Genome Changes in Multi Drug Resistant Tuberculosis

Directly Observed Treatment Shortcourses (DOTS) is a tuberculosis disease program that has been implemented worldwide since 1995. Prevalenve of Tuberculosis has started to decrease but since then there was a new phenomenon of the resistant Tuberculosis or Multi Drug Resistant Tuberculosis (MDR TB). Indonesia is now a country with a high burden of MDR TB in the world. MDR TB is resistance to Anti Tuberculosis drug that is type Isoniasid and Rifampisin. Usually the cause of resistance is irregularity of taking medication. It is now known that Tuberculosis drug resistance is not only caused by inadequate or failed treatment but also due to the emergence of resistant strains transmitted by MDR TB sufferers. Resistant strains arising from changes or mutations in certain genes in the Mycobacterium tuberculosis genome include rpoB gene and katG gene which are the work targets of Anti Tuberculosis Drugs. This resistance mechanism is strongly associated with the occurrence of a number of changes in the structure of the Mycobacterium tuberculosis genome. Mycobacterium tuberculosis develops resistance mechanisms that are different from other bacteria in general. Therefore this paper is expected to help understanding the genomic changes that occur in the mechanism of resistance Tuberculosis.