NDLI: Multidrug-Resistant Tuberculosis (MDR-TB)

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Multidrug-Resistant Tuberculosis (MDR-TB)

Content Provider	Semantic Scholar
Author	McAuslane, Helen Zenner, Dominik
Copyright Year	2018
Abstract	Etiology In any significant population of tuberculosis bacilli, there are several naturally occurring mutants that are resistant to one of the 5 first-line antituberculosis agents (Streptomycin, Isoniazid, Rifampin, Pyrazinamide and Ethambutol). Approximately 1 in every 10 to 10 bacilli will naturally mutate. Such a small quantity of resistance is not detected by laboratory methods. The presence of low level resistance is the reason why all recommended antituberculosis regimens include 3 or more first line agents. The likelihood that a bacillus would spontaneously develop resistance to 2 agents simultaneously is equal to the product of the likelihood that the bacillus would develop resistance to each agent individually. For example, the likelihood of developing resistance to Isoniazid and Rifampin would be equal to 1 in 10 x 1 in 10 = 1 in10 bacilli. Because the number of bacilli inside a TB lesion rarely approaches this amount, spontaneous development of multidrug resistant tuberculosis is exceedingly rare. Therefore, the emergence of MDR TB is not a naturally occurring phenomena but a human creation. MDR TB arises when antituberculosis medications are used incorrectly. For example, with antituberculosis monotherapy, naturally occurring resistant bacilli can flourish and become the predominant infecting strains within as little as 2 weeks. If a second agent is then added, the situation will be as if the patient had started monotherapy again. Bacilli resistant to both agents will be selected for and become the predominant infecting strain. Therefore, like the creation of antituberculosis drugs, the creation of antituberculosis drug resistance is a human made phenomena.
Starting Page	133
Ending Page	146
Page Count	14
File Format	PDF HTM / HTML
DOI	10.1201/9780203733318-12
Alternate Webpage(s)	http://www.on.lung.ca/ots/winter_2001.pdf
Alternate Webpage(s)	https://doi.org/10.1201/9780203733318-12
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article

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