title: Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2005.
abstract: The Australian Mycobacterium Reference Laboratory Network (AMRLN) collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2005, a total of 810 cases were identified by bacteriology; an annual reporting rate of 4.0 cases per 100,000 population. Isolates were identified as M. tuberculosis (n = 806), Mycobacterium africanum (n = 2) and Mycobacterium bovis (n = 2). Fifteen children aged under 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for all 810 isolates for isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). A total of 74 (9.1%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least H and R (defined as multi-drug resistance, MDR) was detected in 12 (1.5%) isolates; nine were from the respiratory tract (sputum n = 8, bronchoscopy n = 1). Of the 74 M. tuberculosis isolates resistant to at least one of the standard drugs, 67 (90.5%) were from new cases, 6 from previously treated cases, and no information was available on the remaining case. Eight were Australian-born, 65 were overseas-born, and the country of birth of one was unknown. Of the 65 overseas-born persons with drug resistant disease, 41 (63.1%) were from 4 countries; Vietnam (n = 16), Papua New Guinea (n = 10), the Philippines (n = 9), and India (n = 6). A retrospective review of AMRLN data on isolates collected between 2000 and 2005 found that none of 70 MDR-TB isolates met the new definition for extensively drug resistant TB (XDR-TB, i.e. MDR-TB with additional resistance to quinolones and second-line injectable agents).
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: Chris
authors.initials: C
authors.lastname: Gilpin
authors.forename: Peter
authors.initials: P
authors.lastname: Jelfs
authors.forename: Terillee
authors.initials: T
authors.lastname: Keehner
authors.forename: Aina
authors.initials: A
authors.lastname: Sievers
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology*; D001315:Australia / Q000453:epidemiology; D002648:Child; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012727:Sex Characteristics; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents