title: Outbreak of isoniazid-resistant tuberculosis in an immigrant community in Spain.
abstract: BACKGROUND
  Tuberculosis (TB) remains a major public health problem. In 2013, 9 million new cases of active TB were estimated globally and the proportion of reported new cases with multi-drug resistance (MDR) was 3.5%.
  
  
  METHODS
  Contact tracing of a case of pulmonary tuberculosis was performed in a Bolivian patient. Diagnostic tests were performed according to national and local protocols.
  
  
  RESULTS
  An outbreak of tuberculosis in an immigrant community was detected, with 5 cases originating from one index case. Genotyping and drug susceptibility testing of the sputum samples determined Mycobacterium tuberculosis resistant to isoniazid (KatG-msp unmutated/inhA 5RBS CT). Active case finding revealed a total of 39 contacts with an incidence of latent infection of 71.43%.
  
  
  CONCLUSIONS
  The present study confirms the importance of active case finding through contact tracing as well as rapid laboratory diagnosis to achieve improvements in early detection of TB. Early diagnosis of the patient, compliance with appropriate treatment protocols and monitoring of drug resistance are considered essential for the prevention and control of TB.
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: cristinahernang@gmail.com.
authors.forename: Cristina
authors.initials: C
authors.lastname: Hernán García
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Moreno Cea
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: Virginia
authors.initials: V
authors.lastname: Fernández Espinilla
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: Gema
authors.initials: G
authors.lastname: Ruiz Lopez Del Prado
authors.affiliation: Servicio de Epidemiología, Dirección General de Salud Pública, Consejería de Sanidad, Valladolid, España.
authors.forename: Socorro
authors.initials: S
authors.lastname: Fernández Arribas
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: Irene
authors.initials: I
authors.lastname: Andrés García
authors.affiliation: Servicio de Medicina Preventiva y Salud Publica, Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: Verónica
authors.initials: V
authors.lastname: Rubio
authors.affiliation: Department of Respiratory Medicine, HELIOS Klinikum Emil von Behring, Berlín, Alemania.
authors.forename: Silvan
authors.initials: S
authors.lastname: Vesenbeckh
authors.affiliation: Hospital Clínico Universitario de Valladolid, Valladolid, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Eiros Bouza
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001500:BCG Vaccine; D001838:Bolivia / Q000208:ethnology; D016358:Contact Tracing; D004196:Disease Outbreaks; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D007538:Isoniazid / Q000494:pharmacology; D055985:Latent Tuberculosis / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D013030:Spain / Q000453:epidemiology; D014374:Tuberculin Test; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D014396:Tuberculosis, Pleural / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission
chemical_list: D000995:Antitubercular Agents; D001500:BCG Vaccine; D007538:Isoniazid
keywords: Brote; Contact tracing; Drug-resistant tuberculosis; Estudio de contactos; Immigration; Infección tuberculosa latente; Inmigración; Latent tuberculosis; Outbreak; Tuberculosis resistente