Tuula Vasankari1, Hanna Soini, Kari Liippo, Petri Ruutu. 1. Epidemiologic Surveillance and Response Unit, Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland. tuula.vasankari@utu.fi
Abstract
INTRODUCTION: The multidrug-resistant tuberculosis (MDR-TB) epidemic in Eastern Europe bordering Finland has raised worries concerning the risk of disease in near-frontier contacts. OBJECTIVES: Our aim was to find out the amount of multidrug resistance, characterise the resistance profiles and evaluate the outcome of treatment. In addition, we analysed the isolates by molecular genotyping methods in order to evaluate the origins of the resistant isolates. METHODS: All culture-verified new MDR-TB cases diagnosed during the years 1994-2005 were included. Treatment outcome categories of the World Health Organization collected 36 months from the beginning of the treatment were used for outcome monitoring. The IS6110 restriction fragment length polymorphism (RFLP) test and spoligotyping were carried out according to standard recommendations. RESULTS: There were 19 culture-confirmed MDR-TB cases during the study period. The mean age was 39.9 years. The proportion of foreign-born patients was 73.7%. The outcome of the treatment was favourable in 14 cases (73.7%). When the spoligotypes were compared with the international spoligotype database, a corresponding spoligotype was found in 17 cases. Seven (36.8%) patients were infected by an isolate belonging to the Beijing genotype (SIT1). CONCLUSION: It is very probable that cases of MDR-TB in Finland are mostly caught abroad. Risk of gaining disease in near-frontier contacts seems to be very low.
INTRODUCTION: The multidrug-resistant tuberculosis (MDR-TB) epidemic in Eastern Europe bordering Finland has raised worries concerning the risk of disease in near-frontier contacts. OBJECTIVES: Our aim was to find out the amount of multidrug resistance, characterise the resistance profiles and evaluate the outcome of treatment. In addition, we analysed the isolates by molecular genotyping methods in order to evaluate the origins of the resistant isolates. METHODS: All culture-verified new MDR-TB cases diagnosed during the years 1994-2005 were included. Treatment outcome categories of the World Health Organization collected 36 months from the beginning of the treatment were used for outcome monitoring. The IS6110 restriction fragment length polymorphism (RFLP) test and spoligotyping were carried out according to standard recommendations. RESULTS: There were 19 culture-confirmed MDR-TB cases during the study period. The mean age was 39.9 years. The proportion of foreign-born patients was 73.7%. The outcome of the treatment was favourable in 14 cases (73.7%). When the spoligotypes were compared with the international spoligotype database, a corresponding spoligotype was found in 17 cases. Seven (36.8%) patients were infected by an isolate belonging to the Beijing genotype (SIT1). CONCLUSION: It is very probable that cases of MDR-TB in Finland are mostly caught abroad. Risk of gaining disease in near-frontier contacts seems to be very low.
Authors: Anna Odone; Taavi Tillmann; Andreas Sandgren; Gemma Williams; Bernd Rechel; David Ingleby; Teymur Noori; Philipa Mladovsky; Martin McKee Journal: Eur J Public Health Date: 2014-12-13 Impact factor: 3.367