Multiple drug resistance: A world-wide threat

R. M. Warren, S. S. Shah, D. Alland

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

The emergence of drug-resistant Mycobacterium tuberculosis threatens the ability of existing health care programmes to treat tuberculosis effectively. Mycobacterium tuberculosis becomes drug resistant primarily through mutations within antituberculosis drug target genes; patient non-compliance with anti- tuberculosis therapy and/or inadequate drug levels promote the selection of these mutations. Drug-resistant tuberculosis can also occur via transmission of an already drug-resistant strain to a susceptible individual. Molecular epidemiology, together with drug sensitivity testing, has shown that transmission accounts for > 50% of the incidence of drug-resistant disease. This demonstrates the inability of current programmes to contain the spread of resistance. The success of future tuberculosis control will depend on a global commitment to directly observed therapy and further research into epidemiology, modern diagnostics and new treatments.

Original languageEnglish (US)
Pages (from-to)77-96
Number of pages20
JournalBailliere's Clinical Infectious Diseases
Volume4
Issue number1
StatePublished - Jan 1 1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Immunology
  • Microbiology (medical)

Keywords

  • DNA fingerprinting
  • Drug resistance
  • Epidemiology
  • Molecular mechanisms
  • RFLP
  • Risk- factors
  • Tuberculosis

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