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Free Content Prevalence of resistance to anti-tuberculosis drugs: results of the 1998/99 national survey in Italy

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OBJECTIVE: To determine the prevalence of resistance to the main anti-tuberculosis drugs in newly and previously treated tuberculosis patients in Italy and to evaluate the contribution of foreign-born and human immunodeficiency virus (HIV) positive cases to drug resistance.

METHODS: Methods and definitions were derived from the WHO/IUATLD Global Project on Anti-tuberculosis Drug Resistance Surveillance. Univariate and multivariate analysis was used to study prevalence rates of drug resistance in risk groups.

RESULTS: In a national survey in Italy, 810 initial isolates of Mycobacterium tuberculosis (683 from new cases, 115 from retreatment cases and 12 from patients whose treatment history was unknown/dubious) were analysed. Low prevalence of drug and multidrug resistance was found in the new cases (isoniazid 2.9%; rifampicin 0.8%; multidrug resistance 1.2%; any drug resistance 12.3%). The prevalence of resistance to isoniazid and rifampicin was significantly higher in immigrants and HIV-positive subjects, respectively. A high prevalence of drug resistance was found in cases with previous treatment failure or default (isoniazid 5.2%; rifampicin 4.3%; multidrug resistance 36.5%; any drug resistance 61.7%).

RECOMMENDATIONS: Special efforts are necessary to monitor trends in drug resistance and to ensure favourable treatment outcomes among immigrants and HIV-positive tuberculosis cases.

Keywords: HIV; drug susceptibility testing; immigrant; prevalence of resistance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: WHO Collaborating Centre for Control of Tuberculosis and Lung Diseases in Europe Department of Pnuemology, Tradate, Italy 2: Supranational Reference Laboratory, Department of Bacteriology and Medical Micology, Istituto Superiore de Sanità, Rome, Italy 3: National Reference Laboratory, Villa Marelli Institute, Milan, Italy 4: Institute of Pulmonary Diseases, University of Rome, Italy 5: Clinic of Infectious Diseases, University of Brescia, Italy 6: G B Morgagni Hospital, Forli, Italy 7: Pulmonary Diseases, University of Pavia, Italy

Publication date: 2002-01-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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