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Free Content Multidrug-resistant tuberculosis in a low-incidence region shows a high rate of transmission

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OBJECTIVE: To describe the characteristics of patients with multidrug-resistant tuberculosis (MDR-TB), a descriptive prospective study was carried out applying a combination of exhaustive conventional epidemiology with molecular genotyping.

SETTING: All patients diagnosed with MDR-TB in Galicia, Spain, between 1998 and 2004 were included in the study.

DESIGN: Of 9895 diagnosed cases of TB, 58 were MDR-TB (0.59%). The site of disease was pulmonary in 56 cases and 46 were smear-positive. Only two cases were co-infected with the human immunodeficiency virus (HIV) and seven were immigrants. Twenty-five (43%) had received previous TB treatment. These cases presented more risk factors for treatment default and a lower frequency of contact with cases of MDR-TB.

RESULTS: Genotyping analysis was performed in 57 patients, showing evidence of four clusters (30 patients, 52.6%), each with identical genetic patterns. The patients included in the clusters were younger, and most had primary forms or had had contact with another case of MDR-TB, especially in hospital. Neither the Beijing/W nor the B strain was identified.

CONCLUSION: There is a low prevalence of MDR-TB in Galicia. Unlike previous studies, there was a high rate of transmissibility, including nosocomial transmission. Transmission is not associated with HIV or previously reported strains with a high capacity for transmission.
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Keywords: epidemiology; multidrug-resistant tuberculosis; prevention and control; transmission

Document Type: Regular Paper

Affiliations: 1: Galician Committee for the Management of MDR-TB, Santiago de Compostela, Spain; Tuberculosis Unit, Department of Pneumology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain 2: Galician Committee for the Management of MDR-TB, Santiago de Compostela, Spain; Tuberculosis Unit, Department of Infectious Diseases and Internal Medicine, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain 3: Galician Committee for the Management of MDR-TB, Santiago de Compostela, Spain; Tuberculosis Unit, Department of Pneumology, Complexo Hospitalario Juan Canalejo, A Coruña, Spain 4: Galician Committee for the Management of MDR-TB, Santiago de Compostela, Spain; Galician Program for the Prevention and Control of Tuberculosis, Directorate General for Public Health Council, Xunta de Galicia, Santiago de Compostela, Spain 5: Galician Committee for the Management of MDR-TB, Santiago de Compostela, Spain; Tuberculosis Unit, Department of Preventive Medicine, Complexo Hospitalario de Santiago, Santiago de Compostela, Spain 6: Department of Microbiology and Public Health, University of Zaragoza, Zaragoza, Spain

Publication date: 01 April 2007

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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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