Antituberculous Drug Resistance in Western Canada (1993 to 1994)

Long, Richard; Fanning, Anne; Cowie, Robert L.; Hoeppner, Vernon; FitzGerald, Mark

doi:10.1155/1997/169521

Cited by 13 publications

(21 citation statements)

References 8 publications

(6 reference statements)

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“…The global rate of resistance to antituberculosis drugs of 8.7% obtained in our study is similar to data published recently in other developed countries [10,22]. In the USA, however, the reported rate was 14.2% in 1991 [7] and 13.2% in 1992 [23], although the figure varies from one state to another.…”

Section: Discussionsupporting

confidence: 90%

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Arevalo¹,

Solera²,

Cebrián³

et al. 1996

Eur Respir J

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The aim of this study was to investigate the incidence of primary and secondary resistance to antituberculosis drugs and the risk factors associated with the resistance in southeast Spain.Our research was based on the clinical histories of 276 patients, diagnosed as having tuberculosis by positive culture, who were tested for drug susceptibility between January 1988 and October 1994. The clinical histories were checked by two independent investigators. Drug-resistant strains were isolated from 24 patients (8.7%). Among the 239 patients without previous tuberculosis therapy, 7 (2.9%) were drug-resistant. Among the 37 patients with previous therapy, 17 (46%) were drug-resistant. Seventeen of the 276 patients (6.2%) had resistance to a single drug. Primary resistance to isoniazid was 1.7%. Previous treatment for tuberculosis (odds ratio (OR) 39.2; 95% confidence interval (95% CI) 10.2-150); hepatic cirrhosis (OR 104; 95% CI 12.8-847); and age 45 yrs and older (OR 4.80; 95% CI 1.15-20.1) were considered risk factors associated with drug-resistant tuberculosis.We conclude that primary and secondary resistance is low in the southeast of Spain and we recommend that susceptibility testing be performed on initial M. tuberculosis isolated from patients with a history of previous tuberculosis therapy, hepatic cirrhosis or more than 44 yrs of age.

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Section: Discussionsupporting

confidence: 90%

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Arevalo¹,

Solera²,

Cebrián³

et al. 1996

Eur Respir J

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“…Based on preliminary results of this study, recommendations in Health Canada's Guidelines for preventing the transmission of tuberculosis in Canadian health care facilities and other institutional settings (21) have attempted to reflect the great variation in the number of TB cases admitted to different hospitals in Canada. The low percentage of TB cases (1.3%) reported to be MDR-TB is consistent with other results recently reported in Canada (4). AFB sputum smear results are an important determinant of a patient's infectivity level and were frequently unknown.…”

Section: Discussionsupporting

confidence: 90%

“…In 1993, 7% of TB cases reported in western Canada were resistant to one or more drugs (4). No outbreaks of multidrug-resistant TB (MDR-TB) (ie, resistant to at least isoniazid [INH] and rifampin) have been reported in Canada, though isolated cases have been reported.…”

mentioning

confidence: 99%

Status of Tuberculosis Infection Control Programs in Canadian Acute Care Hospitals, 1989 to 1993 – Part 1

Holton

Paton

Gibson

et al. 1997

Canadian Journal of Infectious Diseases and Medical Microbiolog

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OBJECTIVE:To document tuberculosis (TB) prevention and control activities in Canadian acute care hospitals from 1989 to 1993. DESIGN: Retrospective questionnaire. PARTICIPANTS: All members of the Community and Hospital Infection Control Association-Canada and l'Association des professionnels pour la prévention des infections who lived in Canada and worked in an acute care hospital received a questionnaire. One questionnaire per hospital was completed. OUTCOME: The study documented the number of respiratory TB cases admitted to the hospital, the type of engineering and environmental controls available, and the type of occupational tuberculin skin test (TST) screening programs offered by the hospital. RESULTS: Questionnaires were received from 319 hospitals. Ninety-nine (32%) hospitals did not admit a respiratory TB case during the study. Thirty-one (10%) hospitals averaged six or more TB cases per year. TST results were reported for 47,181 health care workers, and 819 (1.7%) were reported as TST converters; physicians had a significantly higher TST conversion rate than other occupational groups. Most hospitals did not have isolation rooms with air exhausted outside the building, negative air pressure and six or more air changes per hour. Surgical masks were used as respiratory protection by 74% of staff. CONCLUSIONS: Canadian hospitals can expect to admit TB patients. Participating hospitals did not meet TB engineering or environmental recommendations published in 1990 and 1991. In addition, occupational TB screening programs in 1989 to 1993 did not meet Canadian recommendations published in 1988.

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“…Multidrug resistant disease was not documented during the study period. Our data with regard to the risk of resistance are consistent with previous reports of resistance patterns in TB cases in western Canada (15), and reflect the impact on immigrants from high prevalence countries where drug resistance is a major problem. The pattern of resistance was unchanged during the study period and therefore is unlikely to account for the differences in rates of TB seen.…”

Section: Duringsupporting

confidence: 91%

Tuberculosis among Aboriginal and Nonaboriginal Persons in British Columbia

Wang

Noertjojo

et al. 2000

Canadian Respiratory Journal

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OBJECTIVE:To compare cases of tuberculosis (TB) diagnosed among aboriginal persons with a random sample of nonaboriginal persons diagnosed with TB, and evaluate the trends in rates of disease between both groups during the same period. DESIGN: A case-control study. SETTING: A provincial TB control program. PATIENTS AND METHODS: All patients with TB diagnosed among aboriginal persons in British Columbia between 1992 and 1996 were compared with control patients diagnosed during the same period. For each patient a control patient was identified. INTERVENTION:The demographic details, type of disease, bacteriology, risk factors for TB, therapy received as well as mode of administration were documented. The number of contacts identified for each patient as well as the number of patients completing chemoprophylaxis were identified. The rates of disease during the same period were also documented. RESULTS: During the study, 202 patients with TB were diagnosed among aboriginal persons and 201 controls were chosen. Apart from age at diagnosis (35.1±20 years versus 45.7±19.7), differences in the prevalence of lymphadenopathy (5.9% versus 16.4%, P=0.0008) and pleural disease (21.3% versus 16.4%, P=0.00008), there were no differences in presentation between aboriginal and nonaboriginal people. Aboriginal people were more likely to have a history of contact with a patient with TB (53% versus 17.9%, P<0.05), to have received directly observed therapy (55% versus 33.8%, P=0.00002) and to have contacts who were purified protein derivative (PPD) positive (4±9 versus 2±3, P=0.002). These contacts were more likely to start isoniazid (2±3 versus 1±1, P=0.002). Overall, there was a significant decline in rates of TB among aboriginal persons compared with the general population, but there was a small increase in rates among all subjects in the final year of the study. CONCLUSIONS: In the present study, significant variations in rates of TB among different population groups in British Columbia were found. During the study period, there was a greater decline in the rates of TB among aboriginal persons. A greater use of directly observed therapy and greater use of chemoprophylaxis occurred among aboriginal persons, which may have contributed to this decline, or alternatively, it simply reflects the natural evolution of the TB epidemic.

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Antituberculous Drug Resistance in Western Canada (1993 to 1994)

Cited by 13 publications

References 8 publications

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

Status of Tuberculosis Infection Control Programs in Canadian Acute Care Hospitals, 1989 to 1993 – Part 1

Tuberculosis among Aboriginal and Nonaboriginal Persons in British Columbia

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