Drug-resistant and multidrug-resistant tubercle bacilli

Drug resistant (DR) and multidrug resistant (MDR) tuberculosis (TB) is a co nsequence of human activity and did not exist before chemotherapeutic drugs were introduced. Monotherapy with various drugs in sequence or other inade quate drug regimens have strongly contributed to the creation of MDR-TB. Su ch TB strains are mainly prevalent in regions with weak national TB program mes or poor socio-economic environments. Strains may also spread in some co mmunities such as poorly administered prisons. From these and other sources , MDR-TB may spread in the population from which travellers might transfer strains between countries and continents. Therefore an effective surveillan ce of the resistance pattern of TB bacilli is a demanding task ill all coun tries. In this review some aspects of epidemiology, diagnosis and mechanism s of DR in TB are discussed. MDR-TB is an important international problem o f increasing significance for the whole global community. (C) 1999 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserve d.