title: Drug-resistant tuberculosis in Castilla-León, Spain, 1996-2000.
abstract: 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.
authors.affiliation: Departamento de Microbiología, Hospital del Río Hortega, Rondilla de Santa Teresa, 9 E-47010 Valladolid, Spain. aalberte@hurh.sacyl.es
authors.forename: A
authors.initials: A
authors.lastname: Alberte-Castiñeiras
authors.forename: M F
authors.initials: MF
authors.lastname: Brezmes-Valdivieso
authors.forename: A
authors.initials: A
authors.lastname: Campos-Bueno
authors.forename: I
authors.initials: I
authors.lastname: Montes-Martinez
authors.forename: R
authors.initials: R
authors.lastname: López-Medrano
authors.forename: C
authors.initials: C
authors.lastname: Avellaneda
authors.forename: P
authors.initials: P
authors.lastname: Pérez-Pascual
authors.forename: P
authors.initials: P
authors.lastname: Della-Latta
mesh_terms: 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*
chemical_list: D000995:Antitubercular Agents