India: NTI confirms tuberculosis cases fully drug resistant

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The National Tuber­cu­lo­sis Insti­tute (NTI), Ban­ga­lore has val­i­dated Hin­duja Hospital’s study that con­firms drugs resis­tance to all the known TB drugs (first and sec­ond line) in eight patients whose sam­ples were re-tested.

On 6 Jan­u­ary 2012, Hin­duja Hos­pi­tal had announced that they had detected 12 totally drug resis­tant (TDR) TB cases, a ter­mi­nol­ogy that was not accepted by the World Health Orga­ni­za­tion (WHO). Drugs resis­tance is devel­oped because of mis­man­age­ment of multi-drug resis­tant tuber­cu­lo­sis (MDR-TB). They had pub­lished the study in the sci­en­tific pub­li­ca­tion Clin­i­cal Infec­tious Dis­eases on 21 Decem­ber 2011.

How­ever, after the Cen­tral Tuber­cu­lo­sis Divi­sion (CTD), with their team of experts includ­ing NTI, arrived in Mum­bai to take stock of the sit­u­a­tion, they said that the patients suf­fered from XXDR-TB, which in med­ical lit­er­a­ture is extremely drug-resistant tuber­cu­lo­sis. Of the 12 cases, eight sam­ples were then sent for re-testing to NTI.

“Of the eight sam­ples sent, two patients died early this year (2012). The other six patients live in Mum­bai, one of who is a 15-year-old. Five of these patients are under­go­ing treat­ment with the Revised National Tuber­cu­lo­sis Con­trol Pro­gramme (RNTCP) for exten­sively drugs resis­tant (XDR) TB, while one is being treated at the Hin­duja Hos­pi­tal,” said Dr. Minni Khetarpal, city TB offi­cer, Bri­han­mum­bai Munic­i­pal Corporation.

“The NTI has con­firmed the Hin­duja report. We will place this report on record before the Directly Observed Treat­ment Short­course (DOTS) com­mit­tee and fig­ure out the future line of treat­ment that could be offered to these patients now,” said Dr P.Y. Gaik­wad, state TB officer.

How­ever, Dr Gaik­wad added that two of these patients are sen­si­tive to one second-line drug. “All the other patients are doing well. It shows that immu­nity of the host (patient) also mat­ters, not just the drug sen­si­tiv­ity to the bac­te­ria. Many of these patients are work­ing for a liv­ing,” said Dr Gaikwad.

The full arti­cle may be accessed at http://www.promedmail.org/direct.php?id=20120501.1119816
(ProMED 5/1/2012)

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