What is MDR TB?

Mycobacterium tuberculosis bacteria which become resistant to both isoniazid and rifampicin is termed Multidrug-Resistant strains.

Percentage Occurrence of MDR TB?

In Indian conditions, it is usually 3-5% in new cases and nearly 12-17% in re-treatment cases.

How is MDR different from plain TB?

  • Takes upto or more than 2 years of treatment.
  • Results in social isolation.
  • Results in loss of employment.
  • Causes Long-term socio-economic loss.
  • Also causes severe psychological effects.

Why Resistance develops in Mycobacterium?

  • It has a long generation time
  • Has capacity for dormancy
  • Has low Metabolic activity
  • Gets located in pulmonary cavities, in the empyema pus and also in the solid caseous material, where the penetration of antibiotics is not easy or where the pH is sufficiently low to inhibit the action of most antibiotics
  • Mycobacterium has a strong capacity for genetic mutations, so new strains which are resistant to medicines keep developing

Is MDR TB primary or acquired?

Primary MDR-TB patient is one who has not been infected earlier on with TB, but is directly infected with a strain that is resistant to treatment.

Acquired MDR-TB patients are those who were undergoing treatment but their medicines could not kill the particular strain with which they became infected.

Why patient becomes MDR patient?

  • When they do not take their medicines regularly
  • When they do take all of the medicines as prescribed
  • When they develop TB again, after having taken TB medications irregularly in the past
  • They come from areas where drug-resistant TB is common
  • They have spent time with someone who is known to have drug-resistant TB

Other reasons for getting MDR TB?

  • When patients do not complete their full course of treatment
  • When health-care staff gives wrong treatment
  • Sometimes wrong dose is prescribed
  • Duration of treatment is not correct
  • Sometimes the supply of medicines is not always available
  • At times the drugs are of poor quality

How can MDR TB be prevented?

  • Patient to take all their medicines as prescribed
  • Not to miss even a single dose
  • Do not stop treatment early
  • Patients must tell if they are having any trouble taking the medications
  • If they have to travel, they must ensure they have full medicines while they are away
  • To avoid exposure to the already known MDR TB patients
  • To avoid crowded places such as hospitals, homeless shelters or prisons
  • Take advise from occupational health experts
  • If required personal respiratory protective devices could be used

How Health Care workers can help prevent MDR TB?

  • They can help by quickly diagnosing the cases
  • Ensure that recommended guidelines are followed
  • To monitor patients’ response to treatment
  • Ensuring that therapy is completed