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Previous Volume 356:656-659 February 15, 2007 Number 7 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In early 2005, physicians at a rural hospital in KwaZulu-Natal, a province of South Africa, were concerned by a high rate of rapid death among patients infected with the human immunodeficiency virus (HIV) who also had tuberculosis. A study revealed the presence not only of multidrug-resistant (MDR) tuberculosis but also what came to be called extensively drug-resistant (XDR) tuberculosis. XDR tuberculosis is caused by a strain of Mycobacterium tuberculosis resistant to isoniazid and rifampin (which defines MDR tuberculosis) in addition to any fluoroquinolone and at least one of the three following injectable drugs: capreomycin, kanamycin, and amikacin. Of 53 patients . . . [Full Text of this Article]

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Dr. Raviglione is the director of the Stop TB Department, and Dr. Smith is adviser to the director-general, at the World Health Organization, Geneva.

An interview with Dr. Smith can be heard at www.nejm.org.

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