Pathophysiology: Totally drug-resistant tuberculosis (TDR-TB) is a generic term for tuberculosis strains that are resistant to a wider range of drugs than strains classified as Extensively drug-resistant tuberculosis. TDR-TB has been identified in three countries; India, Iran, and Italy. TDR-TB has resulted from further mutations within the bacterial genome to confer resistance, beyond those seen in XDR- and MDR-TB. Development of resistance is associated with poor management of cases.
Statistics: Incidence of tuberculosis is the estimated number of new and relapse tuberculosis cases arising in a given year, expressed as the rate per 100,000 population. All forms of TB are included, including cases in people living with HIV. In Switzerland the incidence of Tuberculosis reported from 2001-2005 is 7 cases, and from 2006-2015 is also reported as 7 cases.
Treatment: A number of medications are being studied for multi drug resistant tuberculosis including: bedaquiline and delamanid. Bedaquiline received U.S. Food and Drug Administration (FDA) approval in late 2012. The safety and effectiveness of these new agents are still uncertain, because they are based on the results of a relatively small studies.
Major Research: The identification of markers of TB strains that are characteristic of major M. tuberculosis strains families, thus corresponding to more adapted bacilli. Many of them correspond to SNPs affecting DNA repair genes. This opened the way to study genes involved in DNA repair and mycobacterial genome stability. New M. tuberculosis strain markers are being used to differentiate strains within major families and allow the detection of outbreaks.