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Diagnosis of tuberculosis and drug resistant tuberculosis 2

Part 2 of 2
Published on July 31, 2025   32 min

A selection of talks on Infectious Diseases

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Let's now focus on drug-resistant tuberculosis. Drug-resistant tuberculosis is caused by a strain of MTB complex resistant to any of the relevant TB drugs used in the regimen. We have mono-resistant phases. This is the most widespread form of drug-resistant tuberculosis and the resistance to isoniazid is very common. Isoniazid-resistant tuberculosis requires a change in the therapy strategy. It needs to be recognized as early as possible. We do have mono-resistant tuberculosis to rifampicin. In this case, the same strategy that we used to detect MDR is used. Actually, the majority of the tests that we call a test for MDR that are commercially available only detect rifampicin resistance. We assume that being rifampicin resistant is less common than isoniazid resistance, having a dose mutation developing more rarely; the vast majority of strains that become rifampicin resistant have already accumulated a mutation that has made them isoniazid resistant. Rifampicin resistance is a good proxy of MDR. But we still have a consistent number of cases that are isoniazid-sensitive and rifampicin-resistant. Anyway, the bottom line is that rifampicin resistance and MDR follow the same guidelines for treatment. We define MDR-TB as TB strains that are resistant to rifampicin and isoniazid.

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Diagnosis of tuberculosis and drug resistant tuberculosis 2

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