[Multidrug resistant tuberculosis in Iceland--case series and review of the literature].
BACKGROUND
Multidrug resistant tuberculosis (MDR-TB) is a growing health problem in the world. Treatment outcomes are poorer, duration longer and costs higher. We report three cases of MDR-TB diagnosed in Iceland in a six year period, 2003-8.


METHODS
The first case was a 23-year-old immigrant with a prior history of latent TB infection treated with isoniazid. He was admitted two years later with peritoneal MDR-TB. He was treated for 18 months and improved. The second case was a 23-year-old immigrant diagnosed with pulmonary MDR-TB after having dropped out of treatment in his country of origin. Clinical and microbiological response was achieved and two years of treatment were planned. The third case involved a 27-year-old asymptomatic woman diagnosed with MDR-TB on contact tracing, because of her brother's MDR-TB. 18 months of treatment were planned.


CONCLUSIONS
Clustering of cases of MDR-TB in the last six years, accounting for almost 5% of all Icelandic TB cases in the period, suggests that an increase in incidence might be seen in Iceland in coming years. The infection poses a health risk to the patients and the general public as well as a financial burden on the health care system. Emphasis should be put on rapid diagnosis and correct treatment, together with appropriate immigration screening and contact tracing.
Asgeirsson
Hilmir
H
Smitsjúkdómadeild Landspítala Fossvogi, Reykavík.
Blöndal
Kai
K
Blöndal
Thorsteinn
T
Gottfredsson
Magnús
M
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016358:Contact Tracing; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D000995:Antitubercular Agents