Totally drug-resistant tuberculosis in India.

To the Editor—Three years after extensively drug-resistant (XDR) tuberculosis was first described in 2006, Velayati et al [1] drew attention to the emergence of totally drug-resistant (TDR) tuberculosis in a cohort of 15 patients from Iran, resistant to all firstand second-line drugs. Since the first cases of XDR tuberculosis in India were reported from the P. D. Hinduja National Hospital and Medical Research Centre [2], physicians here have grappled with increasingly resistant strains of tuberculosis. We describe the first patients from India with TDR tuberculosis. Drug susceptibility testing (DST) was performed at the Hinduja Hospital, the city’s busiest referral laboratory and a Revised National Tuberculosis Control Programme (RNTCP) accredited