Extremely drug resistant TB, or XDR-TB, is a serious problem in India, according to a study presented May 21 at the American Thoracic Society 2007 International Conference. The study, the first in India to look at the prevalence of XDR-TB, found this type of TB accounts for 8 percent of multi-drug-resistant cases, compared with about 4 percent in the United States.
MDR-TB (multi-drug resistant TB) describes strains of tuberculosis that are resistant to at least the two first-line TB drugs, isoniazid and rifampicin. XDR-TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs. XDR-TB leaves patients (including many people living with HIV) virtually untreatable using currently available anti-TB drugs.
Recent findings from a survey conducted by the World Health Organization and the Centers for Disease Control and Prevention found that XDR-TB has been identified in all regions of the world but occurs most frequently in the countries of the former Soviet Union and in Asia.
Sushil Jain of the Hinduja National Hospital in Mumbai, India, and colleagues examined 3,904 lab samples at their hospital, and found that 1,274 were positive for Mycobacterium tuberculosis. Of these, 32 percent were found to be MDR-TB, out of which 8 percent were XDR-TB. Tuberculosis can infect many sites in the body but most commonly affects the lungs. All XDR-TB cases were in patients with pulmonary tuberculosis, or TB found in the lungs, which can be spread by coughing, sneezing, laughing or singing. Repeated exposure to someone with TB disease is generally necessary for infection to take place.
The death rate of XDR-TB patients in the study was 42 percent, which Jain calls alarmingly high.
An important finding was that the majority of patients with XDR-TB were of younger age group (their average age was 30 years), thus posing a major threat to our economically productive population, Jain notes. Serious efforts are needed to tackle this deadly disease which may become a global emergency.
Jain says that XDR-TB has long existed in India but has been under-recognized and under-treated. Most labs in India are not equipped to perform drug susceptibility tests so exact prevalence is difficult to ascertain, and treatment in the absence of reliable sensitivity reports is difficult. Compounding the problem is the huge costs of treating these most difficult TB patients, he said.
Source: American Thoracic Society
Happy Hand Hygiene Day! Rethinking Glove Use for Safer, Cleaner, and More Ethical Health Care
May 5th 2025Despite their protective role, gloves are often misused in health care settings—undermining hand hygiene, risking patient safety, and worsening environmental impact. Alexandra Peters, PhD, points out that this misuse deserves urgent attention, especially today, World Hand Hygiene Day.
From the Derby to the Decontam Room: Leadership Lessons for Sterile Processing
April 27th 2025Elizabeth (Betty) Casey, MSN, RN, CNOR, CRCST, CHL, is the SVP of Operations and Chief Nursing Officer at Surgical Solutions in Overland, Kansas. This SPD leader reframes preparation, unpredictability, and teamwork by comparing surgical services to the Kentucky Derby to reenergize sterile processing professionals and inspire systemic change.
Show, Tell, Teach: Elevating EVS Training Through Cognitive Science and Performance Coaching
April 25th 2025Training EVS workers for hygiene excellence demands more than manuals—it requires active engagement, motor skills coaching, and teach-back techniques to reduce HAIs and improve patient outcomes.