Emerging Infectious Diseases (Mar 2015)

Multidrug-Resistant Tuberculosis in Europe, 2010–2011

  • Gunar Günther,
  • Frank van Leth,
  • Sofia Alexandru,
  • Neus Altet,
  • Korkut Avsar,
  • Didi Bang,
  • Raisa Barbuta,
  • Graham Bothamley,
  • Ana Ciobanu,
  • Valeriu Crudu,
  • Manfred Davilovits,
  • Martin Dedicoat,
  • Raquel Duarte,
  • Gina Gualano,
  • Heinke Kunst,
  • Wiel de Lange,
  • Vaira Leimane,
  • Cecile Magis-Escurra,
  • Anne-Marie McLaughlin,
  • Inge Muylle,
  • Veronika Polcová,
  • Emanuele Pontali,
  • Christina Popa,
  • Rudolf Rumetshofer,
  • Alena Skrahina,
  • Varvara Solodovnikova,
  • Victor Spinu,
  • Simon Tiberi,
  • Piret Viiklepp,
  • Christoph Lange

DOI
https://doi.org/10.3201/eid2103.141343
Journal volume & issue
Vol. 21, no. 3
pp. 409 – 416

Abstract

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Drug-resistant Mycobacterium tuberculosis is challenging elimination of tuberculosis (TB). We evaluated risk factors for TB and levels of second-line drug resistance in M. tuberculosis in patients in Europe with multidrug-resistant (MDR) TB. A total of 380 patients with MDR TB and 376 patients with non–MDR TB were enrolled at 23 centers in 16 countries in Europe during 2010–2011. A total of 52.4% of MDR TB patients had never been treated for TB, which suggests primary transmission of MDR M. tuberculosis. At initiation of treatment for MDR TB, 59.7% of M. tuberculosis strains tested were resistant to pyrazinamide, 51.1% were resistant to ≥1 second-line drug, 26.6% were resistant to second-line injectable drugs, 17.6% were resistant to fluoroquinolones, and 6.8% were extensively drug resistant. Previous treatment for TB was the strongest risk factor for MDR TB. High levels of primary transmission and advanced resistance to second-line drugs characterize MDR TB cases in Europe.

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