presentation about DR-TB

1. DRUG RESISTANT TUBERCULOSIS
tuberculosis
Tbilisi Medical Academy
2016
student: Nino Dzagania
TUBERCULOSIS

2. • Tuberculosis is a bacterial infection
caused by Mycobacterium
Tuberculosis , that can spread through
the air.
• It is most often found in the lungs,
but can exist in any organ in your
body.
WHAT IS TUBERCULOSIS? (TB)

4. • 1/3 of the world population infected with
Mycobacterium tuberculosis
• There were an estimated 9.6 million new cases of TB in
2014
• In 2014 1.5 million people died of TB
• In 2014 1.2 million people died of HIV and this includes
the 0.4 million TB deaths among HIV positive people
TB IS A ANCIENT DISEASE, BUT IT
IS MORE DISEASE OF PRESENT

5. TB STATISTIC IN GEORGIA
• In Georgia there are 133 cases
of TB per 100 000 population
• Death indicator is 2,5%.
• Georgia is among the 27 high
TB burden countries

6. TB IS CURABLE DISEASE, SO
WHY TB CONTINUOUS TO BE A PROBLEM?
• SOCIAL STIGMA
• TB is an Airborne disease -one untreated
• Patient might infect 10-15 person
• HIV is considered one of the most important factor in the increase
of TB
• DRUG RESISTANT TUBERCULOSISterrupt
TB

7. • Resistant means - drugs can no longer
kill the bacteria
• MDR TB - caused by an organism that is
resistant to at least Isoniazid and
Rifampin, the two most potent TB drugs
• XDR-TB - resistant tuberculosis that
responds to even fewer available medicines,
including the most effective second-line
anti-TB drugs
Isoniazid
(INH)
Rifampin
(RIF)
Pyrazinamide
(PZA)
Ethambutol
(EMB)
WHAT IS DRUG-RESISTANT
TUBERCULOSIS (DR TB)?

8. GLOBAL DRUG
RESISTANT TB
STATISTIC
• Globally in 2014 was 123,000 patients
with MDR-TB
• There are 480,000 cases of MDR-TB
each year
• There were also approximately 190,000
deaths from MDR-TB and more than
half of these patients were in India,
China and the Russian Federation

9. PEOPLE WHO:
• Do not take all of their TB medicine as told by their doctor
or nurse
• Had TB in the past
• Come from areas of the world where drug-resistant TB is
common
• Have spent time with someone known to have drug-
resistant TB
WHO IS AT RISK FOR GETTING DR TB?

10. WHY IS DR-TB SUCH A MATTER OF
CONCERN?
• Possibility of resistance to all major anti-TB drugs
• Requires extensive chemotherapy up to 2 years of treatment
• Expensive
• Treatment could be toxic to patient

11. • Inappropriate or Incorrect use of anti-TB drugs
• Use of poor quality medicines
• Use of ineffective formulations of drugs
• Premature treatment interruption
A PRIMARY CAUSE OF DRUG
RESISTANCE TB

12. Slowest division rates among bacteria
Strongest cell wall defense system
Stretch treatment into a multiple month process
Creating a massive window for human error in the form of
incorrect or missed dosages
UNIQUE CHARACTERISTIC OF Mycobactrium
tuberculosis GIVES IT ENORMOUS POTENTIAL FOR
DEVELOPING RESISTANCE EVEN THE STRONGEST
ANTIBIOTICS

13. Slowest division rates among bacteria
Increases the possibility of evolution-
based antimicrobial resistance by giving
Mycobacterium tuberculosis bacteria
time to mutate
UNIQUE CHARACTRTISTIC OF
Mycobactrium tuberculosis
Mycobacterium of tuberculosis

14. HOW DO WE STOP CREATING NEW
DR TB CASES ?
• Cure the TB patient the first time around
• Provide access to diagnosis
• Ensure adequate infection control in facilities where patients are
treated
• Ensure the appropriate use of recommended second-line drugs

15. 1. World Health Organization (WHO). Laboratory XDR-TB definitions. Geneva: Meeting of the global XDR TB task force 2006.
2. Velayati AA, Masjedi MR, Farnia P, et al. Emergence of new forms of totally drug-resistant tuberculosis bacilli: super
extensively drug-resistant tuberculosis or totally drug-resistant strains in iran. Chest 2009; 136:420.
3. Udwadia ZF, Amale RA, Ajbani KK, Rodrigues C. Totally drug-resistant tuberculosis in India. Clin Infect Dis 2012; 54:579.
4. World Health Organization. Global Tuberculosis Report 2014. http://www.who.int/tb/publications/global_report/en/
(Accessed on July 07, 2015).
5. WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Anti-tuberculosis drug resistance in the
world, report no. 4 http://www.who.int/tb/features_archive/drsreport_launch_26feb08/en/index.html (Accessed on
April 29, 2008).
6. Zignol M, van Gemert W, Falzon D, et al. Surveillance of anti-tuberculosis drug resistance in the world: an updated
analysis, 2007-2010. Bull World Health Organ 2012; 90:111.
7. World Health Organization (WHO). Global tuberculosis control: Epidemiology, strategy, financing, Geneva, WHO report
2009.
8. Zhao Y, Xu S, Wang L, et al. National survey of drug-resistant tuberculosis in China. N Engl J Med 2012; 366:2161.
9. World Helath Organization. Global tuberculosis control 2011. WHO; Geneva, 2011.
10. Poudel A, Nakajima C, Fukushima Y, et al. Molecular characterization of multidrug-resistant Mycobacterium tuberculosis
isolated in Nepal. Antimicrob Agents Chemother 2012; 56:2831.
11. Taype CA, Agapito JC, Accinelli RA, et al. Genetic diversity, population structure and drug resistance of Mycobacterium
tuberculosis in Peru. Infect Genet Evol 2012; 12:577.
12. Tessema B, Beer J, Emmrich F, et al. Analysis of gene mutations associated with isoniazid, rifampicin and ethambutol
resistance among Mycobacterium tuberculosis isolates from Ethiopia. BMC Infect Dis 2012; 12:37.
REFERENCE:

16. IS IT ANY QUESTION?

17. THANK YOU FOR LISTENING!