[Drug resistance among patients with tuberculosis]

Detailed questionnaire has been received from 365 patients with drug resistant tuberculosis. They represented 75% of all such patients in Poland. 360 of them had pulmonary tuberculosis. 76% were men. Among 365 analysed patients 55% were below the age of 50 (of whom 61% had initial drug resistance and 47% had acquired resistance). Among these patients 52% had initial and 48% acquired drug resistance. In 193 patients (i.e. 54%) resistance to one drug (in 97 patients to isoniazid-H, in 80 to streptomycin-S and in 5 to rifampicin-R was observed. Resistance to two drugs was observed in 25% of patients and among them a majority (57%) was resistant to H and S and 23% to H and R. In 11% of patients, resistance to three drugs was observed, in 8% to four drugs, and in 4% to five or more drugs. Multidrug resistance (at least H and R) was observed in 97 patients (25% of the total number) and in 76 patients resistance to other than H and R drugs was observed. Among the total number of analysed patients in 263 (72%) resistance to H was observed, in 208-to S, and in 102 to R. Among patients with initial drug resistance, the majority was resistant to one drug and among those with acquired resistance the majority was resistant to two or more drugs. On the basis of this analysis the estimated total initial drug resistance-2. 8% is 6-8 times lower than 30-40 years ago and have remained at this low level for at least 20 recent years. It is concluded therefore that drug resistance in Poland does not present any danger to the effectiveness of tuberculosis programme. Monitoring, however, should continue.