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1 Drug susceptible TB Limited resistance MDR-TB (Frieden, 1993) XDR-TB

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Presentation on theme: "1 Drug susceptible TB Limited resistance MDR-TB (Frieden, 1993) XDR-TB"— Presentation transcript:

1 1 Drug susceptible TB Limited resistance MDR-TB (Frieden, 1993) XDR-TB
(Alexander and De, 2007) Total DR (Velayati, et al., 2009) Resistance to 1st line anti-TB drugs Rifampicin, Isoniazid Resistance to 2nd line anti-TB drugs Fluoroquinolone, Injectable drugs: Kanamycin, Capreomycin, Amikacin Resistance to all available anti-TB drugs Treatable with 1st line anti-TB drugs Isoniazid, Pyrazinamide, Ethambutol Treatable with 2nd line anti-TB drugs Treatment options seriously restricted No treatment options Fig.1 1

2 a b d c Drug efflux pump Drug target Drug degrading enzyme Drug inactivating enzyme Fig.2

3 PDIM Heme MBT cMBT Econazole SL-1 INH Mycolate wax ester Glycophospholipid MmpL3 MmpL4 MmpL5 MmpL7 MmpL8 MmpL11 Cell Membrane TMM Fig.3

4 Mycobacterium abscessus
TMM AU1235 SQ109 BM212 Indolcarboxamide Spiro THPP PIPD MmpL3 Mycobacterium abscessus Mtb Fig.4

5 Drug efflux Iron acquisition Lipid transport Death of bacterium Fig.5

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