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Clinical Microbiology Reviews, Apr 1995, 180-199, Vol 8, No. 2
KA Sepkowitz, J Raffalli, L Riley, TE Kiehn and D Armstrong
A resurgence of tuberculosis has occurred in recent years in the United
States and abroad. Deteriorating public health services, increasing numbers
of immigrants from countries of endemicity, and coinfection with the human
immunodeficiency virus (HIV) have contributed to the rise in the number of
cases diagnosed in the United States. Outbreaks of resistant tuberculosis,
which responds poorly to therapy, have occurred in hospitals and other
settings, affecting patients and health care workers. This review covers
the pathogenesis, epidemiology, clinical presentation, laboratory
diagnosis, and treatment of Mycobacterium tuberculosis infection and
disease. In addition, public health and hospital infection control
strategies are detailed. Newer approaches to epidemiologic investigation,
including use of restriction fragment length polymorphism analysis, are
discussed. Detailed consideration of the interaction between HIV infection
and tuberculosis is given. We also review the latest techniques in
laboratory evaluation, including the radiometric culture system, DNA
probes, and PCR. Current recommendations for therapy of tuberculosis,
including multidrug-resistant tuberculosis, are given. Finally, the special
problem of prophylaxis of persons exposed to multidrug-resistant
tuberculosis is considered.
Copyright © 1995 by the American Society for Microbiology. All rights reserved.
Tuberculosis in the AIDS era
Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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