Resistance of Mycobacterium tuberculosis to four first-line anti-tuberculosis drugs in Japan, 1997.
METHODS
Five years after the last survey of drug-resistant tuberculosis in Japan, a nationwide survey was conducted by the Tuberculosis Research Committee.


OBJECTIVE
To determine the prevalence of and risk factors for resistance to four first-line anti-tuberculosis drugs.


METHODS
Cultures were obtained from patients hospitalized at 78 hospitals in different districts of Japan throughout a 6-month period, 1 June-30 November 1997. Drug susceptibility testing was carried out at the Research Institute of Tuberculosis, Tokyo, one of the supranational reference laboratories of the WHO/IUATLD global project.


CONCLUSIONS
Among patients with no prior treatment, resistance to any of the four drugs was found in 10.3%, and the prevalence of primary multidrug resistance (MDR) was 0.8%. The prevalence of acquired resistance was 42.4% for any of the four drugs and 19.7% for MDR, indicating a high prevalence rate compared with those reported in the WHO/IUATLD global project. About 73% of resistant isolates from new cases were resistant to one drug, while 64.3% of resistant isolates from the re-treatment cases were resistant to two or more drugs (P < 0.0001). No significant differences in resistance rates by sex, age group, nationality, district, and/or accompanying diseases were observed in any of the new or re-treatment cases. Other factors associated with the high prevalence in re-treatment cases remain to be determined.
Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose-shi, Tokyo. abe@jata.or.jp
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Abe
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Hirano
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Wada
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Aoyagi
D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology*
D000995:Antitubercular Agents