Mycobacterium tuberculosis in Taiwan

Hsueh, Po-Ren; Liu, Yung Ching; So, Jen; Liu, Cheng Yi; Yang, Pan‐Chyr; Luh, Kwen Tay

doi:10.1016/j.jinf.2005.08.008

Cited by 97 publications

(70 citation statements)

References 24 publications

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“…One example is Bangladesh, which has an overall MDR rate of 5.5% but considerably higher levels in the regions of Dhara (14.3%) and Matlab (27.3%) 25 . The resistance rate observed in Cabo is, on the other hand, similar to rates reported in some regions where drug resistance and MDR have been reported to be a major concern such as 54% in Lithuania 4 , 40.2% in Uzbekistan 3 and 30.5% in Taiwan 7 .…”

Section: Discussionsupporting

confidence: 84%

High frequency of resistance to the drugs isoniazid and rifampicin among tuberculosis cases in the city of Cabo de Santo Agostinho, an urban area in Northeastern Brazil

Baliza

Bach

Queiroz

et al. 2008

Rev. Soc. Bras. Med. Trop.

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The objective of the present study was to investigate the frequency and risk factors for developing multidrug-resistant tuberculosis in Cabo de Santo Agostinho, PE. This was a prospective study conducted from 2000 to 2003, in which suspected cases were investigated using bacilloscopy and culturing. Out of 232 confirmed cases of tuberculosis, culturing and antibiotic susceptibility tests were performed on 174. Thirty-five of the 174 cultures showed resistance to all drugs. The frequencies of primary and acquired resistance to any drug were 14% and 50% respectively, while the frequencies of primary and acquired multidrug resistance were 8.3% and 40%. Previous tuberculosis treatment and abandonment of treatment were risk factors for drug resistance. The high levels of primary and acquired resistance to the combination of isoniazid and rifampicin contributed towards the difficulties in controlling tuberculosis transmission in the city. Key-words:Tuberculosis. Drug resistance. Multidrug resistance. Risk factors.Multidrug resistance. Risk factors. RESUMOO objetivo do presente estudo foi investigar a freqüência e fatores de risco para o desenvolvimento de tuberculose multidroga resistente, na Cidade do Cabo de Santo Agostinho, PE. Este é um estudo prospectivo realizado entre 2000-2003 onde casos suspeitos foram investigados por baciloscopia e cultura. De 232 casos de tuberculose confirmados, 174 tiveram cultura e antibiograma realizados. Trinta e cinco das 174 culturas mostraram resistência a qualquer uma das drogas. A freqüência de resistência primária e adquirida a qualquer droga foi 14% e 50% respectivamente enquanto a freqüência primária e adquirida para multidroga resistência foi 8,3% e 40%. Tratamento prévio para tuberculose ou abandono de tratamento consistiu em fatores de risco para resistência a drogas. Os altos níveis de resistência primária e adquirida a combinação isoniazida e rifampicina contribuem para as dificuldades no controle da transmissão da tuberculose no Cabo. The increasing frequency of drug-resistant tuberculosis (TB), which has been leading to failure to respond to either isoniazid (INH) or rifampicin (RMP) is of great concern in relation to successful implementation of large-scale regional TB control programs. In Brazil, the first-line drugs for TB treatment in use since 1982 are INH and RMP for six months in association with pyrazinamide (PZA) for the first two months. The drugs are supplied by the government, without cost to the patient, and the treatment is based on self-administration. PalavrasThe World Health Organization (WHO) defines multidrugresistant tuberculosis (MDR-TB) as TB involving resistance to at least INH and RMP. However, the Brazilian Consensus

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Section: Discussionsupporting

confidence: 84%

High frequency of resistance to the drugs isoniazid and rifampicin among tuberculosis cases in the city of Cabo de Santo Agostinho, an urban area in Northeastern Brazil

Baliza

Bach

Queiroz

et al. 2008

Rev. Soc. Bras. Med. Trop.

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“…However, its implementation in Taiwan has been quite limited before 2005 (2). In 2005, the Taiwan CDC instituted the national``STOP TB'' program with four components.…”

Section: Discussionmentioning

confidence: 99%

“…It is also the most commonly notified infectious disease, and its incidence has been increasing from 1979 to 2002 (2). A devastating threat to TB control is the emergence of drug resistance and multidrug-resistant tuberculosis (MDR-TB), which is already a serious problem in Southeast Asia and the Western Pacific, and accounts for 60z of new TB patients globally (3).…”

Section: Introductionmentioning

confidence: 99%

“…A devastating threat to TB control is the emergence of drug resistance and multidrug-resistant tuberculosis (MDR-TB), which is already a serious problem in Southeast Asia and the Western Pacific, and accounts for 60z of new TB patients globally (3). The rates of combined MDR-TB have been increasing (from 1.5z during 1990-1992 to 5.0z during 1998-2002) in Taiwan, an island nation located on the rim of the Western Pacific (2). Recently, an outbreak of extensively drugresistant tuberculosis (XDR-TB) was reported in KwaZulu Natal Province in South Africa, and it had a high mortality rate (98z) (4).…”

Section: Introductionmentioning

confidence: 99%

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A Reduction in Anti-Tuberculosis Drug Resistance after the Implementation of the National “STOP TB” Program in Central Taiwan, 2003–2007

et al. 2013

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SUMMARY:The aim of this study was to determine the performance of the national``STOP TB'' program in central Taiwan during [2003][2004][2005][2006][2007] by examining trends in the combined drug resistance to firstline anti-tuberculosis (TB) drugs among clinical Mycobacterium tuberculosis isolates. Using 4,819 clinical M. tuberculosis isolates obtained from two mycobacteriology referral laboratories, the resistance to drugs was measured and analyzed along with the treatment outcomes in notified TB patients. The proportion of isolates showing total resistance and multidrug-resistant tuberculosis (MDR-TB) isolates were 17.7z and 3.67z, respectively. More number of MDR-TB isolates showed high-level resistance to isoniazid (84.18z) and streptomycin (SM) (30.51z); low-level resistance to ethambutol (EMB) (61.58z), SM (41.81z), and pyrazinamide (66.1z); and resistance to ofloxacin (30.4z). However, fewer isolates showed high-level resistance to EMB (19.77z), levofloxacin (17.9z), moxifloxacin (19.6z), kanamycin (8.9z), amikacin (8.9z), and capreomycin (8.9z). Of these MDR-TB isolates, 7.1z were extensively drug-resistant. Trends in combined drug resistance to all the first-line anti-TB drugs and the incidence of MDR-TB were stable during the 2 years (2003)(2004) before the implementation of the national``STOP TB'' program. After the``STOP TB'' program, there were significant declines in the incidence of MDR-TB during [2005][2006][2007] in central Taiwan as well as improved TB-treatment outcomes. Thus, the national``STOP TB'' program had a significant positive impact on TB control in central Taiwan.

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“…In addition, the TB incidence rates in the three aboriginal townships (Sioulin, Wanrong, and Jhuosi) of Hualien County were 639.8, 249.4, and 330.1 cases per 100,000 population, respectively, all much higher than the rate in the whole of Hualien County (11). TB has been one of the major causes of death in Taiwan for decades, and the mortality rate due to TB is the highest in eastern Taiwan (6). However, the underlying factors mediating the persistent high TB incidence and mortality rates in eastern Taiwan are not conclusive.…”

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confidence: 99%

Mixed Infection with Beijing and Non-Beijing Strains and Drug Resistance Pattern of Mycobacterium tuberculosis

et al. 2010

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Mixed infection with Beijing and non-Beijing strains of Mycobacterium tuberculosis has been reported and has been suggested to mediate elevation of the reinfection rate in regions with a high incidence of tuberculosis (TB). To evaluate the prevalence of infection with both Beijing and non-Beijing strains of M. tuberculosis in eastern Taiwan, the region with the highest TB incidence in Taiwan, 185 active pulmonary TB patients were enrolled at Tzu Chi General Hospital from October 2007 to September 2008. A modified multiplex PCR method was developed to distinguish Beijing and non-Beijing strains directly using the sputum of patients. Of the 185 patients, 46.5% were infected with a Beijing strain, 42.2% were infected with a non-Beijing strain, and 11.3% were infected with both strain types. Notably, mixed infection with both strain types was not associated with TB treatment history or the high-incidence race group, aborigines. In addition, the incidence rate of mixed infection before treatment with anti-TB medication was as high as that in patients with a history of anti-TB treatment. Further analysis of antibiotic susceptibility revealed that Beijing strains alone had the highest multidrug resistance rate (17.5%), mixed infection had the highest rate of resistance to at least one drug (23.8%), and non-Beijing strains had the highest rate of sensitivity to all drugs (79.5%), implying that Beijing strains are predominant in the development of drug resistance in tuberculosis.

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Mycobacterium tuberculosis in Taiwan

Cited by 97 publications

References 24 publications

High frequency of resistance to the drugs isoniazid and rifampicin among tuberculosis cases in the city of Cabo de Santo Agostinho, an urban area in Northeastern Brazil

High frequency of resistance to the drugs isoniazid and rifampicin among tuberculosis cases in the city of Cabo de Santo Agostinho, an urban area in Northeastern Brazil

A Reduction in Anti-Tuberculosis Drug Resistance after the Implementation of the National “STOP TB” Program in Central Taiwan, 2003–2007

Mixed Infection with Beijing and Non-Beijing Strains and Drug Resistance Pattern of Mycobacterium tuberculosis

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