Primary resistence of mycobacteria in tuberculosis patients

Primary mycobactria resistance especially in some countries may be a serious obstacle to a successful therapy and the number of patients carrier of primary resistant mycobacteria remains almost at the same level in spite of the chemotherapeutic treatments and the usually rapid recover of the newly diagnosed cases. This may probably be attributed to the fact that the number of chronic patients, spitting resistant tubercle bacilli has remained almost the same, because these patients are eliminated little by little. In our country there is a constant regression of the morbidity, but not so rapid as expected, The newly diagnosed patients are generally young and, if well treated, they heal quickly and well; moreover, they are usually not so richly bacillised as they used to be once and the severity of their disease, globally evaluated, appears also reduced. The cultural positivity at the first admission into hospital is also diminishing. From all the above facts it is obvious that in order to eradicate tuberculosis it is necessary: First - to avoid creatin chronic patients; in order to reach this goal the treatment must be the most effective possible from the very beginning: INH and Rifampin. Second - to try to cure the chronic patients and to render them abacillary of, at least, to treat them intensively, with the purpose of inducing in the infecting flora a polyresistance which reners the mycobacteria hypovirulent, especially if it includes a R/AMP resistance over 40-gamma. Third - the role of the primary resistance in the epidemiology and the evolution of tuberculosis in the various countries and in the single patients, may be very different.