title: MDR-TB in Finland--still rare despite the situation in our neighbouring countries.
abstract: BACKGROUND
  The multidrug-resistant tuberculosis (MDR-TB) epidemic in Eastern Europe bordering Finland has raised worries concerning the risk of disease in near-frontier contacts.
  
  
  OBJECTIVE
  Our aim was to find out the amount of multidrug resistance, characterise the resistance profiles and evaluate the outcome of treatment. In addition, we analysed the isolates by molecular genotyping methods in order to evaluate the origins of the resistant isolates.
  
  
  METHODS
  All culture-verified new MDR-TB cases diagnosed during the years 1994-2005 were included. Treatment outcome categories of the World Health Organization collected 36 months from the beginning of the treatment were used for outcome monitoring. The IS6110 restriction fragment length polymorphism (RFLP) test and spoligotyping were carried out according to standard recommendations.
  
  
  RESULTS
  There were 19 culture-confirmed MDR-TB cases during the study period. The mean age was 39.9 years. The proportion of foreign-born patients was 73.7%. The outcome of the treatment was favourable in 14 cases (73.7%). When the spoligotypes were compared with the international spoligotype database, a corresponding spoligotype was found in 17 cases. Seven (36.8%) patients were infected by an isolate belonging to the Beijing genotype (SIT1).
  
  
  CONCLUSIONS
  It is very probable that cases of MDR-TB in Finland are mostly caught abroad. Risk of gaining disease in near-frontier contacts seems to be very low.
authors.affiliation: Epidemiologic Surveillance and Response Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland. tuula.vasankari@utu.fi
authors.forename: Tuula
authors.initials: T
authors.lastname: Vasankari
authors.forename: Hanna
authors.initials: H
authors.lastname: Soini
authors.forename: Kari
authors.initials: K
authors.lastname: Liippo
authors.forename: Petri
authors.initials: P
authors.lastname: Ruutu
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D004359:Drug Therapy, Combination; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics; D012150:Polymorphism, Restriction Fragment Length; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial