A 10 year survey on Mycobacterium tuberculosis isolates in Israel and their drug resistance.

An increased incidence of tuberculosis has been observed in Israel in 1985, 1986 and since 1990--years of large waves of immigrations. A very similar trend of disease was observed in the Mycobacterium Reference Laboratory of Israel, and consequently a survey was undertaken among the 1,181 bacteriologically confirmed tuberculosis cases newly registered there in 1983-92. The overall percent distribution of drug-resistant Mycobacterium tuberculosis during this period was 12.6% (7.3% resistant to one drug and 5.3% (multiple drug resistance). The highest percent distribution of drug-resistant bacilli was found among immigrants from the former Soviet Union (37.3%) and Ethiopia (16.2%). The highest incidence of disease was found in males and in patients aged > 30. Pulmonary disease was the most common form for all patients: among the extrapulmonary cases, the most frequently involved site was the genitourinary system in Israelis and the lymph nodes in Ethiopians. Most isolates fit into one variant by biochemical analysis, indicating the need for a more sensitive method to type M. tuberculosis for epidemiological purposes. The data included in this survey provide information useful for a national tuberculosis program.