[Current epidemiological and clinical aspects of tuberculosis: A study in the Hospital of Pisa]

To describe epidemiological and clinical features of tuberculosis (tbc) cases identified recently in the Pisa area (Tuscany, Italy).

We performed a retrospective study of all cases of tbc notified to the Public Health Service in Pisa during January 1996-December 1998. The diagnosis of tbc was made following the criteria of the Public Health Ministry.

Eighty-eight patients affected by tbc were identified. Diagnosis was microbiologically proven (positive culture for M. tuberculosis) in 42 patients. Sixty-nine patients had pulmonary tbc, 14 extrapulmonary and 5 mixed tbc. Mean age was 56.4 years (range 16-87 years). Nineteen patients were extra European Community citizens. The incidence of tbc (N./100,000) was 8.4 in 1996, 10 in 1997 and 3.2 in 1998. In 5.7% of the cases tbc was associated with advanced HIV infection. The chest X-ray showed pleural effusion in 12 patients and cavitation in 26 patients. Fever was not present in 36.4% of the patients at the moment of diagnosis. 12% of the isolated strains of M. tuberculosis were in vitro multidrug-resistant.

The data presented showed an important rate of tbc in Pisa, similar to the incidence of tbc reported by other studies carried out on a national scale. We have yet to understand if the decreased rate observed in 1998 represents a new trend. The isolation rate of multidrug-resistant strains of M. tuberculosis in Pisa seems higher than the rates reported in other geographical areas. Therefore monitoring of M. tuberculosis susceptibility to antimicrobial agents is necessary.