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Additional info for Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary
While acquired or amplified resistance due to inadequate treatment may explain how the very first cases of XDR TB emerged in South Africa and other parts of the world, it is difficult to say that the current magnitude of the epidemic could be attributable to acquired resistance alone. , 2007), and it is highly likely that the majority of these cases developed as a result of primary or transmitted resistance. But he hypothesized that even among those who had received prior TB treatment and relapsed (a majority of whom had documentation that their TB had been 40 THREAT OF DRUG-RESISTANT TUBERCULOSIS cured or that they had completed their treatment course), the vast majority probably represented new infections rather than acquired resistance.
It is also likely that compensatory mutations take place after an initial drug-resistance mutation. The sequencing of a set of evolved strains is now under way to identify such compensatory mutations. Edward Nardell of Brigham and Women’s Hospital stated that he and colleagues at the South African Medical Research Council and CDC have been researching the transmission of MDR TB from patients directly to sentinel guinea pigs to replicate and expand upon some of the early research of Richard Riley discussed by Murray.
Geneva, Switzerland: WHO. WHO. 2008b. Anti-tuberculosis drug resistance in the world, fourth global report by the WHO/IUATLD Global project on anti-tuberculosis drug resistance surveillance. Geneva, Switzerland: WHO. WHO. 2008c. TB/HIV facts. pdf (accessed February 17, 2009). Zintl, P. 2008. Speaker ����������������������������������������������������������������������������� presentation at the Institute of Medicine Workshop on Addressing the Threat of Drug-Resistant Tuberculosis, Washington, DC, November 5.
Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary by Institute of Medicine