The British Medical Journal reported in May 2008 that strains of the bacterium that causes tuberculosis (TB) have become resistant to isoniazid, a front line tuberculosis treatment used widely in England, Wales and Northern Ireland for active tuberculosis and latent tuberculosis. TB is prevalent in people in the UK who are also infected with HIV.
The greatest increase in resistant to tubercolosis treatment was seen in the London area, where the problem of resurgent TB is the worst in the UK, due to the number of patients with HIV. The cases of tubercolosis have been increasing steadily since the mid 1980s and, in 2006, the last year to be officially reported, 8000 people were diagnosed with TB.
Worldwide, resistance to the antibiotics used to treat tubercolosis has become a big problem – worse in areas of the world where TB is much more common. In the developing world, there is much concern about multidrug resistant strains of tuberculosis – called MDR –TB – in which the plasmids that carry resistance are passed directly from one bacterium to another. So far, according to the BMJ report, there is no evidence that this is happening in the UK – the resistance seems to have developed because people being treated with the antibiotic isoniazid have not completed their therapy properly. This can be difficult as treatment for TB needs to continue over a period of 6 months for the infection to be completely eliminated.
The details of the report show that isoniazid resistance in strains of the bacterium that causes tuberculosis rose from 5% to 7.2% from the mid 1980s until 2003 and it has remained at level since. 0.9% of cases of TB seen in England, Wales and Northern Ireland were of the MDR-TB type.
Increasing anti tuberculosis drug resistance in the United Kingdom: analysis of national surveillance data
BMJ, doi:10.1136/bmj.39546.573067.25 (published 1 May 2008)
Michelle E Kruijshaar, senior scientist, John M Watson, director, Francis Drobniewski, director and consultant medical microbiologist, Charlotte Anderson, scientist, Timothy J Brown, clinical scientist, John G Magee, director, E Grace Smith, director, Alistair Story, tubercolosis nurse specialist, Ibrahim Abubakar, consultant epidemiologist and head of tuberculosis section |
