Tuberculosis Warning: You are not logged in. Your IP address will be publicly visible if you make any edits. If you log in or create an account, your edits will be attributed to your username, along with other benefits.Anti-spam check. Do not fill this in! === Medication resistance === Primary resistance occurs when a person becomes infected with a resistant strain of TB. A person with fully susceptible [[Mycobacterium tuberculosis|MTB]] may develop secondary (acquired) resistance during therapy because of inadequate treatment, not taking the prescribed regimen appropriately (lack of compliance), or using low-quality medication.<ref name=OBrien>{{cite journal | vauthors = O'Brien RJ | title = Drug-resistant tuberculosis: etiology, management and prevention | journal = Seminars in Respiratory Infections | volume = 9 | issue = 2 | pages = 104โ12 | date = June 1994 | pmid = 7973169 }}</ref> Drug-resistant TB is a serious public health issue in many developing countries, as its treatment is longer and requires more expensive drugs. MDR-TB is defined as resistance to the two most effective first-line TB drugs: rifampicin and isoniazid. Extensively drug-resistant TB is also resistant to three or more of the six classes of second-line drugs.<ref name="MMWR2006">{{cite journal | author = Centers for Disease Control and Prevention (CDC) | title = Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs--worldwide, 2000-2004 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 11 | pages = 301โ5 | date = March 2006 | pmid = 16557213 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5511a2.htm | url-status = live | archive-url = https://web.archive.org/web/20170522030229/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5511a2.htm | archive-date = 22 May 2017 }}</ref> Totally drug-resistant TB is resistant to all currently used drugs.<ref name="TR2012">{{Cite magazine|title=Totally Resistant TB: Earliest Cases in Italy|magazine=Wired|url=https://www.wired.com/wiredscience/2012/01/tdr-first-Italy/| vauthors = McKenna M |date=12 January 2012|access-date=12 January 2012|url-status=live|archive-url=https://web.archive.org/web/20120114214156/http://www.wired.com/wiredscience/2012/01/tdr-first-Italy/|archive-date=14 January 2012}}</ref> It was first observed in 2003 in Italy,<ref>{{cite journal | vauthors = Migliori GB, De Iaco G, Besozzi G, Centis R, Cirillo DM | title = First tuberculosis cases in Italy resistant to all tested drugs | journal = Euro Surveillance | volume = 12 | issue = 5 | pages = E070517.1 | date = May 2007 | pmid = 17868596 | doi = 10.2807/esw.12.20.03194-en | doi-access = free }}</ref> but not widely reported until 2012,<ref name="TR2012" /><ref>{{cite web|title=Totally Drug-Resistant TB: a WHO consultation on the diagnostic definition and treatment options|url=https://www.who.int/tb/challenges/xdr/Report_Meeting_totallydrugresistantTB_032012.pdf?ua=1|publisher=World Health Organization (WHO)|access-date=25 March 2016|url-status=live|archive-url=https://web.archive.org/web/20161021151601/http://www.who.int/tb/challenges/xdr/Report_Meeting_totallydrugresistantTB_032012.pdf?ua=1|archive-date=21 October 2016}}</ref> and has also been found in Iran and India.<ref name="EIU 2014">{{cite news | title = Ancient enemy, modern imperative โ A time for greater action against tuberculosis | newspaper = The Economist |url=http://www.economistinsights.com/sites/default/files/Ancient%20enemy%20modern%20imperative.pdf |publisher=[[Economist Intelligence Unit]]|access-date=22 January 2022|date=30 June 2014| vauthors = Kielstra P | veditors = Tabary Z |url-status=dead|archive-url=https://web.archive.org/web/20140810101716/http://www.economistinsights.com/sites/default/files/Ancient%20enemy%20modern%20imperative.pdf |archive-date=10 August 2014}}</ref> There is some efficacy for [[linezolid]] to treat those with XDR-TB but side effects and discontinuation of medications were common.<ref>{{cite journal | vauthors = Singh B, Cocker D, Ryan H, Sloan DJ | title = Linezolid for drug-resistant pulmonary tuberculosis | journal = The Cochrane Database of Systematic Reviews | volume = 3 | pages = CD012836 | date = March 2019 | issue = 3 | pmid = 30893466 | pmc = 6426281 | doi = 10.1002/14651858.CD012836.pub2 | collaboration = Cochrane Infectious Diseases Group }}</ref><ref>{{cite journal | vauthors = Velayati AA, Masjedi MR, Farnia P, Tabarsi P, Ghanavi J, ZiaZarifi AH, Hoffner SE | title = Emergence of new forms of totally drug-resistant tuberculosis bacilli: super extensively drug-resistant tuberculosis or totally drug-resistant strains in Iran | journal = Chest | volume = 136 | issue = 2 | pages = 420โ425 | date = August 2009 | pmid = 19349380 | doi = 10.1378/chest.08-2427 }}</ref> [[Bedaquiline]] is tentatively supported for use in multiple drug-resistant TB.<ref>{{cite web|title=Provisional CDC Guidelines for the Use and Safety Monitoring of Bedaquiline Fumarate (Sirturo) for the Treatment of Multidrug-Resistant Tuberculosis|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6209a1.htm?s_cid=rr6209a1_x|url-status=live|archive-url=https://web.archive.org/web/20140104204359/http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6209a1.htm?s_cid=rr6209a1_x|archive-date=4 January 2014}}</ref> XDR-TB is a term sometimes used to define ''extensively resistant'' TB, and constitutes one in ten cases of MDR-TB. Cases of XDR TB have been identified in more than 90% of countries.<ref name="EIU 2014"/> For those with known rifampicin or MDR-TB, molecular tests such as the Genotype MTBDRsl Assay (performed on culture isolates or smear positive specimens) may be useful to detect second-line anti-tubercular drug resistance.<ref>{{cite journal | vauthors = Theron G, Peter J, Richardson M, Warren R, Dheda K, Steingart KR | title = ยฎ MTBDRsl assay for resistance to second-line anti-tuberculosis drugs | journal = The Cochrane Database of Systematic Reviews | volume = 2016 | pages = CD010705 | date = September 2016 | issue = 9 | pmid = 27605387 | pmc = 5034505 | doi = 10.1002/14651858.CD010705.pub3 | collaboration = Cochrane Infectious Diseases Group }}</ref><ref>{{cite web |url=https://www.who.int/tb/WHOPolicyStatementSLLPA.pdf |title=The use of molecular line probe assays for the detection of resistance to second-line anti-tuberculosis drugs |website=World Health Organization |access-date=18 June 2021 |archive-date=22 September 2021 |archive-url=https://web.archive.org/web/20210922003541/https://www.who.int/tb/WHOPolicyStatementSLLPA.pdf |url-status=live }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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