title: [Resistant tuberculosis in Denmark].
abstract: BACKGROUND
  Increased rates of multidrug-resistant (MDR) tuberculosis (TB) has been reported from countries close to Denmark. We evaluated the incidence of drug resistance in Denmark in order to determine the magnitude of the problem.
  
  
  METHODS
  Susceptibility testing was performed in isolates from 85.4% of all notified patients during 1991-1998. Epidemiological information was retrieved from the mandatory notification forms.
  
  
  RESULTS
  Total drug resistance remained largely constant, although a minor increase was observed in 1997-1998. Monoresistance was observed in 7.3% of the isolates. Among 3.6% polyresistant isolates, resistance to isoniazid and streptomycin accounted for 2.8%, whereas MDR accounted for 0.5%. The MDR strains displayed different restriction fragment length polymorphism (RFLP) patterns, and no matches were identified in the international MDR database. Drug resistance in untreated Danes and foreigners were 5.9% and 14.6%, respectively. Among Danes and foreigners with previous TB, 6.2% and 22.7% had drug resistance, respectively. Increased drug resistance was found among untreated Danes aged 25-54 years mainly due to a single isoniazid- and streptomycin-resistant RFLP-cluster. Among all patients with isoniazid- and streptomycin-resistance, 77.0% had clustered strains.
  
  
  CONCLUSIONS
  In conclusion, although drug resistance among untreated Danes was close to the rate estimated in good national programmes, close monitoring is needed in future years, as active transmission of isoniazid- and streptomycin-resistant Mycobacterium tuberculosis was demonstrated.
authors: Statens Serum Institut, mykobakteriologisk laboratorium og epidemiologisk afdeling, København. vot@ssi.dk
authors: V O
authors: VO
authors: Thomsen
authors: I S
authors: IS
authors: Johansen
authors: J O
authors: JO
authors: Bauer
authors: S O
authors: SO
authors: Glismann
authors: T
authors: T
authors: Lillebaek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D016172:DNA Fingerprinting; D003718:Denmark / Q000453:epidemiology / Q000208:ethnology; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006801:Humans; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000276:immunology; D012150:Polymorphism, Restriction Fragment Length; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents