LOS ANGELES, CA (Catholic Online) - A tuberculosis (TB) doctor at the Hinduja National Hospital in Mumbai, Zarir Udwadia says that compared to classifications used by the government and the World Health Organization (WHO) to describe malicious strains or multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB, that the patients diagnosed at his hospital were different.

"It is an untreatable form of TB in the sense that there are no available first- and second-line drugs for it in the world," he said.

However, if the first course of drugs in the first six months fails to work, so-called second-line drugs are used for longer periods in attempts to cure the TB infection.

"XDR is easier to treat ... there are three to four second-line drugs still available which you can treat these patients with, but (for) our patients there is none."

The doctor says that these patients highlight the need for India to pay more attention to treating patients with severe forms of TB. According to the WHO, TB cases numbered around 110,000 in 2006, a figure Udwadia said was a considerably underestimated.

India's government declared this week that the laboratory at Hinduja hospital was not accredited for some of the tests that Udwadia's team carried out and questioned the term "totally drug resistant TB."

"The term ... is neither recognized by the WHO nor by the Revised National Tuberculosis Control Program," the Indian government said in a statement. Such cases can be managed by national XDR-TB treatment guidelines, according to the WHO.

Udwadia and his colleagues took cultured TB bacteria taken directly from the patients and exposed them to all first and second-line TB drugs. All of the drugs were found to be powerless. They also performed genetic tests on the samples.

"We confirmed that whether we used traditional culture or genetic (tests), we came up with the same resistance pattern. These patients were already exposed to these drugs and ... they did not work in them," Udwadia said.

The doctor said patients who contract drug-resistant TB face a problem as many private doctors are untrained in diagnosing and managing these more severe forms.

"They will get more and more malnourished, eventually they die without any available drug," Udwadia said when asked what would happen to those with untreatable forms of TB.

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