China's National Leader in Tuberculosis Diagnosis & Treatment
The Department of Tuberculosis at Shanghai Pulmonary Hospital — affiliated with Tongji University — is widely recognized as one of China's premier tuberculosis centers and a national reference center for TB diagnosis and treatment. With decades of experience managing drug-susceptible, drug-resistant, and extensively drug-resistant tuberculosis, as well as extrapulmonary TB and TB in immunocompromised patients, the department combines outstanding clinical expertise with a world-class research program and access to the latest approved and investigational anti-TB agents. For international patients with tuberculosis — particularly drug-resistant TB, complex extrapulmonary TB, or TB requiring surgical intervention — Shanghai Pulmonary Hospital represents the gold standard in China. China Medical Concierge Shanghai (CMCS) provides seamless end-to-end coordination for international patients throughout their TB care journey.
About the Department
The tuberculosis department is a national key clinical specialty and national TB reference center operating dedicated TB inpatient wards with negative pressure isolation rooms, a TB outpatient clinic, a drug-resistant TB unit, a TB laboratory with culture, DST, and molecular diagnostics capability, a TB surgery program, and works in close collaboration with respiratory medicine, thoracic surgery, infectious disease, and public health through a fully integrated multidisciplinary TB team.
Faculty members publish regularly in leading TB and infectious disease journals including Lancet Infectious Diseases, Clinical Infectious Diseases, International Journal of Tuberculosis and Lung Disease, Tuberculosis, and European Respiratory Journal.
Drug-Susceptible Tuberculosis (DS-TB)
Pulmonary TB
- Standard Regimen — 2HRZE/4HR (isoniazid + rifampicin + pyrazinamide + ethambutol for 2 months, then isoniazid + rifampicin for 4 months); WHO 2022 guidelines; directly observed therapy (DOT); video-observed therapy (VOT)
- Short-Course Regimens — 4-month regimen: 2HRZE/2HRZ (RIFAQUIN trial); rifapentine + moxifloxacin-based 4-month regimen (Study 31/A5349); for non-cavitary, smear-negative pulmonary TB
- Treatment Monitoring — Sputum smear and culture at 2 months; chest CT response assessment; liver function monitoring; uric acid; visual acuity (ethambutol); therapeutic drug monitoring (TDM) for selected patients
- Treatment Failure & Relapse — DST before re-treatment; empirical re-treatment regimen; DST-guided individualized regimen; one of China's most experienced TB re-treatment programs
Latent TB Infection (LTBI)
- LTBI Testing — IGRA (QuantiFERON-TB Gold Plus; T-SPOT.TB); TST; indications for testing (immunocompromised, close contacts, healthcare workers, migrants)
- LTBI Treatment — 3HP (rifapentine + isoniazid weekly for 3 months — preferred); 1HP (daily rifapentine + isoniazid for 1 month); 4R (rifampicin for 4 months); 6H (isoniazid for 6 months); 9H for HIV-positive
Drug-Resistant Tuberculosis (DR-TB)
Shanghai Pulmonary Hospital's drug-resistant TB program is one of China's most experienced and nationally recognized:
Rifampicin-Resistant & MDR-TB (RR/MDR-TB)
- BPaL Regimen — Bedaquiline + pretomanid + linezolid (ZeNix trial; TB-PRACTECAL trial); 6-month regimen for MDR-TB; superior to longer conventional regimens; one of China's most experienced BPaL programs
- BPaLM Regimen — Bedaquiline + pretomanid + linezolid + moxifloxacin (TB-PRACTECAL); for fluoroquinolone-susceptible MDR-TB; 6-month regimen
- Bedaquiline-Based Regimens — Bedaquiline + background regimen; QTc monitoring; drug-drug interactions; extended bedaquiline beyond 24 weeks for selected patients
- Delamanid — For MDR-TB with limited options; combination with bedaquiline; QTc monitoring
- Shorter MDR-TB Regimen — WHO 9-month all-oral regimen (BDQ + LZD + LFX + CFZ + EMB + PZA + INH-high dose); for fluoroquinolone-susceptible MDR-TB without extensive disease
- Conventional Longer Regimens — For complex cases; individualized based on DST; 18-20 months; group A-D drug classification
Pre-XDR & XDR-TB
- BPaL for XDR-TB — Bedaquiline + pretomanid + linezolid; NELCOR trial; one of China's most experienced XDR-TB treatment programs
- Novel Agents — Sutezolid; TBI-223; macozinone; GSK-286; investigational agents via clinical trial access
- Compassionate Use — Access to pre-approval agents for XDR-TB with no standard options; CMCS facilitates compassionate use applications
Drug Susceptibility Testing (DST)
- Phenotypic DST — MGIT liquid culture; critical concentration testing for first and second-line drugs; MIC determination for novel agents
- Molecular DST — Xpert MTB/RIF Ultra for rapid rifampicin resistance detection; Xpert XDR for isoniazid, fluoroquinolone, and injectable resistance; line probe assay (LPA — GenoType MTBDRplus, MTBDRsl); whole genome sequencing (WGS) for comprehensive resistance profiling and phylogenetic analysis
- Therapeutic Drug Monitoring (TDM) — For bedaquiline, linezolid, fluoroquinolones, and other key drugs; optimizing drug exposure; managing toxicity
Extrapulmonary Tuberculosis
Shanghai Pulmonary Hospital's extrapulmonary TB program is one of China's most comprehensive:
- TB Lymphadenitis — Standard anti-TB therapy; surgical excision for diagnostic or therapeutic purposes; paradoxical reactions management
- TB Meningitis (TBM) — Intensive phase: HRZE + dexamethasone; linezolid for MDR-TBM; intrathecal therapy for refractory cases; hydrocephalus management; coordination with neurology and neurosurgery
- Spinal TB (Pott's Disease) — Anti-TB therapy; surgical decompression and stabilization for neurological compromise or spinal instability; anterior debridement and fusion; posterior instrumentation; coordination with orthopedic spine surgery; one of China's most experienced spinal TB programs
- TB Pericarditis — Anti-TB therapy + corticosteroids; pericardiocentesis; pericardiectomy for constrictive pericarditis; coordination with cardiology and cardiac surgery
- Abdominal TB — Intestinal TB; peritoneal TB; hepatic TB; anti-TB therapy; surgical management for obstruction or perforation; coordination with general surgery
- Genitourinary TB — Renal TB; ureteral TB; anti-TB therapy; ureteral stenting for stricture; coordination with urology
- Osteoarticular TB — Anti-TB therapy; surgical debridement for joint TB; coordination with orthopedics
- Miliary TB — Intensive anti-TB therapy; corticosteroids for TB meningitis and pericarditis; RICU support for respiratory failure
TB in Special Populations
- TB-HIV Coinfection — Early ART initiation (within 2-8 weeks of TB treatment); rifampicin-based regimen; drug-drug interactions (rifampicin + ART); IRIS management; coordination with infectious disease
- TB in Immunocompromised Patients — Transplant recipients; biologic therapy (TNF inhibitors, JAK inhibitors); corticosteroid-treated patients; hematological malignancies; LTBI screening before immunosuppression; prophylaxis and treatment
- TB in Pregnancy — HRE regimen (avoid pyrazinamide in first trimester per some guidelines); streptomycin contraindicated; breastfeeding guidance; neonatal prophylaxis
- Pediatric TB — Weight-based dosing; child-friendly formulations; BCG vaccination; LTBI treatment; coordination with pediatrics
- Diabetes & TB — Bidirectional screening; glycemic control improves TB outcomes; rifampicin drug interactions with oral hypoglycemics; coordination with endocrinology
Surgical Treatment of Tuberculosis
Shanghai Pulmonary Hospital's TB surgery program is one of China's most experienced, uniquely integrated with the world-leading thoracic surgery department:
- Pulmonary Resection for TB — Lobectomy and segmentectomy for destroyed lung; cavitary TB not responding to medical therapy; MDR/XDR-TB adjunctive surgery; bronchiectasis complicating TB; hemoptysis; VATS and open resection; one of China's most experienced TB surgery programs
- Destroyed Lung — Pneumonectomy for unilateral destroyed lung; careful pre-operative assessment; post-pneumonectomy space management
- Thoracoplasty — For post-resection space problems; chronic empyema; selected MDR-TB cases
- Bronchial Stenosis — Bronchoscopic balloon dilation; stenting; surgical resection and reconstruction for severe stenosis
- Hemoptysis Management — Bronchial artery embolization (BAE) coordination with interventional radiology; surgical resection for massive hemoptysis; bronchoscopic tamponade
Why International Patients Choose Shanghai Pulmonary Hospital Tuberculosis
- China's National TB Reference Center — Nationally recognized TB expertise; comprehensive DST including WGS; access to all approved and investigational anti-TB agents
- BPaL/BPaLM for MDR/XDR-TB — One of China's most experienced programs; 6-month regimen; superior outcomes vs. conventional longer regimens
- Whole Genome Sequencing — Comprehensive resistance profiling; phylogenetic analysis; treatment optimization for complex DR-TB
- Spinal TB Surgery — One of China's most experienced spinal TB programs; anterior debridement and fusion; posterior instrumentation
- TB Surgery Integration — Unique integration with world-leading thoracic surgery for adjunctive TB surgery; VATS lobectomy for MDR-TB
- Cost-Effectiveness — World-class TB care at significantly lower cost than equivalent treatment in Western countries
The CMCS Patient Journey
- Initial Inquiry — Share your TB diagnosis, sputum culture and DST results, chest CT imaging, treatment history, and current medications with CMCS.
- Medical Record Preparation — We translate and organize your records for specialist pre-consultation review.
- Specialist Matching — We identify the most appropriate TB specialist based on your condition — drug-susceptible TB, MDR-TB, XDR-TB, extrapulmonary TB, or TB surgery.
- Priority Scheduling — We secure a consultation with minimal waiting time.
- Travel & Logistics — Assistance with visa invitation letters, accommodation near Shanghai Pulmonary Hospital, and Shanghai airport transfers; infection control guidance for travel.
- Diagnostic Assessment — Full coordination of sputum culture, comprehensive DST, molecular testing, WGS, and imaging.
- Treatment Coordination — Full coordination of anti-TB regimen initiation, TDM, and monitoring; surgical coordination where required.
- Post-Treatment Follow-Up — Treatment report translation, culture result interpretation, and remote follow-up coordination after you return home.
Book a Consultation
If you have drug-susceptible TB, MDR-TB, XDR-TB, extrapulmonary TB, spinal TB, or a complex tuberculosis condition — CMCS can arrange a specialist consultation with Shanghai Pulmonary Hospital's world-leading tuberculosis team.
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