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Universal control mac spring8/31/2023 ![]() It includes any resistance to rifampicin, whether monoresistance, multidrug resistance, polydrug resistance, or extensive drug resistance.Įxtensive drug resistance (XDR): Resistance to any fluoroquinolone, and at least one of three second-line injectable drugs (capreomycin, kanamycin, and amikacin), in addition to multidrug resistance. Rifampicin resistance (RR): Resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. Multidrug resistance (MDR): Resistance to at least both isoniazid and rifampicin. Polydrug resistance: Resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin. Monoresistance: Resistance to one first-line anti-TB drug only. TYPES OF DRUG-RESISTANT TB ( WHO 2013b) (TYPES ARE NOT MUTUALLY EXCLUSIVE) In clinical practice today, the possibility of unsuspected drug resistance must always be considered when evaluating a TB patient in any country ( Box 1). MDR-TB is also a growing problem in South Africa, where high rates of HIV (human immunodeficiency virus) have exacerbated both the spread and deadliness of MDR-TB, raising the specter of a “perfect storm” of MDR-TB/HIV coinfection ( Wells et al. In 2012, the China Centers for Disease Control and Prevention reported that 10% of China’s 1.4 million TB patients had MDR-TB, and the great majority of MDR-TB patients had never been treated for TB-evidence of unfettered human-to-human transmission ( Zhao et al. 2012).Įqually worrisome rates have emerged from China and India, which have the highest and second-highest number of MDR-TB patients in the world. ![]() In 2011, Minsk, Belarus reported that 35% of new patients had MDR-TB, as did 75% of those who had been treated previously for TB ( Skrahina et al. In some countries, MDR strains account for up to 20% of new TB cases and well over 50% of patients with a history of previous TB treatment. The highest MDR rates are found in countries of Eastern Europe and central Asia, where MDR strains threaten to become as common as pan-susceptible strains. Globally, MDR-TB is present in 3.8% of new TB patients and 20% of patients who have a history of previous treatment. In 2012, there were approximately 450,000 new cases of MDR-TB and 170,000 deaths. Today, the continuing spread of MDR-TB is one of the most urgent and difficult challenges facing global TB control. Percentage of new TB cases with MDR-TB ( WHO 2013a). ![]() Community-based programs can improve treatment outcomes by allowing patients to be treated in their homes and addressing socioeconomic barriers to adherence. Although patients harboring MDR and XDR strains present a formidable challenge for treatment, cure is often possible with early identification of resistance and use of a properly designed regimen. The main causes of the spread of resistant TB are weak medical systems, amplification of resistance patterns through incorrect treatment, and transmission in communities and facilities. Extensively drug-resistant (XDR) TB refers to MDR-TB strains that are resistant to fluoroquinolones and second-line injectable drugs. In 2012, there were approximately 450,000 new cases and 170,000 deaths because of MDR-TB. Patients who are infected with strains resistant to isoniazid and rifampicin, called multidrug-resistant (MDR) TB, are practically incurable by standard first-line treatment. The continuing spread of drug-resistant tuberculosis (TB) is one of the most urgent and difficult challenges facing global TB control. ![]()
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