools & Resources
- Web-Based Courses & Webinars
- Fact Sheets
- Global TB
- 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
Report of Expert Consultations on Rapid Molecular Testing to Detect Drug-Resistant Tuberculosis in the United States
Introduction
The emergence and spread of drug-resistant strains of Mycobacterium tuberculosis are greatly complicating tuberculosis (TB) control efforts in many countries. An estimated 511,000 cases of multidrug-resistant TB (MDR TB; caused by strains resistant to at least isoniazid and rifampin) occurred globally in 2007 (1). In the United States, a total of 125 cases of MDR TB were reported in 2007 (1.2% of culture-positive cases with susceptibility testing performed) as well as 2 cases of extensively drug resistant TB (XDR TB) (5). MDR TB is significantly more difficult and expensive to treat than drug-susceptible TB. It is estimated that preventing a single case of MDR TB would save the U.S. health care system more than $250,000 (4).
The management of drug-resistant TB cases starts with a reliable diagnosis, which is obtained by isolating M. tuberculosis bacteriafrom clinical specimens and conducting drug-susceptibility tests. The susceptibility of bacteria to a particular drug is usually determined by attempting to grow the bacteria in or on media containing that drug. The agar and liquid culture proportion methods are used by most laboratories in the United States that perform susceptibility testing of M. tuberculosis bacteria (6,7). Because of the slow growth of M. tuberculosis bacteria and the requirement for isolation before drug-susceptibility testing, the agar proportion method typically requires six to eight weeks to provide results while the liquid culture methods can provide results in four to five weeks. Molecular methods can reduce the time required for detection of drug resistance to one to two days. Because of the earlier detection of resistance and earlier initiation of effective therapy, the use of rapid molecular methods for detecting rifampin resistance may reduce periods of infectiousness of MDR TB cases by as much as six weeks, reduce the further spread of MDR TB, and improve treatment outcomes (2,3).
In recognition of the importance of rapid drug-susceptibility testing, a proposed revision of the Diagnostic Standards and Classification of Tuberculosis in Adults and Children (7) is likely to support the use of rapid molecular drug-resistance tests for AFB smear-positive sputum sediments from TB patients who are suspected to have drug-resistant disease or who are from a region or population with a high prevalence of drug resistance. In addition, the Advisory Council for the Elimination of Tuberculosis (ACET) passed a resolution in June 2008 that stated —
Be it resolved that ACET recommends that the Director of CDC fund and expedite implementation of currently available rapid drug-resistance assays in selected qualified reference labs to quickly identify drug-resistant TB, reduce transmission, and prevent further acquired drug resistance; such that by the end of 2008, labs are able to provide this assay for optimal patient care.
In response to the ACET resolution and the proposed revision of the diagnostic standards (7), CDC convened an expert panel to examine the current status of rapid drug-resistance testing in the United States, published evidence, and current guidelines and to provide guidance and make recommendations to CDC for developing a system to provide access to rapid drug-resistance testing. The expert panel included clinicians; control officials; laboratorians; and representatives from the ACET, TB Regional Training and Medical Consultation Centers (RTMCC), National TB Controllers Association (NTCA), Association of Public Health Laboratories (APHL), and CDC.
Contact Us:
- Centers for Disease Control and Prevention
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