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Multidrug-resistant tuberculosis in Western Australia, 1998–2012

Multidrug-resistant tuberculosis (MDR-TB), defined by resistance to both isoniazid and rifampicin, has significant implications for individual patient management and TB control efforts. The current global situation is further complicated by the emergence of extensively drug-resistant TB (XDR-TB), defined by additional resistance to a fluoroquinolone and at least one second-line injectable drug (amikacin, kanamycin or capreomycin).1 Drug resistance may develop in the context of TB treatment, but the majority of MDR-TB cases are contracted as primary infections.2 As with drug-susceptible TB, household transmission is common, frequently affecting young children.3,4 Treatment is resource-intensive and requires longer courses of less effective, more toxic and more expensive drugs compared with drug-susceptible TB.5

Global efforts to combat the threat of MDR-TB have been hampered by a paucity of data. Although progress has been made towards obtaining accurate estimates…