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  • Title: [Drug resistant tuberculosis].
    Author: Zwolska Z, Augustynowicz-Kopeć E.
    Journal: Pol Merkur Lekarski; 2011 May; 30(179):362-6. PubMed ID: 21675144.
    Abstract:
    Drug-resistant tuberculosis, and particularly multidrug-resistant tuberculosis (MDR-TB) and extensive drug resistant TB (XDR-TB) as an increasing health problem and a serious challenge to TB control programs. MDR-Tb and XDR-TB are highly lethal in people living with HIV, with case of fatality rates of over 90%. At the same time, there are not many drugs effective in TB chemotherapy. Information about susceptibility patterns of Mycobacterium tuberculosis isolates against antituberculosis drugs is important aspect of tuberculosis control, and surveillance and analysis of local rates of TB drug resistance is helpful in the detection and monitoring of the extent of MDR and XDR strains, indicating the quality of TB control in the country. In 1994, The World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD) launched a global project on anti-tuberculosis drug resistance surveillance. From 1994 through 2009, the global project has collected data from areas representing almost 60% of the world's TB cases. A survey found that multi-drug tuberculosis has become established worldwide. WHO estimated that 50 million people were infected with drug-resistant strains of M. tuberculosis. The classification of drug resistance as primary or acquired is used as an indicator of the efficiency of national tuberculosis programs and in the adjustment and development of these programs. The rate of primary drug resistance is interpreted as an epidemiological indicator for long-term surveillance of the quality of tuberculosis treatment in the community. The rate of acquired drug resistance reflects the efficacy of management of individual patients Since 1999, WHO developed DOTS-Plus strategy which can help how to manage MDR-TB using second line drugs in low- and middle-income countries within DOTS strategy. Poland joined the global project and in 1997 carried out its first simultaneous survey on primary and acquired drug resistance in tuberculosis patients exactly according WHO/IUATLD recommendations and protocols. Until now 4 surveys have been performed. Drug resistance in tuberculosis patients have been monitored in Poland for a long time. In period of recent 30 years the mean frequency of resistant was on the similar level with very low rate of RMP mono-resistance to M. tuberculosis. Both type of resistance MDR and XDR have been found in Polish tuberculosis patients.
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