Efflux Pump Mediated Second-Line Tuberculosis Drug Resistance

Tuberculosis (TB) caused by Mycobacterium tuberculosis is a serious problem worldwide, with about 9.6 and 13 million incident and prevalent cases reported in 2014 respectively. The burden of TB continues to be a global threat and has shown to be difficult to control in regions with high prevalence to human immune deficiency virus (HIV) infection. There were 1.5 million TB deaths (1.1 million among HIV-negative people and 0.4 million among HIV-positive people), of which approximately 890 000 were men, 480 000 were women and 140 000 were children.

Tuberculosis Drug Resistance
Tuberculosis Drug Resistance

The global resurgence of TB due to progression of antibiotic resistance M. tuberculosis from monoresistant through multi-drug resistant (MDR), extensively drugresistant (XDR) and now totally drug-resistant (TDR) forms is worrisome. Resistance to at least rifampicin (RIF) and isoniazid (INH) the two most effective TB drugs used in first line treatment is defined as MDR-TB. Further resistance of MDR-TB strains to fluoroquinolone (FLQ) and at least one of the three following injectable drugs namely capreomycin (CAP), kanamycin (KAN), and amikacin (AMK) leads to XDR-TB.

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