Failure of second-line drugs used to treat tuberculosis very worrying
Resistant strain means disease could more easily spread
Strains of drug-resistant tuberculosis, a highly contagious respiratory illness have continued to crop up, spreading fears of failing to contain the disease in remote, rural areas. In particular, second-line agents were the single, most predictive risk factor for drug resistance to these classes of agents, including fluoroquinolones.
Rates of XDR infection were highest in South Korea, where 15 percent of the 99 patients evaluated were found to be extensively resistant, and lowest in the Philippines, with a rate of 0.8 percent among 397 cases.
The four-continent study also found that previous exposure to second-line drugs was the strongest and most consistent risk factor for resistance to such agents. This was followed by factors related to ill health such as smoking and unemployment, the Center for Disease Control in Atlanta found.
Scientists called the global scale of TB drug resistance "worrying" and called for control efforts to take "social factors" into account.
It was discovered that risk factors for drug resistance varied by country, which will let government officials to develop policies and treatment strategies tailored to their individual national situations.
Sven Hoffner, PhD, of the Swedish Institute for Communicable Disease Control in Solna, Sweden, agreed that the study findings could be useful in efforts to contain the disease.
"Updated information on MDR [multidrug-resistant) tuberculosis and investigation of the trends are urgently needed, especially since the true scale of the burden of MDR and XDR [extensively drug resistant] tuberculosis might be underestimated and seem to be rapidly increasing," he wrote.
The report involved evaluation of 1,278 tuberculosis cases in Estonia, Latvia, Russia, South Africa, South Korea, the Philippines, Thailand and Peru.
Drug susceptibility results, performed in a Center for Disease Control laboratory, were as follows:
- Resistance to at least one second-line drug: 43.7 percent
- Resistance to at least one second-line injectible drug: 20.0 percent
- Resistance to at least one fluoroquinolone: 12.9 percent
- XDR TB (resistance to first-line drugs and at least two second-line agents in different classes): 6.7 percent
Rates of XDR infection were highest in South Korea, where 15 percent of the 99 patients evaluated were found to be extensively resistant, and lowest in the Philippines, with a rate of 0.8 percent among 397 cases.
© 2012, Catholic Online. Distributed by NEWS CONSORTIUM.
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Keywords: Tuberculosis, second line agents, injectable drugs, study, multi-nation
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Maybe this study will help persuade governments to take the problem of drug resistant TB more seriously. They need to make sure that when patients appear to have drug resistant TB, that facilities such as laboratories are available to provide rapid resistance testing and then for people if necessary to be provided with second line drugs. See www.tbfacts.org