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Volume 13, Number 5—May 2007
Letter

Extensively Drug-resistant Tuberculosis, Italy and Germany

Giovannittista Migliori*Comments to Author , Johannes Ortmann†, Enrico Girardi‡, Giorgio Besozzi§, Christoph Lange¶, Daniela Cirillo#, M. Ferrarese**, Giuseppina De Iaco††, Andrea Gori‡‡, Mario.C. Raviglione§§, and SMIRA/TBNET Study Group
Author affiliations: *Salvatore Maugeri Foundation, Tradate, Italy; †Bad Lippspringe Hospital, Germany; ‡Ospedale Lazzaro Spallanzani, Rome, Italy; §Eugenio Morelli Hospital, Sondalo, Italy; ¶Research Center Borstel, Borstel, Germany; #S. Raffaele Institute, Milan, Italy; **Niguarda Hospital, Milan, Italy; ††University of Brescia, Brescia, Italy; ‡‡University of Milan, Milan, Italy; §§World Health Organization, Geneva, Switzerland

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Table A1

XDR TB patient characteristics, Italy and Germany, 2003–2006*

Age (y), sex Country
 Radiologic cavities, thorax† No. treatment periods‡ Drugs received§ Drug resistance†§ Hospitalization, d Smear conversion, d Culture conversion, d Treatment duration, mo Outcome¶
Of diagnosis Of birth
40, M Italy Italy Bilateral 3 S, R, H, E, Z; Rb S, R, H, E, Z; FQ, AK, Cyc 220 – – 73 Improved
61, F Italy Peru Monolateral 1 S, R, H, E, Z; FQ, Eth, Ak, PAS, Cyc S, R, H, E, Z; FQ, AK, Cyc 83 – – 16 Died
27, F Italy Moldova Monolateral 3 S, R, H, E, Z; FQ Eth AK, PAS, K,Cyc, Clof S, R, H, Z; FQ, Eth, K 406 300 300 10 Improved
46, M Italy Senegal Bilateral 4 S, R, H, E, Z; FQ, PAS, Cyc S, R, H, Z; FQ, Eth, AK, PAS 69 49 35 6 Improved
43, F Italy Italy Bilateral 3 S, R, H, E, Z; FQ, Eth, AK, PAS, C, K, Cyc, Rb, Clof, Dap, Cl, Th S, R, H, E, Z; FQ, Eth, AK, PAS, C, K, Cyc, Rb, Clof 422 – – 94 Died
38, F Italy Italy Bilateral 3 S, R, H, E, Z; FQ, Eth, PAS, C, Cyc S, R, H, E, Z; FQ, AK, PAS, Cyc 80 – – 12 Died
49, F Italy Italy Bilateral 3 S, R, H, E, Z; FQ, Eth, AK, PAS, C, K, Cyc, Rb, Clof, Dap, Cl, Th S, R, H, E, Z; FQ, Eth, AK, PAS, C, K, Cyc, Rb, Clof, Dap, Cl, Th 625 – – 60 Died
33, M Germany Uzbekistan Monolateral 2 S, R, H, E, Z S, R, H, E, Z; FQ, Eth, AK, C, Rb 120 – – 4 Improved
29, M Germany Uzbekistan Bilateral 2 S, R, H, E, Z; Rb S, R, H, E, Z; FQ, C 240 180 160 12 Improved
52, M Germany Azerbaijan Monolateral >1 Not available S, R, H, E, Z; FQ, AK, PAS, C, Cyc, Rb 140 7 35 6 Improved
36, F Italy Romania Bilateral 4 S, R, H, E, Z; FQ, Eth, PAS, Cyc, Rb R, H, Z; FQ, AK, Rb 248 110 – 28 Improved

*XDR TB, extensively drug-resistant tuberculosis; –, not achieved. All patients were HIV seronegative.
†At time of XDR TB diagnosis.
‡Treatment periods >30 d.
§First-line drugs: S, streptomycin; R, rifampin: H, isoniazid, E, ethambutol; Z, pyrazinamide; second-line drugs: FQ, fluoroquinolone; Eth, ethionamide; AK, amikacin; PAS, para-aminosalycilic acid; C, capreomycin; K, kanamycin; Cyc, cycloserine; other drugs: Rb, rifabutin; Clof, clofazimine; Dap, dapsone; Cl, clarithromycin; Th, thiacetazone.
¶Improved, achieved bacteriologic conversion, radiologic and clinical improvement, or both.

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1Members of the SMIRA (Multicenter Italian Study on Resistance to Anti-tuberculosis Drugs)/TBNET (Tuberculosis Network in Europe Trials): Detlef Kirsten, Sabine Ruesch-Gerdes, Federica Piana, Luigi R. Codecasa, Carla Lacchini, Alberto Matteelli, Saverio De Lorenzo, Panaiota Troupioti, Gina Gualano, Patrizia De Mori, Lanfranco Fattorini, Elisabetta Iona, Giovanni Ferrara, and Rosella Centis

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