Acquired multidrug-resistant tuberculosis--Buenaventura, Colombia, 1998.
In 1996, the incidence of tuberculosis (TB) in Colombia was 26.5 per 100,000 population, and mortality was 3.4 per 100,000; in comparison, the incidence in Buenaventura, a port town on the Pacific coast, was 90.5 per 100,000, and mortality was 9.4 per 100,000. The prevalence of multidrug-resistant tuberculosis (MDR-TB) (i.e., Mycobacterium tuberculosis isolates resistant to at least isoniazid [INH] and rifampin [RIF]) was not known because susceptibility testing is not performed routinely, and data on drug resistance for the country have not been collected systematically. During October-November 1997, at the request of the Secretary of Health in Cali, Colombia, the International Center for Training and Medical Investigation in Cali performed sputum cultures for M. tuberculosis and drug-susceptibility testing on isolates from 18 (75%) of 24 TB patients in Buenaventura who were known to be clinically unresponsive to standard TB treatment. MDR-TB was identified in 12 (67%) of these patients, four of whom subsequently died. In March 1998, the International Center for Training and Medical Investigation and the Secretary of Health of Colombia invited CDC to participate in an investigation of these patients with MDR-TB. This report summarizes the findings of this investigation, which indicated that inconsistencies in treatment may have contributed to this outbreak, and provides recommendations for the prevention and control of MDR-TB in Buenaventura.
D000328:Adult; D000368:Aged; D003105:Colombia / Q000453:epidemiology; D004196:Disease Outbreaks; D006801:Humans; D008875:Middle Aged; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*