Nederlands tijdschrift voor geneeskunde · 1996
[Drug resistance in Mycobacterium tuberculosis in The Netherlands].
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Lambregts-van Weezenbeek C S, van Klingeren B, Veen J
Аннотация
OBJECTIVE: To determine magnitude, trend and specific features of the resistance problem.
DESIGN: Descriptive.
SETTING: Royal Netherlands Tuberculosis Association, The Hague, the Netherlands.
METHODS: The data of the National Institute of Public Health and Environmental Protection concerning the prevalence of drug-resistant tuberculosis during the period 1990-1994 were analysed. Also, features of patients with and without drug resistance were compared (Dutch National Tuberculosis Register: cohort 1993).
RESULTS: Isoniazid and streptomycin resistance were each observed in approximately 6% of susceptibility tests, showing no clear trend over the study period. Rifampicin resistance increased from 0% to 1.5% in 1994. In the 1993 patient cohort, 809 cases were analysed, showing resistant organisms in 103 (13%). The resistance group included 84 (82%) foreigners versus 387 (55%) among the 'sensitives' (p < 0.001). The percentages of (known) HIV infections were equal in both groups (5-6%). The percentage of isoniazid-resistance varied from 1.8% in Dutch patients to 7.8% in foreign patients. Recent immigrants and refugees waiting for official status were important risk groups for resistance (p < 0.005). Foreign tuberculosis patients defaulted more often from treatment than Dutch patients (p < 0.001).
CONCLUSION: Drug-resistant tuberculosis in the Netherlands is mainly due to import of resistant strains. Transmission and further development of resistance within the country must be prevented.
DESIGN: Descriptive.
SETTING: Royal Netherlands Tuberculosis Association, The Hague, the Netherlands.
METHODS: The data of the National Institute of Public Health and Environmental Protection concerning the prevalence of drug-resistant tuberculosis during the period 1990-1994 were analysed. Also, features of patients with and without drug resistance were compared (Dutch National Tuberculosis Register: cohort 1993).
RESULTS: Isoniazid and streptomycin resistance were each observed in approximately 6% of susceptibility tests, showing no clear trend over the study period. Rifampicin resistance increased from 0% to 1.5% in 1994. In the 1993 patient cohort, 809 cases were analysed, showing resistant organisms in 103 (13%). The resistance group included 84 (82%) foreigners versus 387 (55%) among the 'sensitives' (p < 0.001). The percentages of (known) HIV infections were equal in both groups (5-6%). The percentage of isoniazid-resistance varied from 1.8% in Dutch patients to 7.8% in foreign patients. Recent immigrants and refugees waiting for official status were important risk groups for resistance (p < 0.005). Foreign tuberculosis patients defaulted more often from treatment than Dutch patients (p < 0.001).
CONCLUSION: Drug-resistant tuberculosis in the Netherlands is mainly due to import of resistant strains. Transmission and further development of resistance within the country must be prevented.