Drug-resistant pulmonary tuberculosis in Israel, a society of immigrants: 1985-1994.
OBJECTIVE
Drug-resistant tuberculosis was uncommon in Israel until 1985, when the waves of immigration began. We studied the incidence and clinical course of resistant pulmonary tuberculosis nationwide.


METHODS
Isolates of Mycobacterium tuberculosis between 1985 and 1994 were surveyed. Data on 150 patients with resistance and 110 patients with drug-sensitive disease were reviewed. Ethnic origin, type of resistance, radiological findings and outcome were analysed.


RESULTS
In total, 16.7% of the isolates showed resistance to at least one drug; 58% had resistance to multiple drugs. In 67% of the patients the resistance was primary. Most patients were immigrants from the former USSR and from Ethiopia; none were Israeli-born Jews. Mortality with resistance was 10%, and was highest (14%) with multiple drug resistance. Mortality among drug-resistant cases was lowest (3%) among Ethiopian Jews. Cavities and extensive disease were more common with drug resistance.


CONCLUSIONS
Drug resistance has become relatively common in Israel due to immigration from the former USSR and Ethiopia. It is more extensive radiologically and carries a poorer outcome.
Sosna
J
J
Department of Radiology, Haddasha University Medical Center, Jerusalem, Israel.
Shulimzon
T
T
Roznman
J
J
Lidgi
M
M
Lavy
A
A
Ben-Dov
I Z
IZ
Ben-Dov
I
I
D004352:Drug Resistance, Microbial; D004641:Emigration and Immigration; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014586:USSR / Q000208:ethnology