title: Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2003. 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 2003. A total of 784 cases were identified by bacteriology, representing an annual reporting rate of 3.9 cases of laboratory confirmed tuberculosis per 100,000 population. The most commonly encountered culture-positive specimens were sputum (n = 351), lymph node (n = 176) and from bronchoscopy (n = 97). Smears containing acid fast bacilli were present in sputum (53.0%), bronchoscopy (32.0%) and lymph node (23.3%). Five children (female n = 3, male n = 2) under 10 years of age had bacteriologically confirmed tuberculosis. Eighty isolates of M. tuberculosis and one of Mycobacterium africanum (10.3%) were resistant to at least one of the standard anti-tuberculosis agents. Mono-resistance to isoniazid, ethambutol, rifampicin, and pyrazinamide was detected in 45, three, two, and one isolates respectively. Multidrug-resistance (MDRTB) defined as resistance to both isoniazid and rifampcin was observed in seven (0.9%) isolates. Of the seven MDRTB isolates, six were from the respiratory tract and four were from smear positive specimens. Of the 81 patients with drug resistant isolates, 78 (96.3%) were classified as having initial resistance; two had acquired resistance and no information was available for one isolate; five were Australian-born; and 76 (93.8%) had migrated from a total of 30 countries.
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: Taryn
authors.initials: T
authors.lastname: Crighton
authors.forename: Chris
authors.initials: C
authors.lastname: Gilpin
authors.forename: Frank
authors.initials: F
authors.lastname: Haverkort
authors.forename: Aina
authors.initials: A
authors.lastname: Sievers
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000494:pharmacology* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000904:Antibiotics, Antitubercular