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The Evolution of Drug-Resistant Tuberculosis: Why the Emergence of XDR-TB Worrys Us?
Tuberculosis (TB), an infectious disease caused by resistant, rapidly mutating bacteria, infects up to one in four people worldwide, so concerns about its mutations are growing. The emergence of expanded drug-resistant tuberculosis (XDR-TB), in particular, has public health experts around the world deeply concerned because this drug-resistant strain makes treatment increasingly difficult in many cases.
What is XDR-TB?
XDR-TB is a type of tuberculosis strain that is resistant to multiple anti-tuberculosis drugs. According to the definition of the World Health Organization (WHO), XDR-TB is a drug that is resistant to at least one fluoroquinolone and at least one second-line injectable drug (such as amikacin, capromycin, or ganamicin). of multidrug-resistant tuberculosis. This means that the treatment options for this type of tuberculosis are greatly reduced, especially for those patients who are already infected with HIV, which is a very serious threat.
Causes of spread of XDR-TB
The prevalence of XDR-TB is closely related to poor tuberculosis management. Misuse and inappropriate administration of anti-tuberculosis drugs are major factors leading to the emergence of these multidrug-resistant strains.
Many countries lack adequate diagnostic facilities and the actual extent of XDR-TB remains unknown. According to the WHO report, as of the end of 2017, 6,480 cases of XDR-TB had been reported in 127 member states around the world, demonstrating the potential severity and speed of spread of this disease.
Symptoms and transmission of XDR-TB
The main symptoms of XDR-TB are similar to those of ordinary tuberculosis, including persistent cough with some blood, high fever, chills, night sweats, fatigue and muscle weakness. If these symptoms occur in conjunction with conditions that do not improve with conventional treatment, patients should promptly notify their healthcare provider.
Like other types of TB, XDR-TB is transmitted primarily through the air. When an infected person coughs or sneezes, TB germs are released into the air, and others can become infected by breathing in only small amounts of the germs.
Diagnosis and Treatment
The diagnosis of XDR-TB requires high-quality medical services and professional laboratory support. Traditional drug susceptibility testing (DST) can determine the sensitivity of bacteria to the four basic anti-tuberculosis drugs, but strains that have shown resistance require longer testing. Recent research shows that a new detection technology, the reverse strand hybridization test (RLBH), can provide accurate drug resistance results in as little as three days, which is helpful in the fight against tuberculosis, especially XDR-TB.
Treatment of XDR-TB requires the use of second-line drugs, which are more toxic than first-line treatments and are associated with a series of side effects, such as hepatitis, depression, hallucinations, and hearing loss.
Multiple studies have shown that appropriate treatment based on current professional practices can significantly improve treatment success rates. Trials like the Nix-TB regimen show that combining drugs offers new hope.
How to prevent XDR-TB?
Measures to effectively prevent XDR-TB include ensuring that domestic tuberculosis control programs meet international standards and that all tuberculosis patients receive appropriate diagnosis and treatment. This also requires strengthening the construction of laboratory capabilities and testing facilities to achieve rapid testing and thereby reduce the risk of transmission.
Conclusion
As the threat of drug-resistant tuberculosis continues to grow, the challenges facing the world have become more severe, especially among people suffering from HIV/AIDS. The public health crisis caused by XDR-TB requires us to re-examine anti-TB drugs. Effectiveness and challenges in tuberculosis. Against this backdrop, can we find more effective ways to deal with this global problem?
