Multidrug-resistant Tuberculosis
Multidrug-resistant tuberculosis: past, present and future Ivan Bastian and Franyoise Portaels Mycobacteriology Unit. Institute of Tropical Medicine. Antwerp. Belgium The Lord hath created medicines out of the earth and he that is wise will not abhor them
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Resurgent and Emerging Infectious Diseases Volume 1
Multidrug-resistant Tuberculosis Edited by
Ivan Bastian Mycobacterium Reference Laboratory, Institute of Medical & Veterinary Science, Adelaide, Australia and
Franchise Portaels Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
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SPRINGER-SCIENCE+BUSINESS MEDIA, B.V.
A C L P . Catalogue record for this book is available from the Library of Congress.
I S B N 978-94-010-5794-3 I S B N 978-94-011-4084-3 (eBook) D O I 10.1007/978-94-011-4084-3
Printed on acid-free paper
A l l Rights Reserved © 2000 Springer Science+Business Media Dordrecht Originally published by Kluwer Academic Publishers in 2000 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from
the copyright owner.
This book is dedicated to all those suffering from tuberculosis, who battle with body and spirit against the disease. Among these are the patients, particularly those in penitentiary hospitals in Siberia, who watch helplessly as their illness is rendered more severe, and often fatal, under the weight of multidrug-resistance. This book also recognises the players in the fight against tuberculosis: the doctors and nurses, health professionals, researchers, and laboratory personnel. Lastly, IB would like to thank Stephanie, who left home for two years though she didn't know why, and Carmela, who knew why but still came.
During the preparation of this book, Ivan Bastian was supported by a Neil Hamilton Fairley Fellowship (987069) from the National Health and Medical Research Council of Australia. Many of the contributors to this book participated in a Colloquium entitled "Tuberculosis, the real millennium bug: addressing the threat in developing and industrialised countries", which was held in Antwerp between 14-17 December 1999 through the auspices of the Institute of Tropical Medicine.
The word of a woman seems simple enough But nothing is ordinary Upon reflection, we see that it is sacred It radiates the joy of the world Most things in life are sacred Many people kneel before the Gods I wish for you a simple happiness And that your dreams come true often The sun comes and goes Thank you for your aid You see, we are given but one life The entire world is shroud in a thick smoke It is a bad omen But we must believe in the forces of good If we are to protect our house From so far away You came to our side You saved us from death And we kneel before you For life is a precious gift from God Written by a tuberculosis patient in a penitentiary hospital in Siberia Translatedfrom Russian by A Disu and B Antoine
Table of Contents Chapter 1 - Introduction 1. Bastian and F. Portaels 1. Historical perspective 2. The Definition ofMRTB 2.1 Rationale for the current definition ofMDRTB 2.2 Importance of a strict definition for MDRTB 3. Virulence and other questions about M
