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Drug resistant tuberculosis in Auckland 1988-92
Aim:
To report the prevalence of drug-resistant Mycobacterium tuberculosis in Auckland.
Method:
Review of all M tuberculosis culture positive cases from January 1988 to December 1992. Ethnicity was recorded from the national Paxus medical information data base and drug sensitivity results from the Green Lane Hospital tuberculosis reference laboratory. The clinical details of all patients with drug resistant tuberculosis were extracted from hospital case records.
Results:
Of the 417 patients with positive cultures, 43 (10%) had isolates resistant to one or more antituberculous drugs. Only 4 patients had multidrug-resistant organisms (defined as resistance to at least isoniazid and rifampicin) and there is no evidence that this is an increasing problem. Resistance rates were highest in those previously treated for M tuberculosis, and those born in, or likely to have acquired their organism from, Samoa, all other Pacific Islands, or South East Asia.
Conclusions:
Drug resistant M tuberculosis is a problem in Auckland but rates and patterns are little different from 1980-1982. Multidrug-resistance is not yet a problem in Auckland, as it is in the United States of America. Ways of maintaining this situation are discussed.