Drug resistance patterns among tuberculosis patients in Rome, 1990-1992.
Prevalence of, and risk factors for, drug-resistance of Mycobacterium tuberculosis were assessed among 407 hospitalized patients with tuberculosis in Rome, Italy, during the period 1990-1992. Resistance to 1 or more drugs was detected in 106 isolates (26%). Resistance to streptomycin was the most common (18.4%), followed by isoniazid (10.3%) and rifampin (7.9%). 23 isolates (5.7%) were resistant to both isoniazid and rifampin. Resistance to at least 1 drug and resistance to both isoniazid and rifampin were significantly more common among recurrent cases (40.7% vs. 22.1%, p < 0.001; and 22.1% vs. 1.2%, p < 0.001). Sex, country of origin and HIV infection were not significantly associated with prevalence of drug resistance. Among recurrent cases, prevalence of resistance to at least 1 drug and of resistance to both isoniazid and rifampin, was higher in subjects who had had a previous episode of tuberculosis later than 1969. In the population studied the prevalence of drug-resistant tuberculosis was high, although the risk of initially becoming infected with a multidrug-resistant strain of M. tuberculosis in this area appears to be low. This study suggests the need for enhanced surveillance of drug-resistance of tuberculosis in our country and for implementation of intervention aimed to ensure adequate and complete therapy for patients with tuberculosis.
Girardi
E
E
Centro di Riferimento AIDS, Servizio di Epidemiologia delle Malattie Infettive, Ospedale Lazzaro Spallanzani, Rome, Italy.
Antonucci
G
G
Tronci
M
M
Bordi
E
E
Ippolito
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D003625:Data Collection; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents