title: Emergence of drug-resistant tuberculosis in Jerusalem: ten-year retrospective review.
abstract: Drug-resistant tuberculosis (TB) has emerged as a worldwide problem. The annual incidence of TB has increased in Israel in the last decade, mainly due to successive waves of immigration. Few data are available on drug-resistant TB in Israel A 10-year retrospective review was conducted on all patients who had been infected with culture-proven Mycobacterium tuberculosis and had been admitted to our hospital. Forty-seven patients had culture-positive TB; 27 (57%) were male, 20 (43%) were female; mean age (+/- SD) was 56 +/- 23 years. Twenty patients (43%) had pulmonary TB. Three patients (6.4%) had single-drug resistance; 4 patients (8.5%) had multi-drug resistance. Six of the seven patients (86%) with drug-resistant TB had been diagnosed after 1990. Six of the 20 patients (30%) with pulmonary TB had drug-resistant organisms. Six of the 7 patients (86%) with drug-resistant TB had pulmonary infection, as compared to 15/40 (37%) of the patients with drug-susceptible TB (p < 0.001). Six of the 7 patients (86%) with drug-resistant TB had a history of TB. Fifteen percent (14.9%) of all new cases diagnosed with TB in our hospital in the last 10 years had drug-resistant M. tuberculosis. Thirty percent of patients with pulmonary TB had drug-resistant organisms. Drug-resistant TB has evidently emerged in Israel and poses a serious clinical and social threat. A strong case for directly-observed treatment in Israel should be made, especially since the incidence of TB here is still small.
authors.affiliation: Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: A M
authors.initials: AM
authors.lastname: Yinnon
authors.forename: A
authors.initials: A
authors.lastname: Sasson
authors.forename: Y
authors.initials: Y
authors.lastname: Schlesinger
authors.forename: D
authors.initials: D
authors.lastname: Raveh
authors.forename: Z
authors.initials: Z
authors.lastname: Jerassi
authors.forename: B
authors.initials: B
authors.lastname: Rudensky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology*; D002648:Child; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000503:physiopathology*
chemical_list: D000995:Antitubercular Agents