Abstract
AbstractMultidrug resistant (MDR) tuberculosis (TB) is becoming more cumbersome especially in developing countries. Already supportive infrastructures are weak as compared to disease burden. Numerous diagnostic techniques for early diagnosis of TB and MDR TB have brought incremental improvements however; the technical intricacies of these assays and their reliance on enthusiastic laboratory infrastructure have restricted their implementation, particularly in low resource and high burden settings. Recently introduced GeneXpert MTB / RIF assay simultaneously detects the presence of MTB, and its susceptibility to the important first line drug rifampicin. Aim of this report is to understand the role of physician in prompt diagnosis and its control in spread of MDR TB and conversion of normal TB to MDR TB using available resources. Watchfulness of physician is an important factor in treating TB patients and early diagnosis of MDR TB using available resources. A good skilled team work is necessary to locate such cases in early stages and pro-mpt treatment can save many lives and ultimately serve as a big barrier in spreading primary MDR TB.Keywords:MDR TB, Tuberculosis, Prompt Diagnosis, GeneXpert.
Highlights
Multidrug resistant (MDR) tuberculosis (TB) has become common especially in developing countries already suffering from fewer infrastructures compared to the disease burden
Multidrug resistant tuberculosis has developed as a noteworthy global health due to alarming reports of growing drug resistance which potentially threaten to disrupt the gains attained in treatment of TB during last decade or so.[1]
MDR TB has been considered essentially a man-made disease due to inadequate treatment is not true in case of present findings as the patient had good compliance and dose was prescribed according to the weight of the patient but patient had other non-communicable diseases like diabetes and renal failure which in turn might be the reasons of poor response to drugs resulted in the drug resistance
Summary
Multidrug resistant (MDR) tuberculosis (TB) has become common especially in developing countries already suffering from fewer infrastructures compared to the disease burden. Physician advised him to provide first morning specimen for smear microscopy, AFB culture and GeneXpert MTB Rif assay. Physician again advised him to give a spot specimen of sputum for AFB smear microscopy and GeneXpert MTB Rif assay. Physician started thinking about the previous reports especially of Genexpert Another sputum specimen for GeneXpert MTB Rif assay to check if there is any personnel error again it was positive for MTB and resistant to rifampicin. It was confirmed that this rifampicin resistance was developed during 6 weeks of treatment by first line anti tubercular drugs He was put on second line ATT and improvement in symptoms has started to appear within one month. Vigilance of physician and GeneXpert helped in prompt diagnosis of MDR TB
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