Pulmonary Multi-Drug Resistant Tuberculosis (MDR-TB)

What is Pulmonary Multi-Drug Resistant Tuberculosis (MDR-TB)?

Pulmonary Multi-Drug Resistant Tuberculosis (MDR-TB) is a type of tuberculosis (TB) infection, caused by bacteria, that is resistant to at least two of the main antibiotics used to treat TB - isoniazid and rifampicin. MDR-TB is a serious global health problem, and is increasingly becoming more resistant to additional drugs, making it Extremely Drug Resistant TB (XDR-TB). This is a major public health challenge that requires fast and coordinated responses.

Signs and symptoms of MDR-TB

The signs and symptoms of MDR-TB are similar to those of regular TB - namely chest pain, a dry cough, night sweats, fever, and fatigue. However, due to the fact that this is a drug-resistant form of TB, these symptoms are often more persistent and difficult to treat.

Causes of MDR-TB

MDR-TB is caused by bacteria that have adapted and become resistant to the drugs which were previously used to treat TB. These resistant bacteria quickly spread if the patient is not treated correctly, leading to ongoing transmission.

Risk Factors of MDR-TB

The most common risk factor for developing MDR-TB is inadequate treatment of regular TB. Lack of access to drugs, incorrect diagnosis and poor adherence to the full course of treatment are common causes of drug-resistant TB. Certain populations are also at increased risk, such as those who have HIV/AIDS, inmates of correctional facilities, healthcare workers and people living in overcrowded areas.

Diagnosis of MDR-TB

The diagnosis of MDR-TB usually involves a skin test or sputum sample to test for TB bacteria. If the initial test is positive, additional tests may be ordered to determine if the TB is resistant to certain drugs. There are also rapid diagnosis tests to identify MDR-TB bacteria, however these tests are not yet widely available in many countries.

Treatment of MDR-TB

Treatment of MDR-TB requires a combination of drugs that are effective against the resistant bacteria. Drug-susceptibility testing is essential to determine which specific drugs should be used to treat MDR-TB. A full treatment of MDR-TB may last up to two years, and requires close monitoring by a healthcare team.

Prevention of MDR-TB

  • Ensuring the full course of recommended TB treatment is taken as prescribed.
  • Regular monitoring of TB patients for early signs of relapse.
  • Implementing infection control measures to prevent transmission.
  • Implementing effective strategies to increase access to quality care and treatment.
  • Eliminating social and financial barriers that may impede treatment adherence.