Multi-drug resistant tuberculosis (MDRTB)

Abstract

MDRTB has been made by treatment failure and has also spread by its contagiousness. I tried to explain how to make MDRTB clinically, and also tried to propose how to prevent it from spreading in a hospital. At first, a principle of modern chemotherapy against tuberculosis was elucidated, i.e. "biphase method of treatment." Danger of mono-therapy, particularly functional one, was warned through a case report. Thus acquired drug-resistance was made, single at first, multi-drug thereafter. According to the increase of patients of acquired MDRTB, primary MDRTB patient has emerged through the direct contagion. We reported nosocomial outbreak cases of MDRTB, including re-infection to patients with pan-sensitive tuberculosis. Therefore, strict isolation of MDRTB with smear-positive sputum must be instituted in a tuberculosis ward. All smear-positive tuberculosis patients should be isolated in a room against air-borne infection just in case of MDRTB. There are, however, not enough isolation rooms in tuberculosis ward in Japan. Rapid detection of rifampicinresistance through the gene analysis must be done in this situation.