Multidrug resistant and Extensively drug resistant TB: A Nuisance to Medical Science

Abstract

Tuberculosis is the topic of discussion for researchers due to the indocile nature of its causative micro-organism, Mycobacterium tuberculosis H 37 Rv (MTB). MTB escapes the human immune system by employing different strategies to render the drugs used for treatment ineffective, due to ultimate alterations in genes such as gyr 90, 91 and 94 which make it resistant to different drugs. Different techniques and methodologies are being developed and used to diagnose, treat and prevent the spread of the disease caused due to drug-resistant MTB. Drug resistance is reported from all over the world. Although very less treatment options are available in case of MDR and XDR-TB but still they are curable. HIV co-infection is also a big hurdle in the way of successful treatment of drug resistant TB as drug-drug interaction is an issue. It is better to improve the community medicine system to battle the TB in a better way. Highest percent of people is showing the resistant against INH so one should be careful about this fact while using the INH in regimen. Multidrug resistant and Extensively drug resistant Journal of Bacteriology and ParasitologyCitation: Singh R, Rajni, Meena A, Meena LS (2011) [12]. Study conducted at All India Institute of Medical Sciences, New Delhi, India, is showing the prevalence of XDR-TB is 2.4% among the MDR-TB cases [13], but these figures are not giving the right picture of XDR-TB scenario in India because sample size is small and all cases belongs to only one hospital. The actual dimensions of prevalence of XDR-TB are still not defined due to the lack of infrastructure and well equipped laboratories to diagnose it in many countries. Potential causes of MDR-TB and XDR-TBFactors related to treatment history: In most of the countries which are adversely affected by drug resistant TB, public health care system is not very good and private practitioners are not used to maintain the treatment history of patient and due to this patient are subjected to be treated improperly.Improper and incomplete treatment: Mismanagement of the treatment for instance, prescribing a single drug and later on adding up off another drug to the collapsing regimen, undiagnosed pre-existing resistance to drugs, prescribing inadequate regimen, inadequate follow up of the regimen by the patient results in the reduced susceptibility of the patient to anti-TB drugs. Non -adherence to the prescribed regimen is mostly ignored by the clinicians dealing with the treatment which makes the patient susceptible to MDR-TB and XDR-TB [2,14,15]. The patients are reluctant to adhere to the prescribed regimen due to the adverse effects of the most of the anti-TB drugs (Table 1) [2]. Incomplete treatment and improper regimen, both poses a selection pressure on the drug resistant strains that's why the prevalence of MDR-TB is higher among the retreated patients compared to the new cases (Figure 4, 5).Infrastructure: Due to the lack of well equipped laboratories and facilities for growing culture for determining the sensitivity of ...

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