- A uniquely-South African killer-strain of extensively
drug- resistant tuberculosis (XDR-TB) was produced by the World Health
Organization's distribution of anti-TB drugs without testing for drug
resistance first, say South African scientists who have studied the strain
for the past twelve years.
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- "The spread of a highly transmissible strain of
drug-resistant tuberculosis has been facilitated by applying standard
treatment regimens for susceptible and multi-drug resistant tuberculosis
in the absence of drug resistance surveillance," said one of the
authors, A. Willem Sturm, MD, of the University of KwaZulu-Natal School
of Medicine in South Africa.
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- "Public health programs for the treatment and control
of infectious diseases need to be supported by drug resistance surveillance
programs."
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- In the beginning, this strain was resistant to several
standard TB treatments; then, in 2001, South Africa adopted the WHO's
standard strategy for fighting multi-drug resistant tuberculosis.
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- The strategy, known as DOTS-plus, recommends several
so-called second line TB drugs -- but the strain was already becoming
immune to these. Their study is published in the latest issue of the
journal "Clinical Infectious Diseases"
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- The scientists say that testing for TB-drug resistance
is expensive and time-consuming -- and while the WHO's strategy successfully
delivered drugs, it didn't test for resistance.
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- "Within a few years, use of the recommended drugs
left behind only those bacteria that could handle it. The strain then
morphed from scary into a true nightmare." The researchers studied
just one strain of so-called XDR-TB, but there are many out there, and
they likely developed in the same way, they believe.
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- Tuberculosis drugs are desperately needed, they said--
but there might be an even greater need for drugs-resistance testing first.
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- Contact for original press release by the Infectious
Diseases Society of America:
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- Steve Baragona - 703 299-0412
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- http://www.eurekalert.org/pub_releases/2007-10/idso-xti101907.php
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