Tracking Antibiotic-Resistant Tuberculosis

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Author: Cynthia B. Schofield, MPH, MT
Reviewer: Hallee Waye, BS, MLS (ASCP)CM

In this course, the presentation of a brief history of tuberculosis (TB) and its developing resistance to anti-tuberculosis drugs, is followed by case histories from India, Italy, and the US-Mexican border. The pathogenesis of TB disease in humans is diagrammed and a review of diagnostic laboratory methods, susceptibility testing, and methods of control are explored.

Continuing Education Credits

Objectives

  • Review the history of Mycobacterium tuberculosis (MTB) and developing antibiotic resistance.
  • Discuss the global case load of tuberculosis (TB), including India, Italy, and the United States (US)-Mexican border.
  • Describe two pediatric TB cases.
  • Diagram and explain MTB pathogenesis.
  • Discuss laboratory methods of MTB diagnosis and susceptibility testing.
  • Review methods of TB treatment and control.

Course Outline

  • Introduction
      • Epidemiology of Multidrug-Resistant Tuberculosis (MDR-TB)
  • Background
      • History
      • Robert Koch made several significant discoveries with regard to the tuberculosis (TB) bacillus. Which statement is FALSE?
      • Early Treatment
      • TB Wonder Drugs
      • Transmission
      • For tuberculosis (TB) patients, the success of sanatorium treatment was based on a combination of several different factors. Which of the factors list...
      • Spread of Resistance: Escalation of Multidrug-Resistant Tuberculosis (MDR-TB)
      • In the 1980s, what major factor directly caused the escalation of multidrug-resistant tuberculosis (MDR-TB)?
      • Spread of Resistance: Global Emergency
      • After the first appearance of extensively drug-resistant tuberculosis (XDR-TB), which control measure was the MOST effective?
  • Global View
      • India
      • Development of Selective Resistance in India
      • Which of the following statements BEST explain India’s rising prevalence of totally drug-resistant tuberculosis (TDR-TB)? (Choose all that apply...
      • Italy
      • Source of Infection in Italian School Epidemic
      • Which three (3) statements help to explain the difficulty in resolving the multidrug-resistant tuberculosis (MDR-TB) epidemic in the Italian school?
      • Case Study of Drug Resistance in Two Children: Patient 1
      • Case Study of Drug Resistance in Two Children: Patient 2
      • Case Study of Drug Resistance in Two Children: Treatment Summary for Both Cases
      • Comparison of Italian Pediatric Cases
      • Which of the following statements accurately describe the similarities present in both of the pediatric case studies presented? (Choose all that apply...
      • United States (US)-Mexican Border
      • United States (US)-Mexican Border, continued
      • What primary factors tend to increase the incidence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) across the...
  • Pathogenesis
      • Pathogenesis of Tuberculosis (TB) Infection
      • All of the following help to explain the mechanism that causes (pathogenesis) tuberculosis (TB) infection, EXCEPT which statement?
  • Laboratory Diagnosis
      • Laboratory Diagnosis
      • Acid-fast Bacilli (AFB) Smear Microscopy
      • Culture
      • Identification (ID)
      • Match the method with the definition that best applies.
      • Antimicrobial Susceptibility Testing (AST)
      • Antimicrobial Susceptibility Testing (AST): Example of an Automated System
      • Match each description with the definition that applies.
      • Molecular Detection of Multidrug-Resistant (MDR) Strains: Isoniazid (INH) Resistance
      • Molecular Detection of Mutidrug-Resistant (MDR) Strains: Rifampin (RIF) Resistance
  • Treatment and Control of Antibiotic-resistant TB
      • Treatment
      • Control and Prevention
      • Which of the following statements are considered essential to the treatment and control of MDR-TB? (Choose all that apply.)
  • Looking Ahead
      • Looking Ahead
  • References
      • References

Additional Information

Level of instruction: Basic to intermediate 

Intended audience:  This course is intended for microbiology bench technicians and technologists, supervisors, and administrators. 

Author information: Cynthia B. Schofield, MPH, MT received her BS degree in Biology at the University of Michigan, Ann Arbor, Michigan and her Masters of Public Health, Epidemiology, and Biostatistics at San Diego State University, San Diego, California. Cynthia is retired with 25 years of supervisory experience in the clinical microbiology laboratory and has written for numerous publications, including ASCP, Advance, and MLO.

Reviewer information: Hallee Waye, BS, MLS (ASCP)CM, has over 7 years of experience as a medical laboratory scientist. She currently works as a clinical microbiologist and the clinical laboratory educator for the Parkview School of Medical Laboratory Science in Pueblo, CO. She obtained her bachelor’s degree in microbiology from Colorado State University and attended the Colorado Center for Medical Laboratory Science to obtain her professional certificate in medical laboratory science. She is currently pursuing her master’s degree in clinical laboratory science at the University of Texas Rio Grande Valley.

Course description: In this course, the presentation of a brief history of tuberculosis (TB) and its developing resistance to anti-tuberculosis drugs, is followed by case histories from India, Italy, and the US-Mexican border. The pathogenesis of TB disease in humans is diagrammed and a review of diagnostic laboratory methods, susceptibility testing, and methods of control are explored.

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This course is part of:
2174 mtb acidfast fig7ASM Microbe Libe
AFB fluorescent stain, courtesy of the CDC.
TB susceptibility agar proportion test, courtesy of CDC.
Ziehl-Neelson stained MTB showing AFB w/cording morphology, courtesy of the CDC
MTB by Ziehl-Neelsen
MTB on LJ
Fluorescent auramine stain w/acridine orange counterstain