臨床感染症: オープンアクセス

Tuberculosis, a bacterial infection caused by the organism Mycobacterium Tuberculosis, is a widespread disease infecting roughly one-fourth of the world’s population. Although a majority of these cases remain asymptomatic, tuberculosis continues to be the second- most common cause of death by infectious disease worldwide. A growing problem that is being exacerbated by the excessive use of multiple types of antibiotics is the emergence of drug resistant strains of tuberculosis. The number of Multiple Drug-Resistant Tuberculosis (MDR-TB) and Extensively Drug Resistant Tuberculosis (XDR-TB) strains are steadily increasing, rendering conventional treatment options ineffective. In order to circumvent the issue of drug-resistance, it is imperative that we understand both the mechanisms involved in resistance and the genetic mutations that cause it. In this review we delve into the important genes involved in drug resistance against common treatment options. We delineate the mechanism of resistance and specify the types and positions of mutations that have been observed in multiple studies worldwide. Finally, we discuss the relevance of the study to drug design, drug targeting and potentially forecasting future mutations by combining the mutation data with predictive analytics.

Primary peritonitis in a healthy young adult has become quite a rare entity in this modern antibiotic era. A case of a 25 years old healthy woman with primary pyoperitonis has been discussed here, who had presented to us with complaints of abdominal pain, high-grade fever and vomiting for a week and subsequently she developed gradual decrease in urine output and generalized edema for last 3 days. Abdominal examination revealed diffuse tenderness and guarding, a diagnosis of primary peritonitis was made based on abdominal imaging and later, fluid analysis and culture reports suggested it to be a case of pyo-peritoneum. Quick diagnosis and prompt management saved her life. Unnecessary delay could have detrimental in such case scenario. High index of suspicion and prompt management is necessary to prevent surgical intervention and death.