Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2008 and 2009
DOI:
https://doi.org/10.33321/cdi.2011.35.11Keywords:
Mycobacterium tuberculosis, Mycobacterium bovis, laboratory diagnosis, drug resistanceAbstract
There were 886 and 1,062 bacteriologically-confirmed cases of tuberculosis (TB) in 2008 and 2009, representing an annual rate of 4.1 and 4.9 cases per 100,000 population respectively. Over the 2 years, a total of 23 children aged under 10 years (male n = 13, female n = 10) had bacteriologically confirmed tuberculosis, including 3 children with TB meningitis. Results of in vitro drug susceptibility testing were available for 885 of 886 and 1,060 of 1,062 isolates for isoniazid (INH), rifampicin (RIF), ethambutol (EMB), and pyrazinamide (PYZ) in 2008 and 2009 respectively. In 2008, a total of 94 (10.7%) isolates of Mycobacterium tuberculosis complex were resistant to at least one of the anti-tuberculosis agents. Any resistance to INH was noted for 76 (8.7%), 23 (2.6%) for RIF, 10 (1.1%) for EMB and 9 (1.0%) for PYZ. Resistance to at least INH and RIF (defined as multidrug-resistant TB (MDR-TB) was detected in 21 (2.4%) isolates. None of the 21 MDR-TB isolates had resistance to either ofloxacin or the injectable agents. In 2009, a total of 168 (15.9%) were resistant to at least one of the anti-TB agents. Any resistance to INH was noted for 150 (14.2%) isolates, 37 (3.5%) for RIF, 5 (0.5%) for EMB and 13 (1.2%) for PYZ. A total of 31 (2.9%) isolates were MDR-TB. In 2009, there were 2 cases of quinolone resistance in MDR-TB from persons born overseas. Mono-resistance to INH was the most commonly detected resistance with 33 and 80 isolates in 2008 and 2009, respectively. Mono-resistance to RIF was infrequently encountered with 2 and 5 isolates in 2008 and 2009 respectively. There were six and 11 MDR-TB patients from the Papua New Guinea (PNG) – Torres Strait Islands (TSI) cross-border region in 2008 and 2009 respectively. The PNG-TSI zone now contributes a substantial proportion of MDR-TB cases to the database. In addition, there were 24 isolates of Mycobacterium bovis bacille Calmette Guérin (BCG), 15 were cultured from males (4 aged ≤ 5 years) and from 9 females (5 aged ≤ 5 years). The predominant site of isolation was from vaccination abscess. Eight males (range: 57–87 years) had M. bovis BCG isolated from urine or blood culture. Commun Dis Intell 2011;35(2):154–161.
Downloads
References
Barry C, Konstantinos A, National Tuberculosis Advisory Committee. Tuberculosis notifications in Australia, 2007. Commun Dis Intell 2009;33(3):304–315.
World Health Organization. Tuberculosis control in the western pacific region. 2009 report. Available from http://stoptb.wpro.who.int
World Health Organization. Tuberculosis in the South-East Asia region. The regional report 2009. SEA-TB-315. Available from http://stoptb.searo.who.int
Lumb R, Bastian I, Carter R, Jelfs P, Keehner T, Sievers A. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2006. Commun Dis Intell 2008;32(1):12–17.
Lumb R, Bastian I, Carter R, Jelfs P, Keehner T, Sievers A. Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2007. Commun Dis Intell 2009;33(3):298–303.
Communicable Diseases Network Australia. National Strategic Plan for TB Control in Australia Beyond 2000.Commonwealth Department of Health and Ageing, Canberra; July 2002.
Australian Bureau of Statistics. Australian Demographic Statistics, June Quarter 2008.
Australian Bureau of Statistics. Australian Demographic Statistics, June Quarter 2009.
World Health Organization. Anti-tuberculosis drug resistance in the world. Fourth global report. QHO/HTM/TB/2008.394. Geneva; World Health Organization.
Waring J, Barry C, Konstantinos A, Stapleton R. Tuberculosis notifications in Australia, 2008/09. Commun Dis Intell 2011; In press.
Dawson D, Cheah DF, Chew F, Haverkort F, Lumb R, Sievers AS. Tuberculosis in Australia, 1989–1992. Bacteriologically confirmed cases and drug resistance. Med J Aust 1995;162(6):287–290.
World Health Organization. Anti-tuberculosis drug resistance in the world. Report No.3 WHO/HTM/TB/2004.343. Geneva; World Health Organization.
Van Deun A, Barrera L, Bastian I, Fattorini L, Hoffmann H, Kam KM, et al. Mycobacterium tuberculosis strains with highly discordant rifampin susceptibility test results. J Clin Microbiol 2009;47(11):3501–3506.
Ohno H, Koga H, Kohno S, Tashiro T, Hara K. Relationship between rifampin MICs and rpoB mutations of Mycobacterium tuberculosis strains isolated in Japan. Antimicrob Agents Chemother 1996;40(4):1053–1056.
Hilleman D, Rusch-Gerdes S, Richter E. Evaluation of the Genotype MTBDRplus assay for rifampicin and isoniazid susceptibility testing of Mycobacterium tuberculosis strains and in clinical specimens. J Clin Microbiol 2007;45(8):2635–2640.
Barnard M, Albert H, Coetzee G, O’Brien R, Bosman ME. Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Am J Crit Care Med 2008;177(7):787–792.
Boehme CC, Nabeta P, Hilleman D, Nicol MP, Shenai S, Krapp F, Allen J, et al. Rapid molecular detection of tuberculosis and rifampicin resistance. N Engl J Med 2010;363(11):1005–1015.
Blakemore R, Story E, Helb D, Kop J, Bandana P, Owens MR, et al. Evaluation of the analytical performance of the Xpert MTB/RIF assay. J Clin Microbiol 2010;48(7):2495–2501.
Hilleman D, Rusch-Gerdes S, Richter E. Feasibility of the genotype MTBDRsl assay for fluoroquinolone, amikacin, capreomycin, and ethambutol resistance testing of Mycobacterium tuberculosis strains and clinical specimens. J Clin Microbiol 2009;47(6):1767–1772.
Brossier F, Veziris N, Aubry A, Jarlier V, Sougakoff W. Detection by GenoType MTBDRsl Test of complex mechanisms of resistance to second-line drugs and ethambutol in multidrug-resistant Mycobacterium tuberculosis complex Isolates. J Clin Microbiol 2010;48(5):1683–1689.
Downloads
Published
How to Cite
License
Copyright (c) 2011 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
