Surveillance of Mycobacterium tuberculosis drug resistance in France, 1995-1997. AZAY Mycobacteria Study Group.
OBJECTIVE
To measure the rate of primary and secondary drug resistance of Mycobacterium tuberculosis on an ongoing basis.


METHODS
Data on all culture-positive tuberculosis were collected prospectively from 1995 through 1997 from a microbiological laboratory network of 19 university hospitals throughout France, and submitted quarterly to the National Reference Centre for Surveillance of Mycobacterial Diseases.


RESULTS
A total of 2998 patients were included in the study. Among the 2333 (78%) previously untreated patients, 8.6% had isolates resistant to any drug, 4.8% to streptomycin (SM) alone, 1.2% to isoniazid (INH) alone, 1.8% to SM + INH, and 0.3% to INH + rifampicin (RMP) or multidrug resistance (MDR). Foreign birth was independently associated with a higher risk of primary resistance to any drug (odds ratio [OR] 1.5). Among the 268 (9%) previously treated patients, 20.9% had isolates resistant to any drug, 6.3% to SM alone, 3.4% to INH alone, 4.1% to SM + INH, and 3.7% to INH + RMP. Foreign birth (OR = 2.3), and human immunodeficiency virus positive status (OR = 4.4) were independently associated with a higher risk of secondary resistance to any drug.


CONCLUSIONS
During the last 30 years there has been no increase in resistance to any drug among previously untreated patients. As expected, secondary resistance was highly associated with foreign birth. MDR-TB remains a rare event in France.
Robert
J
J
Centre National de Référence (NRC) pour la Surveillance des Infections à Mycobactéries et de leur Résistance aux Antituberculeux, Laboratoire de Bactériologie et Hygiène, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Trystram
D
D
Truffot-Pernot
C
C
Carbonnelle
B
B
Grosset
J
J
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology*
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin