High levels of resistance to second-line anti-tuberculosis drugs among prisoners with pulmonary tuberculosis in Georgia.
METHODS
Penitentiary system of Georgia.


OBJECTIVE
To determine the prevalence of resistance to second-line drugs among prisoners with pulmonary tuberculosis (PTB).


METHODS
Retrospective evaluation of resistance to second-line drugs in tuberculosis (TB) patients treated from 2001 to 2003.


RESULTS
The overall observed prevalence of multidrug-resistant TB (MDR-TB) was 14.4% (39/270). The lowest resistance was found for ofloxacin (OFX), which was 2.2% (6/270) overall and 5.1% (2/39) among MDR patients. Isolates from four non-MDR patients who had never received anti-tuberculosis treatment were found to be resistant to OFX. Resistance to kanamycin and capreomycin occurred simultaneously only among MDR patients and was observed in 17/39 cases (43.6%). High rates of resistance to > or =2 second-line drugs (18/39, 46.2%) and > or =3 second-line drugs (10/39, 25.6%) were observed among all MDR-TB patients, reaching respectively 59.3% and 29.6% among previously treated MDR-TB cases. Only one patient was found to be resistant to four second-line drugs. No extensively drug-resistant TB (XDR-TB) according to the latest definition was detected.


CONCLUSIONS
Our findings reveal a serious threat to the TB control efforts in the study population.
Jugheli
L
L
Mycobacteriology Unit, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.
Rigouts
L
L
Shamputa
I C
IC
Bram de Rijk
W
W
Portaels
F
F
D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
D000995:Antitubercular Agents