Návrat tuberkulózy

Celé generace lékařů, politiků i zdravotnických činitelů se usilovně snaží porazit tuberkulózu. Po letech úspěchů se však TBC znovu vrací na scénu. Nárůst výskytu této choroby v rozvinutém světě od roku 1992 byl zpočátku připisován HIV. Postupem času se však objevily i další faktory rostoucího počtu případů, jako jsou přistěhovalectví a jeden konkrétní typ rezistentní TBC.

Světová zdravotnická organizace (WHO) vypracovala strategii potírání návratu TBC, a to včetně standardizované terapie, která specifikuje příslušné léky, dávky a načasování. Multirezistentní tuberkulóza (tzv. MDR-TB), což je jakákoliv forma tuberkulózy odolná vůči tradiční léčbě pomocí izoniazidu a rifampicinu, bohužel představuje vážný problém: jelikož je totiž standardní léčba v takovém případě méně účinná, její přenos pokračuje.

Multirezistentní se navíc stává jakákoliv nedostatečně léčená TBC, takže selhání léčby může být buďto příčinou, anebo následkem MDR-TB. To jen zvýrazňuje potřebu rozhodného režimu dnešní léčby TBC, ale i komplexnější strategie její kontroly, která vyléčí co možná nejvíce případů, zabrání vzniku rezistence a sníží přenos nákazy. WHO doporučuje takzvanou „Strategii přímo sledované terapie“ (DOTS) a stanovila diagnostické prahy na nejméně 70% infekčních případů a léčebné prahy na úroveň 85%.

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