Source: Annual Congress 2002 - Drug resistance in different areas
Disease area: Respiratory infections

Abstract

The aim of the study was to describe the prevalence of drug resistance in Italy.
Principles, methods and definitions were derived from the World Health Organization-International Union Against Tuberculosis and Lung Disease Global Project on anti-TB Drug Resistance Surveillance (minimum sample size: 642 cases; representative network: 46 units, 20 laboratories). The study was preceded by proficiency testing. Prevalence rates to isoniazid (H), rifampicin (R), ethambutol and streptomycin were stratified by history of previous treatment, age, sex, HIV status and country of birth.
806 strains were studied (688 in cases without previous treatment; 108 in previously treated cases). Among not previously treated cases, the prevalence of resistance to H was 2.0%, to R 0.4% and to H+R (multidrug-resistance) 1.2%.
In patients not previously treated, the prevalence of resistance to monoH (RR 1.89; 95%CI 1.34-2.67; P=0.01) and to anyH (RR 1.52; 95%CI 1.16-2.01; P<0.01) but not to R, was higher in immigrants than in native Italians. No difference was found stratifying prevalence data by age, sex and HIV status. In cases with previous treatment a significant decrease had been observed (from 36.5% to 24.1%; RR 0.72; 95% CI 0.52-1.01; P<0.05), for multidrug-resistance, for any resistance (from 61.7% to 47.2%; RR 0.74; 95% CI 0.57-0.97; P=0.029) and for anyR resistance (from 47.8% to 29.6%; RR 0.66; 95% CI 0.48-0.90; P<0.01).
The prevalence results are consistent with those detected during the 1998/99 exercise.
Resistance to H is associated to immigration, as observed in 1998/99.

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G. B. Migliori, R. Centis, L. Fattorini, P. Vaccarino, G. Besozzi, C. Saltini, G. Orefici, E. Iona, C. Piersimoni, C. Scarparo, D. Cirillo, A. Gori, A. Cassone (Tradate, Italy). Prevalence of drug resistance in Italy: national report, year 2000. Eur Respir J 2002; 20: Suppl. 38, 2555

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