The National Tuberculosis Institute (NTI) at Bangalore has confirmed that all eight patients whose sputum samples for a re-test have show resistance to all the known TB drugs (first and second line). The confirmation report by institute was sent to the Delhi-based Central TB Division (CTD) on April 19, which was sent to the state health department on Monday.
On January 6, Hinduja hospital announced that it had detected 12 cases of totally drug-resistant (TDR) tuberculosis - a terminology not accepted by the World Health Organisation (WHO). Resistance to every available TB drug develops because of wrong treatment of multi-drug resistant tuberculosis (MDR-TB) and extensively drug resistant (XDR) TB. Three of the 12 Hinduja patients died early this year. After the CTD, with their team of experts, arrived in Mumbai to take stock of the situation, they said the patients suffered from "XXDR-TB" which, in medical literature, stands for Extremely Drug-Resistant Tuberculosis. Of the 12 cases, eight samples were sent for re-testing to NTI while four old samples were destroyed.
"The report sent by CTD said the samples sent from Hinduja to NTI are XDR with additional resistance to second line drugs," said Dr Camilla Rodrigues, head of microbiology department, Hinduja Hospital, who was part of the study. However, the terminology of the ailment is still left ambiguous as TDR-TB or XXDR-TB is not approved by the WHO.
"We will place this report on record before the DOTS+ (Directly Observed Treatment Shortcourse Plus) committee that deals with drug resistant TB and figure out the line of treatment that could be offered to these patients now," said state TB officer Dr PY Gaikwad.
"Six patients belong to Mumbai. While five of these are undergoing treatment with the Revised National Tuberculosis Control Programme for XDR-TB treatment, one patient is being treated at Hinduja hospital," said Dr Minni Khetarpal, city TB officer, Brihanmumbai Municipal Corporation.
Dr Gaikwad said that two of these six patients are sensitive to one second-line drug. "All other patients are doing well. It shows that immunity of the host (patient) also matters, not just the drug sensitivity to the bacteria," said Dr Gaikwad.