IZINDABA 318 A top-level think tank on KwaZulu-Natal's perplexing 'outbreak' of XDR-TB has recommended urgent inpatient point prevalence surveys and better screening of HIV-positive TB-symptomatic patients in order to better assess its country-wide extent. Speaking after provincial health, World Health Association (WHO) and Medical Research Council (MRC) officials met in Pietermaritzburg at the...

The emergence of extensively drug-resistant tuberculosis (XDR-TB) has raised public health concern for global control of TB. Although molecular characterization of drug resistance-associated mutations in multidrug-resistant isolates in Nepal has been made, mutations in XDR isolates and their genotypes have not been reported previously. In this study, we identified and characterized 13 XDR Mycob...

There are limited data on the temporal relationship between the regional introduction of multidrug-resistant tuberculosis (MDR-TB) treatment and the subsequent development of extensively drug-resistant TB (XDR-TB). The first XDR-TB case in the Western Cape province of South Africa was recorded in 1992, approximately 5 - 7 years after the regional introduction of MDR-TB-like treatment. Between 1...

Treatment outcome in multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is often unsuccessful, but the particular determinants of poor treatment outcome have remained obscure. The present authors therefore analysed treatment effectiveness and predictors of poor treatment outcome in pulmonary MDR-TB and XDR-TB in Estonia, a European country with one of the highest M...

AIM Recently increased attention and interest for Acinetobacterbaumannii are the result of the occurrence of multidrug resistant (MDR), extensive drug resistant (XDR) and pandrug resistant (PDR) isolates around the world. The aim of this study was to examine the resistance of A. baumannii isolates to antimicrobials in Clinical Centre University of Sarajevo, Bosnia and Herzegovina. METHODS Two...

We evaluated risk factors and treatment outcomes associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in Germany in 2004-2006. In 177 (4%) of 4,557 culture-positive TB cases, Mycobacterium tuberculosis isolates were identified as MDR TB; an additional 7 (0.15%) met criteria for XDR TB. Of these 184 patients, 148 (80%) were born in countries of the for...

Recent reports have shown that certain bacterial strains attain the New Delhi Metallo-beta-lactamase-1 (NDM-1) enzyme and become resistant to a broad range of antibiotics. Similarly, more dangerous "superbugs" of multi-drug resistant (MDR) and extensive drug resistant (XDR) Mycobacterium tuberculosis strains are gradually emerging through rapid genetic mutation caused by prescription non-compli...

The latest UK annual tuberculosis (TB) report shows that the rates of TB have remained at a more consistent level in the UK over recent years; however, the incidence of TB in the UK remains high (13.9 per 100 000 population) in comparison to most other Western European Countries. The proportion of multi-drug-resistant (MDR-TB) cases is stable at 1.6% with two cases of extensively drugresistant ...

The increasing incidence of extensively drug-resistant (XDR) Mycobacterium tuberculosis in high-tuberculosis-burden countries further highlights the need for improved rapid diagnostic assays. An increasing incidence of XDR M. tuberculosis strains in Pakistan has been reported, but drug resistance-associated mutations in these strains have not been evaluated previously. We sequenced the "hot-spo...

BACKGROUND . The treatment of extensively drug-resistant tuberculosis (XDR TB) presents a major challenge. Second-line antimycobacterial drugs are less effective, more toxic, and more costly than first-line agents, and XDR TB strains are, by definition, resistant to the most potent second-line options: the injectable agents and fluoroquinolones. We conducted a meta-analysis to assess XDR TB tre...