Extensively Drug-Resistant Tuberculosis (XDR TB) PODCAST

Emergence of Extensively Drug Resistant Tuberculosis - PODCAST. Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.

Here we see Mycobacterium tuberculosis in a sputum smear is stained using fluorescent acid-fast stain. M. tuberculosis is an acid-fast bacterium (AFB), and is therefore, undetectable when stained using a Gram stain technique.

However, using this method, the M. tuberculosis bacteria glow yellow under ultraviolet light microscopy.

Photomicrograph of a sputum sample containing Mycobacterium tuberculosis. M. tuberculosis bacteria can attack any part of the body, but usually the lungs causing Tuberculosis. It is spread when infected individuals cough or sneeze, releasing microdroplets into the air that contain the bacteria, which others then inhale.

Extensively drug-resistant tuberculosis (XDR TB) is a relatively rare type of multidrug-resistant tuberculosis (MDR TB). It is resistant to almost all drugs used to treat TB, including the two best first-line drugs: isoniazid and rifampin. XDR TB is also resistant to the best second-line medications: fluoroquinolones and at least one of three injectable drugs (i.e., amikacin, kanamycin, or capreomycin).

Because XDR TB is resistant to the most powerful first-line and second-line drugs, patients are left with treatment options that are much less effective and often have worse treatment outcomes.

XDR TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. These persons are more likely to develop TB disease once they are infected, and also have a higher risk of death once they develop TB disease.

The risk of acquiring XDR TB in the United States appears to be relatively low. However, it is important to acknowledge the ease at which TB can spread. As long as XDR TB exists, the United States is at risk and must address the threat. Morbidity rate 70%

Investigation of U.S. Traveler with Extensively Drug–Resistant Tuberculosis (XDR TB)

• Flight Itinerary of U.S. Traveler with Extensively Drug–Resistant Tuberculosis (XDR TB) (May 30, 2007)
• Press Conference Transcript, May 29, 2007
• CDC Health Advisory: May 29, 2007

Fact Sheets

• Extensively Drug-Resistant Tuberculosis (XDR TB)
• CDC’s Role in Preventing Extensively Drug-Resistant Tuberculosis (XDR TB)
• Multidrug-Resistant Tuberculosis (MDR TB)
• Tuberculosis Information for International Travelers

Morbidity and Mortality Weekly Reports (MMWRs)

• Extensively Drug-Resistant Tuberculosis - United States, 1993--2006 MMWR 2007; 56 (No. 11) (PDF - 329KB)
• Revised Definition of Extensively Drug-Resistant Tuberculosis MMWR November 3, 2006 Vol. 55, No. 43 (PDF - 298k)
• Emergence of Mycobacterium tuberculosis with Extensive Resistance to Second-Line Drugs — Worldwide, 2000–2004 MMWR March 24, 2006 Vol. 55, No.11 (PDF - 406k)

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