title: Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2002: a report of the Australian Mycobacterium Reference Laboratory Network.
abstract: The Australian Mycobacterium Reference Laboratory Network collected and analysed laboratory data on new cases of disease caused by Mycobacterium tuberculosis complex in the year 2002. A total of 712 cases were identified by bacteriology, representing an annual reporting rate of 3.6 cases of laboratory-confirmed tuberculosis per 100,000 population. The most commonly encountered culture-positive specimens were sputum (n=325), lymph node (n=142) and bronchoscopy (n=100). Smears containing acid fast bacilli were present in sputum (53.2%), bronchoscopy (37.9%) and lymph node (21.2%). Eight children (male n=3, female n=5) under 10 years of age had bacteriologically-confirmed tuberculosis. A total of 55 isolates (7.7%) of M. tuberculosis were resistant to at least one of the standard anti-tuberculosis agents. Resistance to at least isoniazid and/or rifampicin was noted for 53 isolates (7.4%), with multidrug-resistance (MDRTB) observed in 12 (1.9%) isolates. Of the 12 MDRTB isolates, eight were from the respiratory tract and five were from smear positive specimens. Of the patients with drug resistant M. tuberculosis isolates, 51/55 (92.7%) were classified as having initial resistance, none had acquired resistance during treatment in Australia. The country of birth was known for 54 of 55 such patients; four were Australian-born, and 50 (90.9%) had migrated from a total of 17 countries. Nucleic acid amplification testing (NAAT) was performed on 139 (19.5%) of the 712 culture-positive specimens. Of smear positive respiratory specimens, 74/80 (92.5%) were NAAT positive. For smear negative respiratory specimens, 12/17 (70.6%) reported a NAAT positive result. Importantly, false-negative NAAT results were obtained from 1/16 and 5/64 of smear positive bronchoscopy and sputum specimens respectively.
authors.affiliation: Infectious Diseases Laboratories, Institute of Medical and Veterinary Science, Adelaide, South Australia. richard.lumb@imvs.sa.gov.au
authors.forename: Richard
authors.initials: R
authors.lastname: Lumb
authors.forename: Ivan
authors.initials: I
authors.lastname: Bastian
authors.forename: William
authors.initials: W
authors.lastname: Chew
authors.forename: Chris
authors.initials: C
authors.lastname: Gilpin
authors.forename: Frank
authors.initials: F
authors.lastname: Haverkort
authors.forename: Greg
authors.initials: G
authors.lastname: James
authors.forename: Aina
authors.initials: A
authors.lastname: Sievers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D001999:Bronchoscopy / Q000379:methods; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011237:Predictive Value of Tests; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin