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Home / The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 2

High prevalence of drug-resistant tuberculosis, Republic of Lithuania, 2002

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BACKGROUND: Nations of the former Soviet Union have the world's highest reported levels of resistance to anti-tuberculosis drugs. We conducted the first national survey of anti-tuberculosis drug resistance in the Republic of Lithuania.

METHODS: We tested Mycobacterium tuberculosis isolates from all incident culture-positive pulmonary TB patients registered in 2002. New patients were those treated for <1 month with any first-line anti-tuberculosis drug (isoniazid [INH], rifampin [RMP], ethambutol, or streptomycin); previously treated patients were those treated for ≥1 month.

RESULTS: Of 1163 isolates, 475 (41%) were resistant to at least one first-line drug, and 263 (23%) were resistant to at least INH and RMP (MDR); this included 76/818 (9.3%) from new patients and 187/345 (54%) from previously treated patients. Of 52 MDR isolates randomly selected for extended testing at an international reference laboratory, 27 (51%, 95%CI 38–66) had resistance to pyrazinamide, 21 (40%, 95%CI 27–55) to kanamycin, and 9 (17%, 95%CI 8–30) to ofloxacin.

CONCLUSIONS: The prevalence of MDR-TB in Lithuania is among the world's highest. Among MDR-TB isolates, aminoglycoside and fluoroquinolone resistance were common. To combat drug-resistant TB, Lithuania has implemented the WHO global TB control strategy (DOTS), and is developing an MDR-TB treatment program (DOTS-Plus).

Keywords: Europe; Lithuania; multidrug-resistant; prevalence; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: National Institute of Tuberculosis and Lung Diseases, Vilnius, Lithuania 3: Statens Serum Institut, Copenhagen, Denmark

Publication date: 01 February 2005

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