| dc.contributor |
Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Rome, Italy; Forschungszentrum Borstel National Reference Center for Mycobacteria, Borstel, Germany; Medecins Sans Frontieres, Paris, France; Dipartimento di Biologia Molecolare, Universita` di Siena, Italy; Dipartimento di Scienze Odontostomatologiche, Universita` di Cagliari, Italy; University of Leicester, United Kingdom; 3Es (Essai clinique Evaluation Epidemiologie Statistiques), Paris, France; London School of Hygiene and Tropical Medicine, London, United Kingdom; LGL, Oberschleibheim, Germany; Epicentre, Geneva, Switzerland |
|
| dc.creator |
Pardini, M |
|
| dc.creator |
Niemann, S |
|
| dc.creator |
Varaine, F |
|
| dc.creator |
Iona, E |
|
| dc.creator |
Meacci, F |
|
| dc.creator |
Orrù, G |
|
| dc.creator |
Yesilkaya, H |
|
| dc.creator |
Jarosz, T |
|
| dc.creator |
Andrew, P |
|
| dc.creator |
Barer, M |
|
| dc.creator |
Checchi, F |
|
| dc.creator |
Rinder, H |
|
| dc.creator |
Orefici, G |
|
| dc.creator |
Rüsch-Gerdes, S |
|
| dc.creator |
Fattorini, L |
|
| dc.creator |
Oggioni, M R |
|
| dc.creator |
Bonnet, M |
|
| dc.date |
2009-06-18 |
|
| dc.date.accessioned |
2017-01-31T07:51:28Z |
|
| dc.date.available |
2017-01-31T07:51:28Z |
|
| dc.identifier |
Tuberculosis (Edinb)2009;89 (4):317-24 |
|
| dc.identifier |
1873-281X |
|
| dc.identifier |
19539531 |
|
| dc.identifier |
10.1016/j.tube.2009.04.002 |
|
| dc.identifier |
http://hdl.handle.net/10144/132810 |
|
| dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/132810 |
|
| dc.identifier |
Tuberculosis |
|
| dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/132810 |
|
| dc.description |
Although multidrug-resistant (MDR) tuberculosis (TB) is a major public health problem in Eastern Europe, the factors contributing to emergence, spread and containment of MDR-TB are not well defined. Here, we analysed the characteristics of drug-resistant TB in a cross-sectional study in Abkhazia (Georgia) between 2003 and 2005, where standard short-course chemotherapy is supplemented with individualized drug-resistance therapy. Drug susceptibility testing (DST) and molecular typing were carried out for Mycobacterium tuberculosis complex strains from consecutive smear-positive TB patients. Out of 366 patients, 60.4% were resistant to any first-line drugs and 21% had MDR-TB. Overall, 25% of all strains belong to the Beijing genotype, which was found to be strongly associated with the risk of MDR-TB (OR 25.9, 95% CI 10.2-66.0) and transmission (OR 2.8, 95% CI 1.6-5.0). One dominant MDR Beijing clone represents 23% of all MDR-TB cases. The level of MDR-TB did not decline during the study period, coinciding with increasing levels of MDR Beijing strains among previously treated cases. Standard chemotherapy plus individualized drug-resistance therapy, guided by conventional DST, might be not sufficient to control MDR-TB in Eastern Europe in light of the spread of "highly transmissible" MDR Beijing strains circulating in the community. |
|
| dc.language |
en |
|
| dc.relation |
http://www.tuberculosisjournal.com/article/S1472-9792(09)00030-4/abstract |
|
| dc.rights |
Archived with thanks to Elsevier and Tuberculosis (Edinburgh, Scotland) |
|
| dc.title |
Characteristics of drug-resistant tuberculosis in Abkhazia (Georgia), a high-prevalence area in Eastern Europe |
|
| dc.type |
Article |
|