Tracking Antibiotic-Resistant Tuberculosis
Continuing Education Credits
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.
Objectives
- Review the history of Mycobacterium tuberculosis (MTB) and developing antibiotic resistance.
- Discuss the global history of tuberculosis (TB) resistance and subsequent challenges in regions of 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, control, and recent advances.
Course Outline
- Introduction
- Epidemiology of Drug-Resistant Tuberculosis
- Drug-Resistant Tuberculosis Classification
- True or False: According to the most recent WHO Global Tuberculosis Report, India, Indonesia, and the Philippines account for more than >50% of TB cases.
- The World Health Organization (WHO) recognizes which of the following classification categories of drug-resistant TB?
- Background
- History
- Robert Koch made several significant discoveries concerning 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 factors. Which factors listed were not part of the formula responsible for successful sanatorium treatment?
- Spread of Resistance: Escalation of Multidrug-Resistant Tuberculosis
- 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
- Examples of TB Resistance and Challenges
- India: TB Resistance and Challenges
- Development of Selective Resistance in India
- Which of the following statements does not explain India’s rising prevalence of TB cases that are resistant to all known drug treatments?
- Italy: TB Resistance and Challenges
- Source of Infection in Italian School Epidemic
- Which statement helps 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 describes the similarities present in both of the Italian pediatric case studies presented?
- United States-Mexican Border: TB Resistance and Challenges
- The Cost of TB Resistance
- What primary factors tend to increase the incidence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) across the border between California and Mexico?
- Pathogenesis
- Pathogenesis of Tuberculosis Infection
- Tuberculosis (TB) is spread through the air from one person to another via aerosolized droplets. The inhaled viable bacteria (tubercle bacilli) begin to multiply in the air sacs of the lungs. How many TB bacilli are usually contained within one droplet nucleus?
- Choose the statement that does not properly explain the mechanism of pathogenesis causing tuberculosis (TB) infection.
- Laboratory Diagnosis
- Laboratory Diagnosis
- Acid-fast Bacilli Smear Microscopy
- Culture
- Identification
- Match the method with the definition that best applies.
- Antimicrobial Susceptibility Testing
- Antimicrobial Susceptibility Testing: Example of an Automated System
- Match each description with the definition that applies.
- Molecular Detection of Multidrug-Resistant Strains: Isoniazid Resistance
- Molecular Detection of Multidrug-Resistant Strains: Rifampin Resistance
- Treatment and Control of Antibiotic Resistant Tuberculosis
- Treatment of Drug Resistant Tuberculosis
- Control and Prevention
- Which of the following statements is considered essential to the treatment and control of MDR-TB?
- Looking Ahead
- Looking Ahead
- True or False: Although the MVA85A TB vaccine trial did not improve protection (when combined with BCG) against M. tuberculosis, other vaccine candidates, such as M72/ASO1E, are proving to be effective in clinical trials.
- The United Nations Global Plan to End TB is intended to stop and reverse the incidence of TB by:
- References
- References
Additional Information
Level of Instruction: Basic to intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, microbiologists, laboratory supervisors, and laboratory managers. This
course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Cynthia B. Schofield, MPH, MT, received her BS degree in Biology at the University of Michigan, Ann Arbor, Michigan, and her Master 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:
Laurie Bjerklie, MA, MLS(ASCP)CM, is an Education Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty
positions in both MLT and MLS programs.
Dr. Julie Ann West is certified by the American Society for Clinical Pathology (ASCP) as a Medical Laboratory Scientist (MLS) and as a Specialist in Microbiology (SM). In addition, Dr. West has earned a PhD in Public Health - Infectious Disease Epidemiology - and is Certified in Public Health (CPH) by the National Board of Public Health Examiners. Dr. West is experienced as a Technical Specialist, Safety Officer, Educator, and Lead in the Veterans Administration Healthcare System, and has prior experience as an Administrative Laboratory Director.
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 of TB resistance and subsequent challenges from regions of 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.