Increasing antituberculosis drug resistance in the United Kingdom: analysis of national surveillance data

Michelle E. Kruijshaar, John M. Watson, Francis Drobniewski, Charlotte Anderson, Timothy J. Brown, John G. Magee, E. Grace Smith, Alistair Story, Ibrahim Abubakar

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Objective To identify recent trends in, and factors associated with, resistance to antituberculosis drugs in England, Wales, and Northern Ireland. Design Cohort of tuberculosis cases reported to the enhanced tuberculosis surveillance system matched to data on drug susceptibility and national strain typing data. Setting England, Wales, and Northern Ireland 1998-2005. Main outcome measures Unadjusted and adjusted odds ratios for drug resistance and associated factors. Proportion of multidrug resistant tuberculosis cases clustered. Results 28?620 culture confirmed cases were available for analysis. The proportion of cases resistant to isoniazid increased from 5% to 7%. Rifampicin resistance increased from 1.0% to 1.2% and multidrug resistance from 0.8% to 0.9%. Ethambutol and pyrazinamide resistance remained stable at around 0.4% and 0.6%, respectively. Regression analyses showed a significant increase in isoniazid resistance outside London (odds ratio 1.04, 95% confidence interval 1.01 to 1.07, a year, associated with changes in age (0.98, 0.98 to 0.99, a year), place of birth (1.49, 1.16 to 1.92), and ethnicity (P
Original languageEnglish
Pages (from-to)1231-1234
Number of pages4
JournalBritish Medical Journal
Issue number7655
Publication statusPublished - 31 May 2008

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