Cases of drug-resistant tuberculosis on the increase in the UK
Changes in the population and ongoing migration have increased cases of drug-resistant tuberculosis in the UK, according to a new study
(BMJ Online First, 2 May 2008).
Researchers used data from the national tuberculosis surveillance system,
involving 28,620 confirmed cases of the disease, to present the latest
trends in resistance to antituberculosis drugs.
Overall, the proportion of cases resistant to any first-line drug had
increased from 5.6 per cent in 1998 to 7.5 per cent in 2005 (with a peak
of 7.9 per cent in 2004). The researchers report an increasing proportion
of isoniazid resistance (6.9 per cent) and small increases in rifampicin
resistance (1.0 to 1.2 per cent) and multidrug resistance (0.8 to 0.9
per cent).
The authors suggest that the rise in resistance to isoniazid outside
London reflects the increasing number of patients with tuberculosis who
were not born in the UK.
In London, the rise in isoniazid resistance has been linked to an ongoing
outbreak associated with imprisonment and drug misuse and includes mainly
the UK-born population.
The researchers suggest that most cases of multidrug resistance result
from problems with patient management rather than transmission within
the UK.
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