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Infectious Diseases in an Age of Change The Impact of Human Ecology and Behavior on Disease Transmission (1995) / Chapter Skim
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Evolution of Drug-Resistant Tuberculosis: A Tale of Two Species
Pages 135-140

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From page 135...
... Unfortunately, the environmental factor that is essential for the rising prevalence of drug-resistant tuberculosis around the globe is humankind. The interplay between the two species, Mycobacterium tuberculosis and Homo sapiens, and its role in the creation of strains of tuberculosis resistant to modern medications will be described below.
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From page 136...
... Although it is a bacterium, the tuberculosis bacillus is highly resistant to the conventional antibiotics, such as penicillin or sulfa, which were developed in the 1930s and 1940s. Selman Waksman, a specialist in soil biology at Rutgers, while screening microbes recovered from the earth, came upon a substance elaborated by one of them with substantial activity against the tubercle bacillus in 194 ~1944; this compound, streptomycin, was pressed rapidly into clinical use, with initial reports of its efficacy appearing in 1945 (3~.
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From page 137...
... In New York City, where a variety of elements, including poverty, substance abuse, and deteriorating public health programs, combined to confound tuberculosis control, 33% of tuberculosis strains recovered in April 1992 were resistant to at least one drug, and 19% were resistant to two or more agents (10~. Tragically, in some developing nations where resources
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From page 138...
... Unfortunately, the HIV epidemic is afflicting persons from countries and/or socioeconomic groups in which tuberculosis latent infection and disease are highly prevalent. Because HIV infects, disables, and kills the cell that is central to tuberculosis immunity the CD4+ or helper T lymphocyte the viral epidemic has led to a dramatic upsurge in tuberculosis in regions such as sub-Saharan Africa and cities including New York, Miami, Los Angeles, Rio de Janeiro, Brazil, and Bangkok, Thailand, where HIV and tuberculosis are coincident.
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From page 139...
... the highly effective prevention strategy of prophylactic treatment with isoniazid, a very inexpensive drug, to block the transition from latent infection to active disease will be rendered ineffectual. In summary, human societal failures have potentiated the evolution of drug-resistant strains of the tubercle bacillus in the United States and around the world.
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From page 140...
... 17. Centers for Disease Control (1991)
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Key Terms

  • tubercle bacillus
  • wholesale transmission
  • inadequate therapy
  • hiv epidemic
  • immunodeficiency virus

  • human immunodeficiency
  • epidemic threatens
  • human societal
  • promote wholesale
  • immense morbidity

  • latent infection
  • infectious diseases
  • societal failures
  • whom inadequate
  • highly prevalent

  • hiv infects
  • rose steadily
  • tuberculosis speculated
  • active disease
  • natural reservoir

  • hiv rises
  • preferential survival
  • enable drug
  • lost intensity
  • strains recovered

  • dramatic upsurge
  • defenses associated
  • soon recognized
  • emerging influence
  • involved failed


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