Multidrug-resistant Tuberculosis or commonly called MDR-TB is a condition where the TB bacteria is resistant to the most important tuberculosis medicines i.e. isoniazid and rifampicin. Delay in diagnosis of tuberculosis and especially drug resistant tuberculosis is common in India.
Who is at high risk for Multi Drug Resistant Tuberculosis or MDR-TB?
Certain groups of children are at high risk for having Multi Drug Resistant Tuberculosis or MDR-TB. These are children who have been treated for tuberculosis previously, children with poor response even after one month of appropriate TB treatment and children with tuberculosis who have stopped treatment in between for more than a month. Children with a family member with Multi Drug Resistant Tuberculosis or MDR-TB are also at high risk for Multi Drug Resistant Tuberculosis or MDR-TB.
How is Multi Drug Resistant Tuberculosis or MDR-TB diagnosed?
For diagnosis of Multi Drug Resistant Tuberculosis or MDR-TB sputum samples are subjected to specialized tests. In children who are unable to bring out sputum, swallowed sputum is taken from the stomach by inserting a thin tube [gastric aspirate] or directly from the lungs by performing a bronchoscopy.
Drug resistance to tuberculosis bacteria is detected using special lab tests which test the bacteria for sensitivity to the drugs. Molecular tests which are PCR based are most commonly used such as Xpert MTB/RIF or GeneXpert, TruNat, Line Probe Assay or Hain’s test). Tuberculosis cultures are also used of which most common is the Mycobacterial Growth Indicator Tube culture or MGIT960. MGIT culture involves growing the tuberculosis bacteria in a special tube, which is followed by testing for various drugs called drug sensitivity testing. These tests help to choose the medications that are most likely to work in a child with Multi Drug Resistant Tuberculosis or MDR-TB.
Why is it important to diagnose Multi Drug Resistant Tuberculosis or MDR-TB early?
Early diagnosis of Multi Drug Resistant Tuberculosis or MDR-TB is essential. It is not uncommon to see children being treated with TB medicines without no proper tests. Improper treatment leads to extensive damage to the lungs and other organs involved. In addition the patient with Multi Drug Resistant Tuberculosis or MDR-TB would spread the drug resistant bacteria to close contacts.
If your child is suspected to have drug resistant tuberculosis or Multi Drug Resistant Tuberculosis or MDR-TB you need to get in touch with a child tuberculosis specialist for proper diagnosis and treatment.
