A negative sputum test does not rule out a diagnosis of TB. Recovery and identification of mycobacteria from specimens has become more rapid with test procedures such as liquid medium systems and DNA probes (Communicable Diseases Section, Victorian Government Department of Human Services, 2005)
The association of TB with youth makes this disease an important factor in the economy of many countries, which simultaneously experience a low gross national product and a high incidence of TB, because the disease affects the most economically productive sector of the economy. As a result, an organized TB control program, unlike many other health-related activities, is a net contributor to economic development (Kaufmann and Hahn, 2003)
). MDRTB Strain Imported The identification of a specific MDRTB in Spain transmitted from Equatorial Guinea reveals that strains can be spread across continents, making it a global threat (Gavin et al
). Resistance to Pyrazinamide and Ethambutol MDRTB is resistance to at least isoniazid and rifampicin and a global concern (Hoek et al
This increased use produced MDRTB strains extensively resistant to both first-and-second-line drugs (Morbidity & Mortality Report). Epidemiology Close to 500,000 or 5% of all new cases of TB diagnosed in 2006 were MDRTB, as they were resistant to isoniazid and rifampicin (Mitnick et al
, Morbidity & Mortality Weekly). Molecular Epidemiology Outbreaks in the 80s and early 90s in New York City caused widespread transmission of MDRTB strains in hospitals and state prisons (Munsiff et al
). Multidrug Resource-Limited Settings Evidence of successful treatments of MDRTB comes mainly from referral hospitals in advanced or high-income countries (Nathanson et al
). Double Infection One can get infected with a resistant and a multidrug-resistant strain of mycobacterium tuberculosis (Niemann et al
). Newer Diagnostics Recent advances in the field led to the development of new tools for faster TB diagnosis (Palomino 2006)
). Methods for Drug Susceptibility Testing WHO reported that there were 511,000 MDRTB cases in 2007 or 5% of all TB cases worldwide (Richter et al
S. In the late 80s and 90s spurred the use of massive resources that would insure safe workplaces (Sepkowitz 2001)
Tests are more needed and relevant in these settings for a realistic control of TB (Palomino). Treatment The proper implementation of the DOTS strategy can cure TB and prevent the development of drug resistance (Tam et al
tuberculosis under these circumstances has been assumed to take for granted a dormant status in which it can remain viable for years without causing observable disease. A succeeding breakdown of the immune system of the host may permit its emergence from this dormant status, resulting in reactivation of the latent disease (Manganelli, Dubnau, Tyagi, Russell and Smith, 1999)
When the time occurs that these atypical mycobacteria cause infection, they are very hard to cure. Drug therapy for these organisms must be given for one and a half to two years and requires multiple medications to be used (Schiffman, 2010)
However, persons with lowered immune systems, including the elderly and especially persons with HIV or cancer diagnoses, are at risk for developing the disease after exposure. Persons with substance abuse problems including tobacco addiction are also at higher risk for developing the disease due to lowered immune system ("Risk Factors," 2015)
Newer strains of the bacteria are creating epidemics worldwide ("Understanding Tuberculosis: The Basics," 2015). In fact, some of the newer forms of tuberculosis are completely unresponsive to current drug interventions (Udwadia, et al
Exposure to the Mycobacterium tuberculosis bacteria does not necessarily lead to manifestations of the illness, because the bacteria can live inside the body and remain inactive. Moreover, when the bacteria remain inactive or latent, the disease will not be contagious ("Understanding Tuberculosis: The Basics," 2015)
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