Drug-resistant tuberculosis: What to know

The article was consulted professionally by Dr Phan Dinh Thuy Tien – General Internal Medicine Doctor – Department of Medical Examination and Internal Medicine – Share99 Nha Trang International Hospital.

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Multi-drug-resistant tuberculosis (MDR-TB) is an extremely dangerous disease in the diseases of tuberculosis with side effects that seriously damage the health of patients. Treatment of drug-resistant tuberculosis is expensive and the duration of treatment is many times longer than that of people with regular tuberculosis.

1. What is drug-resistant tuberculosis?

Drug-resistant TB is a condition where TB bacteria are resistant to anti-tuberculosis drugs, making treatment difficult and the patient himself a dangerous source of transmission to the community. Getting drug-resistant tuberculosis will cause patients to face serious health conditions along with time-consuming and money-consuming treatment.

The causes of drug-resistant tuberculosis include:

  • The patient does not carry out adequate treatment as directed by a tuberculosis specialist.
  • Due to improper treatment by the physician (improper drug coordination, improper instructions for the patient to take the drug, instructions for the patient to take the medicine improperly …), or when the patient is treated by a doctor who does not have a professional understanding in the private clinic.
  • In addition, patients can also get drug-resistant tuberculosis from pre-treatment (inhalation of drug-resistant TB bacteria from the source of the disease in the community).

Drug-resistant tuberculosis

Drug-resistant TB is a disease where TB bacteria are resistant to anti-tuberculosis drugs

2. Why do TB bacteria become resistant?

Drug-resistant tuberculosis is dangerous and is on the rise, many hypotheses have been put up for this trend but the gene mutation theory is most noticeable:

  • Scientists claim that drug-resistant TB bacteria are natural changes that do not have the effects of drugs for tuberculosis. Anti-tuberculosis drugs here only selectively mean the destruction of non-resistant strains, while drug-resistant strains of tuberculosis persist and are increasing.
  • The resistance of TB bacteria is believed to be a random mutation of TB bacterial chroma selected during treatment due to insufficient use of dosage and not combining drugs together. Viet Nam is among the top 30 countries with the highest multi-resistance tuberculosis burden in the world, ranking 16th out of 30 countries with the highest number of patients. ( WHO – Global tuberculosis report 2018)
  • Drug-resistant TB bacteria may be a first or second. Predocular TB are drug-resistant strains of bacteria in TB patients who have no prior history of TB treatment or TB treatment for less than a month. Drug-resistant tuberculosis is resistant to drugs that appear in patients who have been treated for more than 1 month.

3. Manifestations of drug-resistant tuberculosis

Clinical: Patients with drug-resistant tuberculosis during the treatment of tuberculosis, symptoms such as fever, cough, sputum sputum do not remission or remission for some time and then appear with increased symptoms, patients constantly lose weight.

Subclinical: Some drug-resistant TUBERCULOSIS patients test positive continuously or negative for a while and then test positive again or positive, alternating negative. Antibiotics are resistant to anti-tuberculosis drugs 1 and or 2nd class injections. The lesion on X-rays does not differ much from that of ordinary tuberculosis patients.

tuberculosis

Drug-resistant tuberculosis is dangerous and is on the rise

4. How does diagnosis determine drug-resistant tuberculosis?

Diagnosis of drug-resistant tuberculosis should be based on antibiotic testing or a validated rapid diagnostic tests such as Hain test, Gene Xpert MTB/RIF,… with the classification of drug-resistant tuberculosis as follows:

  • Prescription resistance: Resistant to only one other anti-tuberculosis drug Rifampicin.
  • Resistant to many drugs: Resistant to 2 or more anti-tuberculosis drugs without resistance to Rifampicin.
  • Rifampicin-resistant tuberculosis: Resistant to Rifampicin and may or may not be further resistant to other top-of-the-line anti-tuberculosis drugs (be it prescription resistance, multi-drug resistance, multi-drug resistance or super-resistant)
  • Multi-drug resistant (MDR-TB): Conc simultaneous resistance to at least 2 anti-tuberculosis drugs is Isoniazid and Rifampicin.
  • Pre-resistant: Multi-resistant tuberculosis is more resistant to any fluoroquinolone drug or with at least one of the three second-line injections (Capreomycin, Kanamycin, Amikacin) (not both)
  • Super-resistant (XDR-TB): Multi-resistant TB is more resistant to any fluoroquinolone drug and at least one of the three second-line injections is as above.

5. Treatment of drug-resistant TUBERCULOSIS

Multi-resistant tuberculosis treatment requires coordination of multiple groups of drugs, lasting a minimum of 9 months. Patients need to follow the treatment according to the doctor's instructions and will be monitored by the doctor to respond to the treatment, the disadvantaged effects of the drug through many tests (blood, sys, epidemic, straight chest x-ray, CTscan, endoscopy …) to help patients achieve a clean effect, avoid spreading the community.

Share99 International Health Hub currently provides BCG vaccination services for tuberculosis prevention of Vaccines and Medical Bio-products, manufactured in Vietnam.

The advantages of vaccination at Share99 International Health Hub include:

  • Vaccines are imported and stored in modern cold storage systems, with COLD chains meeting GSP standards, keeping the vaccine in the best condition to ensure quality.
  • Clients will be examined by specialists, fully screened for health and physical issues, advice on vaccines and vaccination regimens, how to monitor and care after vaccination before prescribing vaccinations according to the latest recommendations of the Ministry of Health / World Health Organization to ensure the best and safest effect for children.
  • Being monitored before, during and after vaccination at Share99 Health System and always have emergency ekip ready to coordinate with the vaccination department to handle cases of anaphylalactic shock, respiratory failure – stop cyclic, ensure timely treatment, the right regimen when incidents occur.
  • The vaccination room is airy, has a play area, helping customers feel comfortable and have a good mentality before and after vaccination.
  • A team of experienced, professional pediatric doctors and nurses, understand the child's psychology and apply effective pain relief to the child during vaccination.
  • 100% of vaccination customers are monitored 30 minutes after vaccination and re-evaluated before leaving.
  • For child customers, parents will receive a reminder message before the date of vaccination and the child's vaccination information will be synchronized with the national immunization information system.

Dr Thuy Tien has 18 years of experience in medical examination and treatment. Currently, he is a General Internal Medicine Doctor of Medical Examination and Internal Medicine department of Share99 Nha Trang International Health Hub.

SEE MORE:

  • What kind of tuberculosis is there?
  • Pregnancy is prone to tuberculosis, why?
  • How are tuberculosis and pulmonary tuberculosis different?

For direct advice, please click the HOTLINE number or register online HERE. In addition, you can register for remote consultation HERE

SEE MORE:

  • Is pleural tuberculosis transmitted through saliva?
  • What is a TUBERCULOSIS test? Who should take a tuberculosis test?
  • NEGATIVE AFB child tuberculosis

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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