A case-control study for multidrug-resistant tuberculosis: risk factors in four European countries.
The aim of this study was to detect risk factors for multidrug resistance in patients with pulmonary tuberculosis in four European Union countries: France, Germany, Italy, and Spain. A prospective epidemiological case control study was conducted, made up of patients with clinically diagnosed and microbiologically confirmed pulmonary tuberculosis in the four countries between 1997 and 2000. A total of 138 cases and 276 controls were studied. Considering the four countries as a whole, the most statistically significant risk factors were as follows: intravenous drug use (OR 4.68); asylum-seeker support (OR 2.55) as income factor; living in a nursing home (OR 2.05); previous tuberculosis (OR 2.03) with pulmonary location; prison (OR 2.02); known tuberculosis contacts (OR 2.01); immunosuppression other than human immunodeficiency virus (HIV) (OR 1.96); acquired immunodeficiency syndrome (AIDS) (OR 1.96); current tuberculosis with pulmonary location (OR 1.77); and health-care worker (OR 1.69). These risk factors will have to be taken into account in the European Union as a whole, as well as in each individual country, to establish a health policy of monitoring and control for these cases of multidrug resistance. Although rare, their seriousness makes them particularly important.
Casal
M
M
Mycobacteria Reference Center, Faculty of Medicine, University of Córdoba, Spain. mi1carom@uco.es
Vaquero
M
M
Rinder
H
H
Tortoli
E
E
Grosset
J
J
Rüsch-Gerdes
S
S
Gutiérrez
J
J
Jarlier
V
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000517:prevention & control*; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control / Q000635:transmission
D000995:Antitubercular Agents