title: Multidrug-resistant tuberculosis in New South Wales, Australia, 1999-2010: a case series report.
abstract: METHODS
  The emergence of multidrug-resistant tuberculosis (MDR-TB) threatens the ongoing control of tuberculosis (TB). The Australian state of New South Wales (NSW) has low TB and MDR-TB incidence.
  
  
  OBJECTIVE
  To examine the epidemiology and the clinical and public health management of MDR-TB in NSW.
  
  
  METHODS
  A retrospective case-series analysis of MDR-TB diagnosed in NSW between 1999 and 2010 was undertaken. A standardised questionnaire was used to collect information from the public health surveillance system, medical records and the State Mycobacterium Reference Laboratory about clinical features, drug susceptibility, treatment regimens, hospitalisation, risk factors for tuberculous infection, contact tracing and patient outcomes.
  
  
  RESULTS
  Fifty-five cases of culture-confirmed MDR-TB, including two cases of extensively drug-resistant TB, were diagnosed. All cases were reviewed by an expert management panel. Fifty cases (91%) were foreign-born, and 50 cases (91%) had fully supervised treatment. Of the 55 cases, 46 (84%) successfully completed treatment, 3 (5%) died of TB and 3 (5%) required surgery. No MDR-TB cases were reported among contacts.
  
  
  CONCLUSIONS
  Using a multidisciplinary, expert guided, case-management approach, the NSW TB Control Program achieved excellent MDR-TB outcomes. The impact of global increases in MDR-TB requires sustained commitment to TB in all settings.
authors.affiliation: New South Wales Health, North Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Roberts-Witteveen
authors.affiliation: New South Wales Health, North Sydney, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Reinten
authors.affiliation: New South Wales Health, North Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Christensen
authors.affiliation: Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, Australia.
authors.forename: V
authors.initials: V
authors.lastname: Sintchenko
authors.affiliation: School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Seale
authors.affiliation: New South Wales Health, North Sydney, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Lowbridge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000145:classification* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents