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Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France.

Isabelle Bonnet 1, 2 Elie Haddad 2, 3 Lorenzo Guglielmetti 1, 2, 4 Pascale Bémer 5 Louis Bernard 6 Anne Bourgoin 7 Rachel Brault 7 Gaud Catho 8 Eric Caumes 9 Lélia Escaut 10, 11 Eric Fourniols 12 Mathilde Fréchet-Jachym 13 Alice Gaudart 14 Hélène Guillot 15 Barthélémy Lafon-Desmurs 16 Jean-Philippe Lanoix 17, 18 Philippe Lanotte 6 Adrien Lemaignen 6 Bénédicte Lemaire 13 Nadine Lemaître 17 Christophe Michau 19 Philippe Morand 20, 21 Faïza Mougari 22, 23 Dhiba Marigot-Outtandy 13 Solene Patrat-Delon 24 Thomas Perpoint 8 Caroline Piau 24 Valérie Pourcher 9, 3 Virginie Zarrouk 25, 23 Valérie Zeller 26 Nicolas Veziris 1, 4, 27, 28, 29, 30 Stéphane Jaureguiberry 31, 9, 3, 2 Alexandra Aubry 1, 4, 2 
Abstract : The optimal treatment for osteoarticular infection due to multidrug-resistant tuberculosis strains (MDR-OATB) remains unclear. This study aims to evaluate the diagnosis, management and outcome of MDR-OATB in France. We present a case series of MDR-OATB patients reviewed at the French National Reference Center for Mycobacteria between 2007 and 2018. Medical history and clinical, microbiological, treatment and outcome data were collected. Twenty-three MDR-OATB cases were reported, representing 3% of all concurrent MDR-TB cases in France. Overall, 17 were male, and the median age was 32 years. Six patients were previously treated for TB, including four with first-line drugs. The most frequently affected site was the spine (n = 16). Bone and joint surgery were required in 12 patients. Twenty-one patients (91%) successfully completed the treatment with a regimen containing a mean of four drugs (range, 2-6) for a mean duration of 20 months (range, 13-27). Overall, high rates of treatment success were achieved following WHO MDR-TB treatment guidelines and individualized patient management recommendations by the French National TB Consilium. However, the optimal combination of drugs, duration of treatment and role of surgery in the management of MDR-OATB remains to be determined.
Keywords : MDR-TB XDR-TB bone spinal
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https://hal-u-picardie.archives-ouvertes.fr/hal-03711168
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Soumis le : vendredi 1 juillet 2022 - 11:13:45
Dernière modification le : vendredi 5 août 2022 - 11:25:53

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Isabelle Bonnet, Elie Haddad, Lorenzo Guglielmetti, Pascale Bémer, Louis Bernard, et al.. Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France.. Microorganisms, 2022, 10 (6), ⟨10.3390/microorganisms10061215⟩. ⟨hal-03711168⟩

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