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Free Content Drug resistance trends among previously treated tuberculosis patients in a national registry in Peru, 1994–2001

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Abstract:

SETTING: National mycobacteriology reference laboratory in Peru conducting routine testing of susceptibility to isoniazid, rifampin, ethambutol, pyrazinamide, and streptomycin, in Mycobacterium tuberculosis isolates from previously treated patients.

OBJECTIVE: To determine the percentage of isolates resistant to each of five anti-tuberculosis agents and to ascertain in these data the presence of trends of clinical relevance.

DESIGN: Retrospective study of a national registry of M. tuberculosis isolates from patients referred for drug susceptibility testing between 1994 and 2001.

RESULTS: Among 14736 isolates tested, 10837 (73.5%, 95%CI 72.8–74.3) demonstrated anti-tuberculosis resistance, and 8455 (57.4%, 95%CI 56.6–58.2) demonstrated resistance to at least both isoniazid and rifampin, by convention defined as multidrug-resistant tuberculosis (MDR-TB). A significant increasing trend could be discerned for resistance to each of the drugs tested and in isolates classified as MDR-TB (P < 0.001 for trend). Additional clinically relevant trends were found in polyresistance and multidrug resistance percentages.

CONCLUSIONS: Data from a national reference laboratory can be used to inform the design of retreatment regimens.

Keywords: MDR-TB; national reference laboratory; surveillance; treatment failure

Document Type: Regular Paper

Affiliations: 1: Instituto Nacional de Salud, Laboratorio de Referencia de Micobacterias, Lima, Peru 2: Instituto Nacional de Salud, Laboratorio de Referencia de Micobacterias, Lima, Peru; and Universidad Peruana Cayetano Heredia, Lima, Peru 3: Socios En Salud—Sucursal Peru/Partners in Health, Lima, Peru; and Harvard Medical School, Department of Social Medicine, Boston, Massachusetts, USA 4: Harvard Medical School, Department of Social Medicine, Boston, Massachusetts, USA

Publication date: 2004-04-01

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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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