Tuberkulose im Erwachsenenalter

Tom Schaberg; Folke Brinkmann; Cornelia Feiterna-Sperling; Hilte Geerdes-Fenge; Pia Hartmann; Brit Häcker; Barbara Hauer; Walter Haas; Jan Heyckendorf; Christoph Lange; Florian P. Maurer; Albert Nienhaus; Ralf Otto-Knapp; Martin Priwitzer; Elvira Richter; Helmut J.F. Salzer; Otto Schoch; Nicolas Schönfeld; Ralf Stahlmann; Torsten Bauer

doi:10.1055/a-1934-8303

Pneumologie 2022; 76(11): 727-819
DOI: 10.1055/a-1934-8303

Leitlinie

Tuberkulose im Erwachsenenalter

Eine S2k-Leitlinie zur Diagnostik und Therapie, Chemoprävention und Chemoprophylaxe der Tuberkulose im Erwachsenenalter des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose e. V. (DZK) und der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V. (DGP)^[*] Tuberculosis in adulthoodThe Sk2-Guideline of the German Central Committee against Tuberculosis (DZK) and the German Respiratory Society (DGP) for the diagnosis and treatment of adult tuberculosis patients

Tom Schaberg

¹Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin

,

Folke Brinkmann

²Abteilung für pädiatrische Pneumologie/CF-Zentrum, Universitätskinderklinik der Ruhr-Universität Bochum, Bochum

,

Cornelia Feiterna-Sperling

³Klinik für Pädiatrie mit Schwerpunkt Pneumologie, Immunologie und Intensivmedizin, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin

,

Hilte Geerdes-Fenge

⁴Zentrum für Innere Medizin, Universitätsmedizin Rostock

,

Pia Hartmann

⁵Labor Dr. Wisplinghoff Köln, Klinische Infektiologie, Köln

⁶Department für Klinische Infektiologie, St. Vinzenz-Hospital, Köln

,

Brit Häcker

¹Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin

,

Barbara Hauer

⁷Robert Koch-Institut, Berlin

,

Walter Haas

⁷Robert Koch-Institut, Berlin

,

Jan Heyckendorf

⁸Klinik für Innere Medizin I, Universitätsklinikum Schleswig-Holstein, Campus Kiel

,

Christoph Lange

⁹Klinische Infektiologie, Forschungszentrum Borstel

¹⁰Deutsches Zentrum für Infektionsforschung (DZIF), Standort Hamburg-Lübeck-Borstel-Riems

¹¹Respiratory Medicine and International Health, Universität zu Lübeck, Lübeck

¹²Baylor College of Medicine and Texas Childrenʼs Hospital, Global TB Program, Houston, TX, USA

,

Florian P. Maurer

¹³Nationales Referenzzentrum für Mykobakterien, Forschungszentrum Borstel, Borstel

¹⁴Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsklinikum Hamburg-Eppendorf, Hamburg

,

Albert Nienhaus

¹⁵Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg

,

Ralf Otto-Knapp

¹Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin

,

Martin Priwitzer

¹⁶Gesundheitsamt, Landeshauptstadt Stuttgart

,

Elvira Richter

¹⁷MVZ Labor Dr. Limbach & Kollegen GbR, Heidelberg

,

Helmut J.F. Salzer

¹⁸Kepler Universitätsklinikum, Linz, Österreich

,

Otto Schoch

¹⁹Kantonsspital St. Gallen, Schweiz

,

Nicolas Schönfeld

²⁰Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin

,

Ralf Stahlmann

²¹Institut für klinische Pharmakologie und Toxikologie, Charité Universitätsmedizin, Berlin

,

Torsten Bauer

¹Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose e. V. (DZK), Berlin

²⁰Lungenklinik Heckeshorn, Helios Klinikum Emil von Behring, Berlin

› Institutsangaben

Abstract

Zusammenfassung

Die Tuberkulose ist in Deutschland eine seltene, überwiegend gut behandelbare Erkrankung. Weltweit ist sie eine der häufigsten Infektionserkrankungen mit ca. 10 Millionen Neuerkrankungen/Jahr. Auch bei einer niedrigen Inzidenz in Deutschland bleibt Tuberkulose insbesondere aufgrund der internationalen Entwicklungen und Migrationsbewegungen eine wichtige Differenzialdiagnose. In Deutschland besteht, aufgrund der niedrigen Prävalenz der Erkrankung und der damit verbundenen abnehmenden klinischen Erfahrung, ein Informationsbedarf zu allen Aspekten der Tuberkulose und ihrer Kontrolle. Diese Leitlinie umfasst die mikrobiologische Diagnostik, die Grundprinzipien der Standardtherapie, die Behandlung verschiedener Organmanifestationen, den Umgang mit typischen unerwünschten Arzneimittelwirkungen, die Besonderheiten in der Diagnostik und Therapie resistenter Tuberkulose sowie die Behandlung bei TB-HIV-Koinfektion. Sie geht darüber hinaus auf Versorgungsaspekte und gesetzliche Regelungen wie auch auf die Diagnosestellung und präventive Therapie einer latenten tuberkulösen Infektion ein. Es wird ausgeführt, wann es der Behandlung durch spezialisierte Zentren bedarf.

Die Aktualisierung der S2k-Leitlinie „Tuberkulose im Erwachsenenalter“ soll allen in der Tuberkuloseversorgung Tätigen als Richtschnur für die Prävention, die Diagnose und die Therapie der Tuberkulose dienen und helfen, den heutigen Herausforderungen im Umgang mit Tuberkulose in Deutschland gewachsen zu sein.

Abstract

In Germany tuberculosis is a rare disease and usually well treatable. Worldwide it is one of the most common infectious diseases with approximately 10 million new cases every year.

Even with low incidences in Germany, tuberculosis is an important differential diagnosis especially due to international developments and migration movements. With a decreasing experience there’s a continuous demand on accurate and up-to-date information. This guideline covers all aspects of microbiological diagnostics, basic principles of standard therapy, treatment of extrapulmonary tuberculosis, management of side effects, special features of diagnosis and treatment of resistant tuberculosis, and treatment in TB-HIV coinfection. Also, it explains when treatment in specialized centers is required, aspects of care and legal regulations and the diagnosis and preventive therapy of latent tuberculosis infection.

The update of the S2k guideline “Tuberculosis in Adults” is intended to serve as a guideline for prevention, diagnosis, and treatment of tuberculosis for all those involved in tuberculosis care and to help meet the current challenges in dealing with tuberculosis in Germany.

Volltext

Referenzen

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