Tuesday, February 26, 2008


Extensively drug-resistant tuberculosis

Extensively drug-resistant tuberculosis

Dtsch Med Wochenschr. 2008 Feb

C. Lange1, M. P. Grobusch2, D. Wagner3
1 Klinische Infektiologie, Medizinische Klinik, Forschungszentrum Borstel2 Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Services and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Südafrika3 Zentrum für Infektiologie und Reisemedizin, Medizinische Klinik, Universität Freiburg

Recently an increasing number of antibiotic-resistant MYCOBACTERIUM TUBERCULOSIS (MTB) strains have been described worldwide. The term XDR- (extensively drug-resistant) tuberculosis (TB) has been introduced by the World Health Organisation (WHO) to characterize multi-drug-resistant MTB strains that are in vitro resistant against fluorochinolones and one of the injectible substances amikacin, capreomycin or kanamycin in addition to isoniazid and rifampin. Strains of XDR-MTB are currently increasingly seen in HIV-seropositive individuals with tuberculosis in southern Africa, where these strains are passed by person-to person contact. XDR-TB has become a serious problem for the health administrations in this region. In contrast, cases of XDR-TB are only rarely seen in Germany so far, mainly among the population of pre-treated migrants from eastern Europe. The development of rapid diagnostic tests for resistance testing and new drugs for the treatment of tuberculosis has lacked support for several decades. The sudden emergence of XDR-MTB strains now warrants immediate action for the development of such tests and new classes of antibiotics to give all patients with TB a chance for a successful treatment.

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