Connect
MJA
MJA

Extensively resistant tuberculosis in the lands Down Under

Paul D R Johnson
Med J Aust 2011; 194 (11): . || doi: 10.5694/j.1326-5377.2011.tb03104.x
Published online: 6 June 2011

As tuberculosis resistance increases linearly, the cost and complexity of managing these cases increases exponentially

New Zealand’s first case of extensively drug-resistant tuberculosis (XDR-TB) is reported in this issue of the Journal.1 Even though the patient did not have transmissible pulmonary TB, the case highlights the complexity of managing such patients and draws attention to the long delay between suspecting TB and confirming XDR-TB. Two cases of XDR-TB have been reported in Australia, one in 20042 and one in 2010,3 but there have been many more cases overseas.4 Still, only three cases in our two countries — should we care?


  • Infectious Diseases Department, Austin Health and University of Melbourne, Melbourne, VIC.


Correspondence: Paul.Johnson@austin.org.au

  • 1. Goh T, Towns CR, Jones KL, et al. Extensively drug resistant tuberculosis: New Zealand’s first case and the challenges of management in a low-prevalence country. Med J Aust 2011; 194: 602-604. <MJA full text>
  • 2. Lumb R, Bastion I, Carter R, et al. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2007. A report of the Australian Mycobacterium Reference Laboratory Network. Commun Dis Intell 2009; 33: 298-303.
  • 3. Communicable Diseases Branch, NSW Department of Health. Communicable Diseases Report, NSW, September and October 2010. N S W Public Health Bull 2010; 21: 274-279.
  • 4. World Health Organization, International Union Against Tuberculosis and Lung Disease. Anti-tuberculosis drug resistance in the world. Fourth global report. Geneva: WHO, 2008. http://www.who.int/tb/publications/2008/drs_report4_26feb08.pdf (accessed May 2011).
  • 5. Williams HE, Phelan PD. The epidemiology, mortality and morbidity of tuberculosis in Australia: 1850-94. J Paediatr Child Health 1995; 31: 495-498.
  • 6. Frith D. Archie Jackson: the Keats of cricket. London: Pavilion, 1974.
  • 7. Dubos R, Dubos J. The white plague: tuberculosis, man, and society. Rutgers University Press, 1952.
  • 8. World Health Organization Statistical Information System (WHOSIS). World Health Statistics 2010. Geneva: WHO, 2011. http://www.who.int/whosis/whostat/2010/en/index.html (accessed May 2011).
  • 9. Ghafur AK. An obituary — on the death of antibiotics! J Assoc Physicians India 2010; 58: 143-144.
  • 10. Trauer JM, Krause VL. Assessment and management of latent tuberculosis in a refugee population. Med J Aust 2011; 194: 579-582. <MJA full text>
  • 11. Lavender CJ, Brown LK, Johnson PD. Multidrug-resistant tuberculosis in Victoria: a 10-year review. Med J Aust 2009; 191: 315-318. <MJA full text>
  • 12. Brown H. WHO identifies drug-resistant tuberculosis “hotspots”. Former Russian states are worst affected, but lack of data from China hides true extent of disease. Lancet 2004; 363: 951.
  • 13. XDR-TB — a global threat. Lancet 2006; 368: 964.
  • 14. Cox HS, Kalon S, Allamuratova S, et al. Multidrug-resistant tuberculosis treatment outcomes in Karakalpakstan, Uzbekistan: treatment complexity and XDR-TB among treatment failures. PLoS One 2007; 2: e1126.
  • 15. Australian Government Department of Health and Ageing. National notifiable diseases surveillance system. 2011. http://www9.health.gov.au/cda/source/CDA-index.cfm (accessed Feb 2011).
  • 16. Taleb NN. The black swan — the impact of the highly improbable. New York: Random House, 2007.
  • 17. Banerjee R, Allen J, Westenhouse J, et al. Extensively drug-resistant tuberculosis in California, 1993-2006. Clin Infect Dis 2008; 47: 450-457.
  • 18. ABC Television. The 7.30 Report. Govt shuts down TB clinics. 19 April 2011. http://www.abc.net.au/7.30/content/2011/s3196038.htm (accessed May 2011).
  • 19. Boehme CC, Nabeta P, Hillemann D, et al. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med 2010; 363: 1005-1015.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.