Multidrug-resistant tuberculosis
Prab R. Tumpati, MD — Editor-in-Chief, WikiMD Medical Encyclopedia
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| Multidrug-resistant tuberculosis | |
|---|---|
| Synonyms | MDR-TB |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Cough, fever, night sweats, weight loss |
| Complications | Lung damage, respiratory failure, death |
| Onset | Gradual |
| Duration | Months to years |
| Types | N/A |
| Causes | Mycobacterium tuberculosis resistant to isoniazid and rifampicin |
| Risks | HIV/AIDS, immunosuppression, previous tuberculosis treatment |
| Diagnosis | Sputum culture, molecular tests |
| Differential diagnosis | Drug-sensitive tuberculosis, non-tuberculous mycobacterial infection |
| Prevention | Directly observed therapy, infection control, vaccination |
| Treatment | Second-line anti-tuberculosis drugs, bedaquiline, linezolid |
| Medication | Fluoroquinolones, aminoglycosides, ethionamide |
| Prognosis | Variable, depends on drug resistance and treatment adherence |
| Frequency | 500,000 cases globally (as of 2018) |
| Deaths | 230,000 deaths annually (as of 2018) |
Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis (TB) infection caused by bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications (drugs), isoniazid and rifampin. Some forms of TB are also resistant to second-line medications, and are called extensively drug-resistant TB (XDR-TB).
Causes[edit]
MDR-TB is caused by Mycobacterium tuberculosis that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. Such drug resistance is caused by two key mechanisms: spontaneous mutation and inadequate treatment.
Diagnosis[edit]
Diagnosis of MDR-TB involves laboratory testing to determine the drugs to which the bacteria are susceptible. This often involves the use of culture and sensitivity testing, as well as molecular techniques such as polymerase chain reaction (PCR).
Treatment[edit]
Treatment of MDR-TB involves the use of second-line drugs, usually four or more anti-TB drugs for a prolonged period of time. The treatment can be expensive, has many side effects, and can be fatal.
Epidemiology[edit]
MDR-TB is a serious public health problem that threatens progress made in TB care and control worldwide. It is present in virtually all countries surveyed.
Prevention[edit]
Prevention of MDR-TB involves prompt detection of drug-resistant TB and proper treatment with second-line drugs.