Source: Annual Congress 2002 - Drug resistance
Disease area: Paediatric lung diseases, Respiratory infections

Abstract

Although according to the last national investigation the primary MDR-TB (2,8%) and secondary MDR-TB (14,2%) don't increase much, the incidence in Romania in 2001 (134,7%000) and in the 4th sector of Bucharest (118,9%000) determined us to analize the impact of MDR-TB cases to the household contacts (0-20 years). 39 cases MDR-TB due to M.tuberculosis were detected in the 4th sector between 1999-2002. The microbial resistance was primary in 13 cases (33,3%) and secondary to poorly designed previous treatments in 26 cases (66,7%). In addition of being resistant only to major drugs Isoniazid and Rifampicin (5 cases), there were also 34 cases resistant to at least 1 to 4 drugs more. 79,4% of sources had positive smear sputum. We examined 55 intrafamilial contacts (0-20 years) exposed to smear/culture positive MDR patients. 20% of the children were tuberculin non-reactors (of which 6 cases had a PPD skin conversion), 54,5% cases had tuberculin reactivity>=10mm and 13% cases had active TB (3- primary TB and 4- secondary TB). 85% of children had a BCG scar. We discovered 4 children with smear-positive acid-fast bacilli (sputum, gastric lavage). Isolated My TB was MDR in 3 cases. The treatment of these contacts with active TB with individualized regimens had favorable rezults (cured and complet treatments), only 1 case failured. Most of the children live in ethnic communities where MDR sources are non-compliant to treatment (chronic cases), have low income, so not all of the contacts received individualised chemoprofilaxis (only 36% cases). The application of measures of National Control Tuberculosis Programme 2001-2005 will increase the compliance to treatment and DOTS strategy remain the most important [dsquote]weapon[dsquote] to avoid the occurence of new MDR cases.

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R. Cretul, C. Didilescu (). The impact of MDR tuberculosis cases detected in the 4th sector of Bucharest (1999- 2002) to children and teenagers household contacts. Eur Respir J 2002; 20: Suppl. 38, 3840

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