       Document 0033
 DOCN  M9610033
 TI    Multidrug-resistant tuberculosis.
 DT    9601
 AU    Lee SK; Tan KK; Chew SK; Snodgrass I; Department of Tuberculosis
       Control, Communicable Disease Centre,; Singapore.
 SO    Ann Acad Med Singapore. 1995 May;24(3):442-6. Unique Identifier :
       AIDSLINE MED/96022350
 AB    In 1993, the World Health Organization declared tuberculosis a global
       emergency. Tuberculosis is the leading cause of death attributable to a
       single infectious pathogen. One-third of the world's population are at
       risk of developing the disease. In countries confronted with the human
       immunodeficiency virus (HIV) epidemic, the overlap of these two
       populations leads to a rapid acceleration of active tuberculosis and of
       the emergence of multidrug-resistant tuberculosis. Multidrug-resistant
       tuberculosis is defined as isolates resistant to both isoniazid and
       rifampicin with or without resistance to other antituberculosis drugs.
       In the United States, outbreaks of multidrug-resistant tuberculosis have
       been reported in patients with HIV infection and acquired
       immunodeficiency syndrome (AIDS) as well as HIV sero-negative patients.
       These reports have caused great concern owing to the very high
       case-fatality rate. The treatment outcome of multidrug-resistant
       tuberculosis is poor. The use of second-line drugs is frequently
       associated with toxicity and intolerance. Patients require admission to
       hospitals at the beginning of treatment and adjunctive resectional
       surgery should be considered when the sputum does not convert after 4
       months of therapy. The incidence of multidrug-resistant tuberculosis
       among Singapore residents remains low. Organisms resistant to one drug
       occurred in 3.8% of newly diagnosed tuberculosis cases with positive
       culture and 8.7% of relapsed tuberculosis cases with positive cultures.
       Organisms resistant to two or more drugs occurred in 1.6% of newly
       diagnosed culture positive tuberculosis cases and 4.6% of relapsed cases
       where cultures were positive. This is the result of vigilant
       surveillance, effective treatment including supervised chemotherapy and
       close monitoring for non-compliance.
 DE    Human  *Tuberculosis, Multidrug-Resistant/EPIDEMIOLOGY/THERAPY  JOURNAL
       ARTICLE  REVIEW  REVIEW LITERATURE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

