Mechanism and Treatment of Multi-Drug Resistance of Mycobacterium Tuberculosis: A Review

Abstract

Tuberculosis (TB) is the greatest common cause of infection which is related to death worldwide. Multi-drug-resistant tuberculosis (MDR-TB) is tuberculosis (TB) infection which is caused by bacteria that are resistant to medication with at least two of the most powerful first-line antituberculosis medications (drugs), isoniazid and rifampin and the tuberculosis which are resistant to second-line medications are called extensively drug-resistant tuberculosis (XDR-TB). The isoniazid resistance has been associated with mutations in numerous genes that include katG, ahpC, inhA, kasA and ndh.  The rifampicin resistant to m.tuberculosis appear mutations in the gene rpoB which encodes the β-subunit of RNA polymerase and results in low affinity for the drug and develops resistances. Clofazimine, linezolid and bedaquiline is used in the treatment of multidrug resistance for m.tuberculosis. Pulmonary resection may be required in patients with tuberculosis (TB) due to in drug-resistant cases when medication regimen is failed. The multidrug resistant tuberculosis creates a risk to health care workers, doctors and other patients, which should be prevented such as nosocomial transmission. The miliary disease and tubercular (TB) meningitis are the first and most deadly complications of primary tuberculosis.

Keywords: tuberculosis, multidrug resistant, mechanism, treatment, bedaquiline, linezolid, prevention.