Medikamentenresistente Tuberkulose auf dem Vormarsch

BALTIMORE – Eine der lebensbedrohlichsten Infektionskrankheiten, die Tuberkulose, kehrt vor allem in Afrika mit aller Macht zurück. Die extrem medikamentenresistente Tuberkulose (XDR-TB) ist ein schwierig zu behandelnder Tuberkulosestamm, der in Regionen mit traditionell schlechten Gesundheitssystemen um sich greift, vor allem in Gebieten mit hoher HIV-Häufigkeit. Wenn es nicht gelingt, lokale Ausbrüche einzudämmen, Maßnahmen und Strategien zur Identifizierung und Behandlung von XDR-TB zu finden und in längerfristige Verbesserungen der Tuberkulose-Kontrolle zu investieren, könnten sich unsere pharmakologischen Wunderwaffen gegen die Tuberkulose bald als unwirksam herausstellen.

Aufgrund der Entwicklung von Medikamenten gegen Tuberkulose zwischen den 1940er und den 1970er Jahren wurde aus der einst tödlichen „weißen Pest“ eine heilbare Krankheit. Allerdings ist die Behandlung der Tuberkulose seit der Erfindung der Antibiotika vom Phänomen der Medikamentenresistenz überschattet. Vor fünfzehn Jahren löste eine Epidemie multiresistenter Tuberkulose (MDR-TB) in New York beinahe Panik aus. Nachdem man enorme finanzielle Mittel in das öffentliche Gesundheitswesen gepumpt hatte, wendete sich in den USA das Blatt und das öffentliche Interesse schwand. Dennoch blieb das Problem der Medikamentenresistenz bestehen und Bemühungen, eine Lösung  auf globaler Ebene zu finden, waren unzureichend.

Man denke an die XDR-TB. Laut Schätzungen der Weltgesundheitsorganisation gab es im Jahr 2004 insgesamt 425.000 neue Fälle von MDR-TB, wobei über 60 % der neuen Krankheitsfälle in China, Indien und Russland auftraten. Aber erst ein Ausbruch von XDR-TB bei HIV-infizierten Menschen im südafrikanischen KwaZulu-Natal lenkte die weltweite Aufmerksamkeit auf extrem medikamentenresistente Organismen. 

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