Tracking Antibiotic-Resistant Tuberculosis (by LabCE)

(based on 407 customer ratings)

Author: Cynthia B. Schofield, MPH, MT
Reviewer: Catherine Dragoni, MT(ASCP)SM

Course provided by LabCE.

In this course, the presentation of a brief history of tuberculosis (TB) and its developing resistance to anti-tuberculosis drugs, is followed by case histories from India, Italy, and the US-Mexican border. The pathogenesis of TB disease in humans is diagrammed and a review of diagnostic laboratory methods, susceptibility testing, and methods of control are explored.

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Continuing Education Credits

Florida Board of Clinical Laboratory Personnel Credit Hours - General (Microbiology/Mycology/Parasitology): 2 hour(s)
Course number 20-547961, approved through 9/1/2020


  • Review the history of Mycobacterium tuberculosis (MTB) and developing antibiotic resistance.
  • Discuss the global case load of tuberculosis (TB), including India, Italy, and the United States (US)-Mexican border.
  • Describe two pediatric TB cases.
  • Diagram and explain MTB pathogenesis.
  • Discuss laboratory methods of MTB diagnosis and susceptibility testing.
  • Review methods of TB treatment and control.

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(based on 407 customer ratings)

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Course Outline

  • Introduction
      • Epidemiology of Multidrug-Resistant Tuberculosis (MDR-TB)
  • Background
      • History
      • Early Treatment
      • TB Wonder Drugs
      • Transmission
      • Spread of Resistance: Escalation of Multidrug-Resistant Tuberculosis (MDR-TB)
      • Spread of Resistance: Global Emergency
  • Global View
      • India
      • Development of Selective Resistance in India
      • Italy
      • Source of Infection in Italian School Epidemic
      • Case Study of Drug Resistance in Two Children: Patient 1
      • Case Study of Drug Resistance in Two Children: Patient 2
      • Case Study of Drug Resistance in Two Children: Treatment Summary for Both Cases
      • Comparison of Italian Pediatric Cases
      • United States (US)-Mexican Border
      • United States (US)-Mexican Border, continued
  • Pathogenesis
      • Pathogenesis of Tuberculosis (TB) Infection
  • Laboratory Diagnosis
      • Laboratory Diagnosis
      • Acid-fast Bacilli (AFB) Smear Microscopy
      • Culture
      • Identification (ID)
      • Antimicrobial Susceptibility Testing (AST)
      • Antimicrobial Susceptibility Testing (AST): Example of an Automated System
      • Molecular Detection of Multidrug-Resistant (MDR) Strains: Isoniazid (INH) Resistance
      • Molecular Detection of Mutidrug-Resistant (MDR) Strains: Rifampin (RIF) Resistance
  • Treatment and Control of Antibiotic-resistant TB
      • Treatment
      • Control and Prevention
  • Looking Ahead
      • Looking Ahead
  • References
      • References

Additional Information

Level of instruction: Basic to intermediate 

Intended audience:  This course is intended for microbiology bench technicians and technologists, supervisors, and administrators. 

Author information: Cynthia B. Schofield, MPH, MT received her BS degree in Biology at the University of Michigan, Ann Arbor, Michigan and her Masters of Public Health, Epidemiology, and Biostatistics at San Diego State University, San Diego, California. Cynthia is retired with 25 years of supervisory experience in the clinical microbiology laboratory and has written for numerous publications, including ASCP, Advance, and MLO.

Reviewer information: Catherine Dragoni, MT(ASCP)SM received her BS degree in Medical Technology from the State University of New York, Upstate Medical Center, Syracuse. She began her career as a bench microbiologist at Maine Medical Center, Portland, Maine. Currently she is the Chief Technologist of Microbiology and Molecular Pathology at NorDx Laboratories, Scarborough, Maine.

Course description: In this course, the presentation of a brief history of tuberculosis (TB) and its developing resistance to anti-tuberculosis drugs, is followed by case histories from India, Italy, and the US-Mexican border. The pathogenesis of TB disease in humans is diagrammed and a review of diagnostic laboratory methods, susceptibility testing, and methods of control are explored.


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Course provided by LabCE.
2174 mtb acidfast fig7ASM Microbe Libe

AFB fluorescent stain, courtesy of the CDC.

Fluorescent auramine stain w/acridine orange counterstain

MTB by Ziehl-Neelsen


TB susceptibility agar proportion test, courtesy of CDC.

Ziehl-Neelson stained MTB showing AFB w/cording morphology, courtesy of the CDC

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