Drug-resistant tuberculosis in Castilla-León, Spain, 1996-2000.
METHODS
During 1996-2000, a regional anti-tuberculosis drug resistance survey was conducted in Castilla-León, Spain.


OBJECTIVE
To determine the incidence of drug-resistant tuberculosis (TB) in newly treated human immunodeficiency virus (HIV) negative and HIV-positive TB patients.


METHODS
Nine hundred and eighty-five Mycobacterium tuberculosis strains isolated from HIV-negative (926) and HIV-positive (59) patients were studied (one strain per patient). Univariate and multivariate analyses were used to determine the prevalence of drug resistance in high-risk groups.


RESULTS
Thirty-eight isolates (3.8%) showed resistance to one of the following drugs: streptomycin (S), isoniazid (H), rifampicin (R) or ethambutol (E). Of these, 36 (3.9%) were from HIV-negative and 2 (3.4%) from HIV-positive patients. The rate of drug resistance among HIV-negative patients was 1.2%, 2.0%, 0.3% and 0.8%, respectively, for S, H, R and E, and for HIV-positive patients it was 3.4%, 0%, 0% and 1.7%. Among the HIV-negative patients, monoresistance was observed in 32 (3.4%) strains and resistance to both H and R (multi-drug resistance) was detected in one.


CONCLUSIONS
The incidence of primary drug resistance in the surveyed area was low and increased resistance was not observed in the HIV-positive group (P = 0.99). Routine surveillance of drug resistance is recommended by the TB control programme in representative patient populations to optimise treatment regimens.
Alberte-Castiñeiras
A
A
Departamento de Microbiología, Hospital del Río Hortega, Rondilla de Santa Teresa, 9 E-47010 Valladolid, Spain. aalberte@hurh.sacyl.es
Brezmes-Valdivieso
M F
MF
Campos-Bueno
A
A
Montes-Martinez
I
I
López-Medrano
R
R
Avellaneda
C
C
Pérez-Pascual
P
P
Della-Latta
P
P
D000995:Antitubercular Agents / Q000494:pharmacology*; D016009:Chi-Square Distribution; D004352:Drug Resistance, Microbial; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
D000995:Antitubercular Agents