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Updated: Nov 2, 2025
23:06
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
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Evidence-based Definition for Extensively Drug-Resistant Tuberculosis.
Maroussia Roelens1, Giovanni Battista Migliori2, Liudmila Rozanova1
1Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Summary
The study proposes a new definition for extensively drug-resistant tuberculosis (XDR-TB) based on resistance to fluoroquinolones and key newer drugs. This updated definition, MDR-TB plus resistance to fluoroquinolones and bedaquiline/linezolid, improves XDR-TB classification.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- The definition of extensively drug-resistant tuberculosis (XDR-TB) has been challenged by updated treatment guidelines.
- Previous definitions relied on resistance to older drug classes, which are now less central to treatment regimens.
Purpose of the Study:
- To propose an updated, clinically relevant definition for XDR-TB.
- To evaluate treatment outcomes based on evolving drug resistance patterns in tuberculosis.
Main Methods:
- Analysis of a large dataset of patients with multidrug-resistant tuberculosis (MDR-TB).
- Logistic regression used to assess factors associated with unfavorable treatment outcomes.
- Stratification by resistance to fluoroquinolones (FQ), second-line injectable drugs (SLID), and use of newer drugs like bedaquiline and linezolid.
Main Results:
- Resistance to FQs significantly increased the odds of unfavorable treatment outcomes (aOR, 1.91).
- Treatment with bedaquiline and/or linezolid improved outcomes, irrespective of FQ or SLID resistance.
- Among XDR-TB patients, newer drugs (linezolid, bedaquiline) substantially reduced unfavorable outcomes compared to no newer drug use.
Conclusions:
- The study supports a revised XDR-TB definition: MDR-TB with additional resistance to FQs plus bedaquiline and/or linezolid.
- This new definition aids in better surveillance and informs treatment choices for drug-resistant tuberculosis.
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