Source: Annual Congress 2010 - Multidrug-resistant and extensively drug-resistant tuberculosis
Disease area: Respiratory infections

Abstract

Background. Effective infection control in tuberculosis (TB) hospitals depends on early identification, isolating, rapidly and effectively treating of patients with TB. Long hospital stays for TB treatment can increase risk of reinfection with multi- and extensively drug resistance (MDR or XDR) strains.
Aims: To evaluate the risk of nosocomial transmission of MDR&XDR TB among TB patients, during treatment cure in TB hospitals from Moldova.
Methods: Were performed DNA fingerprinting with restriction-fragment–length polymorphism analysis on pairs of isolates of M.tuberculosis from patients who became MDR TB patients after 2 – 4 month of TB treatment.
Results: Were identified patients who developed MDR or XDR TB after being treated for less resistant TB. Both initial and follow-up isolates were available for IS6110 DNA fingerprinting for 26 of these patients. Most of patients had strains sensitive to anti-TB first line drug (17), or monoresistant (5) before treatment was started. Four patients had strains resistance on 2 drugs (SM and INH) at baseline. For 13 of the 26 patients, the restriction fragment–length polymorphism banding patterns for the isolates obtained after the 2-3 mounts of treatment were different from those of the initial isolate, indicating exogenous reinfection. This finding indicates that reinfection was the cause of the MDR&XDR TB during curative treatment.
Conclusions. Exogenous reinfection is an important mechanism for the development of MDR and XDR TB. Effective infection control strategies are urgently needed to reduce the transmission of infection. The failure of treatment sometimes can be explain by nosocomial transmission of MDR TB in a high incidence setting.

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V. Crudu, S. Ruch-Gerdes, S. Niemann, N. Moraru, L. Carchilan, V. Lesan, G. Blagodeteleva, E. Stratan (Chisinau, Republic Of Moldova; Borstel, Germany). Poor infection control increase risk of reinfection with MDR or XDR-TB strains. Eur Respir J 2010; 36: Suppl. 54, 350

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