Resistance of Mycobacterium tuberculosis to antituberculosis drugs in the Central Region of Thailand, 1996.
OBJECTIVE
To determine the proportion and profile of antituberculosis drug resistance among Mycobacterium tuberculosis isolates in Thailand.


METHODS
A 500-bed cardiothoracic centre.


METHODS
From January to December 1996, isolates of M. tuberculosis from consecutive patients with pulmonary tuberculosis underwent susceptibility testing to isoniazid (H), rifampicin (R), ethambutol (E), streptomycin (S), kanamycin (K), and ofloxacin (O).


RESULTS
In all, 1861 strains were tested, 1738 from new cases and 123 from previously treated cases. Overall initial and acquired resistance were 20.9% and 53.6%, respectively. The percentages of initial resistance to R, H, S, O, K and E were 12.6, 8.3, 6.6, 1.8, 1.1 and 0.8, respectively, whereas those of acquired resistance were 43.0, 29.2, 21.1, 9.7, 8.1 and 4.8, respectively. Multidrug resistance was observed in 4.2% of new patients and 25.2% of previously treated patients.


CONCLUSIONS
The overall drug resistance of M. tuberculosis in the central region of Thailand is high, and acquired multidrug resistance has reached an ominous level. The results have serious implications for tuberculosis control in Thailand. Urgent measures are needed to control the spread of drug resistance, and supervised treatment of standard protocol should be adhered to more strictly.
Central Chest Hospital, Department of Communicable Disease Control, Ministry of Public Health, Thailand.
P
P
Riantawan
J
J
Punnotok
R
R
Chaisuksuwan
V
V
Pransujarit
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; D007538:Isoniazid / Q000494:pharmacology; D007612:Kanamycin / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012293:Rifampin / Q000494:pharmacology; D013785:Thailand; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents; D007612:Kanamycin; D007538:Isoniazid; D012293:Rifampin