What is XDR and how is it different from MDR tuberculosis?

Multidrug resistant tuberculosis (MDR-TB) is a strain of TB that cannot be treated with the two most powerful first-line treatment anti-TB drugs. Extensively drug resistant tuberculosis (XDR-TB) is a form of TB caused by bacteria that are resistant to several of the most effective anti-TB drugs.

What test is used to determine the sensitivity of MBT to anti-TB drugs?

The Xpert MTB/RIF assay is a new test that is revolutionizing tuberculosis (TB) control by contributing to the rapid diagnosis of TB disease and drug resistance. The test simultaneously detects Mycobacterium tuberculosis complex (MTBC) and resistance to rifampin (RIF) in less than 2 hours.

What should be done when a health care worker suspects that a patient has TB?

Persons who have or are suspected of having infectious TB disease should be placed in an area away from other patients, preferably in an airborne infection isolation (AII) room.

How long does it take to treat XDR?

MDR- and XDR-TB need prolonged treatment duration, from 18 to 24 months after sputum culture conversion, as recommended by the World Health Organization (WHO) [2]. A prolonged duration of treatment may lead to poor adherence, higher cost and undue toxicity.

How is GeneXpert done?

A sputum sample is collected from the patient with suspected TB. The sputum is mixed with the reagent that is provided with the assay, and a cartridge containing this mixture is placed in the GeneXpert machine. All processing from this point on is fully automated.

How does Gene Xpert work?

The Xpert® MTB/RIF purifies and concentrates Mycobacterium tuberculosis bacilli from sputum samples, isolates genomic material from the captured bacteria by sonication and subsequently amplifies the genomic DNA by PCR.

How do you manage MDR-TB?

MDR regimens should include at least pyrazinamide, a fluoroquinolone, an injectable anti-TB drug, ethionamide (or prothionamide) and either cycloserine or PAS (para-aminosalycylic acid) if cycloserine cannot be used (conditional recommendation, very low quality evidence)(1).