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Antibiotics increase tuberculosis resistance risk

Society For General Microbiology : 15 June, 2006  (Company News)
Drug resistant tuberculosis may be on the increase due to a limited repertoire of effective drugs, which need to be given in combination, and the inability of some TB bacteria to repair their own DNA properly, leading to faster mutations, according to scientists presenting their research at the Society for General Microbiology's 158th Meeting at the University of Warwick, UK.
Microbiologists working at the University College London in collaboration with St. George's University of London have discovered that a commonly used type of antibiotic called quinolones may be speeding up the development of even more drug resistant strains of the TB-causing bacterium, Mycobacterium tuberculosis.

'Quinolones are used to treat a wide variety of bacterial infections, including drug resistant TB,' says Denise O'Sullivan from the Royal Free & University College London Medical School. 'The problem is that many tuberculosis patients don't complete their standard six month treatment course, allowing some bacteria to develop resistance and survive'.

Tuberculosis kills 2 million people annually. Tuberculosis rates in children living in London have risen 130% in the last ten years, and more TB is being diagnosed in 10-16 year olds than in any other childhood age group.

The disease affects the lungs and the bacteria that cause it are spread through the air by coughing, sneezing or even just talking to someone. A single sneeze releases millions of mycobacteria into the air, and one person with active TB will go on to infect up to 15 people throughout the year.

'The new and worrying mechanism we have uncovered is that drug doses of quinolones which are too low to kill the bacteria can instead increase their mutation rate by 120 fold, hugely increasing the chances of a drug resistant strain emerging,' says Denise O'Sullivan. 'The effect works because quinolones interfere with the bacteria's normal DNA repair mechanisms, a process which constantly goes on in the life of the bacteria, and which is essential for survival and adaptation to new environments'.

Tuberculosis was in decline in the UK until 1988, but since then it has risen again. London now has one of the highest rates of tuberculosis in Europe. In the developing world TB never went away. Increased population movements due to global air travel, exotic holidays and immigration have helped spread the disease back to developed countries.

'We are concerned that the bacteria could become resistant to quinolones by mutating due to a switch in the bacterial DNA repair mechanisms,' says Denise O'Sullivan. 'Care must be taken when introducing a quinolone in the treatment regimen for TB'.
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