title: Outbreak of multidrug-resistant tuberculosis in two secondary schools.
abstract: OBJECTIVE
  To describe an outbreak of multidrug-resistant tuberculosis (MDR-TB) in two schools
  
  
  METHODS
  This was a prospective, observational study of an outbreak of MDR-TB in 2 schools located in the towns of Onda and Nules, in the Spanish province of Castellon, from the moment of detection in November 2008 until November 2014, including patient follow-up and contact tracing.
  
  
  RESULTS
  Five cases of MDR-TB were diagnosed. Overall attack rate was 0.9%, and among the contacts traced, 66 had latent tuberculous infection, with an infection rate of 14.4%. Molecular characterization of the 5M. tuberculosis isolates was performed by restriction fragment length polymorphism (RFLP) analysis of the IS6110 sequence. In all 5 patients, cultures were negative at 4-month follow-up, showing the efficacy of the treatment given. No recurrence has been reported to date.
  
  
  CONCLUSIONS
  In the context of globalization and the increased prevalence of MDR-TB, outbreaks such as the one presented here are only to be expected. Contact tracing, strict follow-up of confirmed cases, the availability of fast diagnostic techniques to avoid treatment delay, and chemoprophylaxis, together with the molecular characterization of strains, are still essential.
authors.affiliation: Sección de Neumología, Hospital La Plana, Villarreal, Castellón, España. Electronic address: miravet_lui@gva.es.
authors.forename: Luis
authors.initials: L
authors.lastname: Miravet Sorribes
authors.affiliation: Sección de Epidemiología, Centro de Salud Pública, Castellón, España; CIBER-ESP grupo 41.
authors.forename: Alberto
authors.initials: A
authors.lastname: Arnedo Pena
authors.affiliation: Sección de Epidemiología, Centro de Salud Pública, Castellón, España; CIBER-ESP grupo 41.
authors.forename: Juan B
authors.initials: JB
authors.lastname: Bellido Blasco
authors.affiliation: Sección de Epidemiología, Centro de Salud Pública, Castellón, España.
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Romeu García
authors.affiliation: Sección de Microbiología, Hospital La Plana, Villarreal, Castellón, España.
authors.forename: María
authors.initials: M
authors.lastname: Gil Fortuño
authors.affiliation: Sección de Neumología, Hospital La Plana, Villarreal, Castellón, España.
authors.forename: Patricia
authors.initials: P
authors.lastname: García Sidro
authors.affiliation: Sección de Neumología, Hospital La Plana, Villarreal, Castellón, España.
authors.forename: Pascual
authors.initials: P
authors.lastname: Cortés Miró
mesh_terms: D000293:Adolescent; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
keywords: Brote; Colegio; Multidrug-resistant tuberculosi; Outbreak; Schools; Spoligotyping; Tuberculosis multirresistente