India doctor's claim of "totally" drug resistant TB disputed

HONG KONG Tue Jan 17, 2012 7:42pm IST

Jotindra Singh, 65, suffering from Tuberculosis (TB) waits for his free treatment outside a medical centre in Siliguri March 24, 2009. REUTERS/Rupak De Chowdhuri/Files

Jotindra Singh, 65, suffering from Tuberculosis (TB) waits for his free treatment outside a medical centre in Siliguri March 24, 2009.

Credit: Reuters/Rupak De Chowdhuri/Files

Related Topics

Priyanka Gandhi Vadra, daughter of Congress party chief Sonia Gandhi, adjusts her flower garlands as she campaigns for her mother during an election meeting at Rae Bareli in Uttar Pradesh April 22, 2014. REUTERS/Pawan Kumar

Election 2014

More than 814 million people — a number larger than the population of Europe — are eligible to vote in the world’s biggest democratic exercise.  Full Coverage 

HONG KONG (Reuters) - A tuberculosis strain among a dozen patients in India's financial hub and most populous city has been disputedly declared as "totally drug resistant" by a doctor who said on Tuesday the cases highlight the need for more research.

Zarir Udwadia, a tuberculosis doctor at the Hinduja National Hospital in Mumbai, said compared to classifications used by the government and the World Health Organization to describe malicious strains - multi-drug resistant and extensively drug-resistant TB - the patients diagnosed at his hospital were different.

"It is an untreatable form of TB in the sense that there are no available first- and second-line drugs for it in the world," he said in a telephone interview.

If a first six-month course of drugs fails to work, so-called second-line drugs are used for longer periods in attempts to cure the TB infection.

"XDR is easier to treat ... there are three to four second-line drugs still available which you can treat these patients with, but (for) our patients there is none."

He said the cases highlighted the need for India to pay more attention to treating patients with severe forms of TB, which the WHO said numbered around 110,000 in 2006, a figure Udwadia said was a "considerable underestimate."

But India's government said on Tuesday the laboratory at Hinduja hospital was not accredited for some of the tests that Udwadia's team carried out and questioned the term "totally drug resistant TB".

"The term ... is neither recognised by the WHO nor by the Revised National Tuberculosis Control Programme," it said in a statement. Such cases can be managed by national XDR-TB treatment guidelines, according to the WHO.

Udwadia and colleagues cultured TB bacteria taken from the patients, exposed them to all first- and second-line TB drugs and found them all powerless. They also performed genetic tests on the samples.

"We confirmed that whether we used traditional culture or genetic (tests), we came up with the same resistance pattern. These patients were already exposed to these drugs and ... they did not work in them," Udwadia said.

Udwadia said patients who contract drug-resistant TB face a problem as many private doctors are untrained in diagnosing and managing these more severe forms.

"They will get more and more malnourished, eventually they die without any available drug," Udwadia said when asked what would happen to those with untreatable forms of TB.

The first four of Udwadia's patients with this form of TB were described in a letter that he and colleagues published in the journal Clinical Infectious Diseases in December 2011.

According to medical literature, cases of such untreatable TB were first reported in 2007 in Europe. In 2009, 15 patients in Iran were reported to be resistant to all anti-TB drugs.

TB is caused by mycobacterium tuberculosis and destroys lung tissue, causing victims to cough up the bacterium, which then spreads through the air and can be inhaled by others.

An ancient, long-neglected disease, the world has had no new vaccines or drugs to fight TB for decades even though it is still a leading killer. In 2010, 8.8 million new cases were reported, with 1.45 million deaths worldwide.

(Writing by Tan Ee Lyn; Editing by Ed Lane)

Comments (0)
This discussion is now closed. We welcome comments on our articles for a limited period after their publication.

  • Most Popular
  • Most Shared


Big Buyback

Big Buyback

Apple expands buybacks by $30 billion.  Full Article 

Solar Dispute

Solar Dispute

Green groups urge U.S. to drop solar trade case against India.  Full Article 

Facebook Results

Facebook Results

Facebook Q1 revenue grows 72 percent on rising mobile ads.  Full Article 

Obama's Japan Visit

Obama's Japan Visit

Obama seeks to ease Asian allies' doubts during visit to Japan.  Full Article 

Uncharted Waters

Uncharted Waters

Phelps facing toughest challenge yet.  Full Article 

Reuters India Mobile

Reuters India Mobile

Get the latest news on the go. Visit Reuters India on your mobile device.  Full Coverage