Totally drug-resistant tuberculosis

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Totally drug-resistant tuberculosis (TDR-TB) is a generic term for tuberculosis strains that are resistant to a wider range of drugs than strains classified as extensively drug-resistant tuberculosis. TDR-TB has been identified in three countries; India, Iran, and Italy. The emergence of TDR-TB has been documented in four major publications.[1][2][3][4] However, it is not yet recognised by the World Health Organization.

TDR-TB has resulted from further mutations within the bacterial genome to confer resistance, beyond those seen in XDR- and MDR-TB. Development of resistance is associated with poor management of cases. Drug resistance testing occurs in only 9% of TB cases worldwide. Without testing to determine drug resistance profiles, MDR- or XDR-TB patients may develop resistance to additional drugs.[2] TDR-TB is relatively poorly documented, as many countries do not test patient samples against a broad enough range of drugs to diagnose such a comprehensive array of resistance. The United Nations' Special Programme for Research and Training in Tropical Diseases has set up a TDR Tuberculosis Specimen Bank to archive specimens of TDR-TB.[5]

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  1. ^ Migliori GB, De Iaco G, Besozzi G, Centis R, Cirillo DM (May 2007). "First tuberculosis cases in Italy resistant to all tested drugs". Euro Surveillance. 12 (5): E070517.1. doi:10.2807/esw.12.20.03194-en. PMID 17868596. 
  2. ^ a b Rowland, Katherine (2012). "Totally drug-resistant TB emerges in India". Nature. doi:10.1038/nature.2012.9797. 
  3. ^ Velayati AA, Masjedi MR, Farnia P, Tabarsi P, Ghanavi J, ZiaZarifi AH, Hoffner SE (August 2009). "Emergence of new forms of totally drug-resistant tuberculosis bacilli: super extensively drug-resistant tuberculosis or totally drug-resistant strains in iran". Chest. 136 (2): 420–425. doi:10.1378/chest.08-2427. PMID 19349380. 
  4. ^ Udwadia ZF, Amale RA, Ajbani KK, Rodrigues C (February 2012). "Totally drug-resistant tuberculosis in India". Clinical Infectious Diseases. 54 (4): 579–81. doi:10.1093/cid/cir889. PMID 22190562. 
  5. ^ Nathanson CM, Cuevas LE, Cunningham J, Perkins MD, Peeling RW, Guillerm M, Moussy F, Ramsay A (November 2010). "The TDR Tuberculosis Specimen Bank: a resource for diagnostic test developers". The International Journal of Tuberculosis and Lung Disease. 14 (11): 1461–7. PMID 20937188. 

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