Multidrug resistant tuberculosis in Auckland 1988-95.
OBJECTIVE
To review all cases of multidrug resistant tuberculosis (MDRTb) in Auckland between 1988-95; and to look for ways in which the diagnosis and management may be improved.


METHODS
Cases of multidrug resistant tuberculosis were identified from Green Lane Hospital tuberculosis laboratory records. Clinical details were obtained from hospital case records, and radiographs were reviewed.


RESULTS
Nine of the 838 (1.1%) confirmed cases of tuberculosis had multidrug resistant tuberculosis. Eight were foreign-born and four had previously been treated for tuberculosis. Three patients underwent thoracic surgery. Two patients died and one was not treated, No relapses have occurred. Potential to improve on the treatment given was evident in retrospect in three patients.


CONCLUSIONS
Assessment of risk factors for multidrug resistant tuberculosis and early transfer of specimens to a tuberculosis reference laboratory are required to enable multidrug resistance to be identified early. Extensive disease, drug side effects and coexistent medical problems make MDRTb very difficult to cure. Directly observed therapy is recommended for multidrug resistant tuberculosis cases and is underutilised in Auckland.
Cameron
R J
RJ
Department of Respiratory Services, Green Lane Hospital, Auckland.
Harrison
A C
AC
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D012008:Recurrence; D012111:Residence Characteristics; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014504:Urban Health
D000995:Antitubercular Agents