Disturbing rise in super-resistant TB

HEALTH experts have reported a disturbing increase around the world in tuberculosis infections resistant to antibiotics.

"It's basically a death sentence. If people are failing first and second-line drugs and we don't have in the pipeline a new drug for immediate use, that's a crisis," said Dr Marcos Espinale, executive secretary of the World Health Organisation's Stop TB Partnership.

As campaigners raised awareness on World TB Day yesterday, it emerged that the number of cases of tuberculosis in England, Wales and Northern Ireland has topped 7,000 a year.

Latest figures from the Health Protection Agency showed a total of 7,167 cases reported in 2004 compared with 6,837 in 2003.

The Centres for Disease Control and Prevention and WHO surveyed a network of 25 tuberculosis laboratories on six continents from 2000 to 2004 and found that one in 50 TB cases around the world is resistant not only to the usual first-choice TB treatments, but also to many medications that represent the second line of defence.

The survey represents the first international data on what is being called "extensively drug-resistant" TB.

For more than a decade, health officials have worried about "multidrug-resistant" TB, which can withstand the mainline antibiotics isoniazid and rifampin. One in five TB cases falls into that category.

But the survey also found many cases of a more difficult form of TB one that does not respond to at least three of six classes of second-line drugs. That is especially worrisome, because second-line drugs are generally considered more toxic and less effective.

"These are individuals who are virtually untreatable with available drugs," said Dr Kenneth Castro of the CDC.