Health Tip
What Is Extensively Drug-Resistant Tuberculosis?
Extensively drug-resistant tuberculosis (XDR TB) is a relatively rare type of multidrug-resistant tuberculosis. It is resistant to almost all drugs used to treat tuberculosis (TB), including the two best first-line drugs: isoniazid and rifampin. Extensively drug-resistant tuberculosis is also resistant to the best second-line medications.
How Is XDR TB Spread?
Drug-susceptible (regular) tuberculosis and XDR TB are spread the same way. Tuberculosis germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected. Tuberculosis in NOT spread by:
- Shaking someone’s hand
- Sharing food or drink
- Touching bed linens or toilet seats
- Sharing toothbrushes
- Kissing
- Smoking or sharing cigarettes
Why Is XDR TB So Serious?
Because XDR TB is resistant to the most powerful first-line and second-line drugs, patients are left with treatment options that are much less effective and often have worse treatment outcomes. XDR TB is of special concern for person with HIV infection or other conditions that can weaken the immune system. These persons are more likely to develop TB disease once they are infected and also have a higher risk of death once they develop tuberculosis.
Who Is at Risk for Getting XDR TB?
Drug-resistant tuberculosis is more common in people who:
- Do not take their tuberculosis medicine regularly
- Do not take all of their tuberculosis medicines as directed by their doctor or nurse
- Develop active TB disease again, after having taken tuberculosis medicine in the past
- Come from areas of the world where drug-resistant TB is common
- Have spent time with someone known to have drug-resistant tuberculosis
How Can I Prevent Myself from Getting TB?
Avoid close contact or prolonged time with known TB patients in crowded, enclosed environments like clinics, hospitals, prisons, or homeless shelters.
Can the TB Vaccine Help Prevent XDR TB?
There is a vaccine for TB disease call Bacille Calmette-Guerin (BCG). It is used in some countries to prevent severe forms of tuberculosis in children. However, BCG is not generally recommended in the United States because it has limited effectiveness for preventing tuberculosis in adults. The effects of BCG against XDR TB would likely be similar to the effect on drug-susceptible tuberculosis.
Can XDR TB Be Treated and Cured?
Yes, in some cases. Some tuberculosis control programs have shown that cure is possible for an estimated 30 percent of affected people. Successful outcomes depend greatly on the extent of the drug resistance, the severity of the disease, and whether the patient’s immune system is weakened.
What Are the Symptoms of XDR TB?
The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs may also include coughing, chest pain, and coughing up blood. Symptoms of TB disease in other parts of the body depend on the area affected. If you have these symptoms, you should contact your doctor or local health department.
What Should I Do If I Have Been around Someone Who Has XDR TB?
If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin test or TB blood test. Tell your doctor or nurse when you spent time with this person.
How Long Does It Take to Find Out If You Have XDR TB?
If TB bacteria are found in the sputum (phlegm), the diagnosis of tuberculosis can be made in a day or two, but this finding will not be able to distinguish between drug-susceptible (regular) TB and drug-resistant TB. To determine drug susceptibility, the bacteria need to be grown and tested in a laboratory. Final diagnosis for tuberculosis, and especially XDR TB, may take from six to 16 weeks.