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[Resistant lung tuberculosis in Berlin 1987-1993]
T Schaberg1, G Gloger, B Reichert
1Pneumologie, Institut für Mikrobiologie, Immunologie und Laboratoriumsmedizin, Berlin.
Pneumologie (Stuttgart, Germany)
|January 1, 1996
Summary
Multidrug-resistant tuberculosis (MDR-TB) strains increased significantly in German hospitalized patients from 1987 to 1993. Previous therapy and foreign-born status were key risk factors for drug resistance.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Context:
- Rising global concern over Mycobacterium tuberculosis (M. tb) drug resistance.
- Lack of existing public health data on tuberculosis resistance in German urban populations.
- Study conducted on 1011 hospitalized patients over a seven-year period (1987-1993).
Purpose:
- To investigate the prevalence and trends of drug resistance in M. tb strains among hospitalized patients in Germany.
- To identify risk factors associated with single-drug resistance (SDR) and multidrug-resistant (MDR) tuberculosis.
- To inform initial therapeutic strategies based on resistance patterns.
Summary:
- Observed a stable rate of single-drug resistance (SDR) at 5.9% but a significant increase in multidrug-resistant (MDR) strains from 1.7% in 1987 to 5.8% in 1993.
- MDR strains involved resistance to two (69%) or three or more (31%) first-line drugs.
- Identified previous therapy (OR 4.5 for MDR) and foreign-born status (OR 3.5 for MDR) as significant risk factors for drug resistance (p < 0.0001).
Impact:
- Highlights a considerable increase in MDR tuberculosis within the studied hospital population.
- Suggests higher primary and acquired resistance rates in foreign-born patients compared to German-born patients.
- Recommends a four-drug regimen for initial therapy in patients with a history of prior treatment or those from high-resistance regions to combat increasing drug resistance.