[M. tuberculosis complex drug resistance in Navarre: differences between the local and immigrant populations]. / Resistencias de M. tuberculosis complex en Navarra: diferencias entre población autóctona e inmigrante (2000-2007).

BACKGROUND: Tuberculosis is an important public health problem, whose epidemiology in our country has changed in recent years due to the increase in the immigrant population. The aim of this article is to evaluate the frequency of resistance to the four principal antitubercular drugs in both the local and immigrant populations. METHODS: A study was made of the antibiograms of 457 isolations of Mycobacterium tuberculosis carried out in the Hospital of Navarre in 2000-2007. The antibiograms were processed using the BACTEC460TB system. RESULTS: Twenty six point three percent of the strains corresponded to immigrants, with a significant increase occurring over the period. The frequencies of resistances to the different antitubercular drugs in the local and immigrant populations respectively were: to at least one 5.6% vs 20.8% (p <0.001); to isoniazid 4.5% vs 14.2% (p <0.001); to streptomycin 2.4% vs 12.6% (p <0.001); to rifampicin 0.9% vs 5% (p <0.05); to ethambutol 0.3% vs 2.5% (p <0.05); and multiresistance 0.3% vs 2.5% (p <0.05). CONCLUSION: There are significant differences between local and immigrant populations in the pattern of resistances of the strains isolated. The immigrant population, due to the high frequency with which resistance is shown to isoniazid, must be treated initially with a pattern of four drugs until the result of the biogram is available.

Resistencias de M. tuberculosis complex en Navarra: diferencias entre población autóctona e inmigrante (2000-2007) / M. tuberculosis complex drug resistance in Navarre: differences between the local and immigrant populations

Fundamento. La tuberculosis es un importante problemade salud pública, cuya epidemiología ha cambiadoen los últimos años en nuestro país debido al aumentode población inmigrante. El objetivo de este trabajo hasido valorar la frecuencia de resistencias a los cuatroantituberculosos principales, tanto en población autóctonacomo inmigrante.Material y métodos. Se han estudiado los antibiogramasde 457 aislamientos de Mycobacterium tuberculosisrealizados en el Hospital de Navarra en el periodo 2000-2007. Los antibiogramas fueron procesados mediante elsistema BACTEC460TB.Resultados. El 26,3% de las cepas correspondieron a inmigrantes,produciéndose a lo largo del periodo un incrementosignificativo. Las frecuencias de resistenciasa los distintos fármacos antituberculosos en poblaciónautóctona e inmigrante, respectivamente fueron: a almenos uno 5,6% vs 20,8% (p <0,001), a isoniacida 4,5%vs 14,2% (p <0,001), a estreptomicina 2,4% vs 12,5% (p<0,001), a rifampicina 0,9% vs 5% (p <0,05), a etambutol0,3% vs 2,5% (p <0,05) y multirresistencia 0,3% vs 2,5%(p <0,05).Conclusión. Existen diferencias significativas entre lapoblación autóctona e inmigrante en el patrón de resistenciasde las cepas aisladas. Esta última, debidoa la alta frecuencia con que presenta resistencia a laisoniacida, debe tratarse inicialmente con una pautade cuatro fármacos hasta disponer del resultado del antibiograma(AU)

Background. Tuberculosis is an important publichealth problem, whose epidemiology in our countryhas changed in recent years due to the increase in theimmigrant population. The aim of this article is to evaluatethe frequency of resistance to the four principalantitubercular drugs in both the local and immigrantpopulations.Methods. A study was made of the antibiograms of 457isolations of Mycobacterium tuberculosis carried out inthe Hospital of Navarre in 2000-2007. The antibiogramswere processed using the BACTEC460TB system.Results. Twenty six point three percent of the strainscorresponded to immigrants, with a significant increaseoccurring over the period. The frequencies of resistancesto the different antitubercular drugs in the local andimmigrant populations respectively were: to at leastone 5.6% vs 20.8% (p <0.001); to isoniazid 4.5% vs 14.2%(p <0.001); to streptomycin 2.4% vs 12.5% (p <0.001);to rifampicin 0.9% vs 5% (p <0.05); to ethambutol 0.3%vs 2.5% (p <0.05); and multiresistance 0.3% vs 2.5% (p<0.05).Conclusion. There are significant differences betweenlocal and immigrant populations in the pattern of resistancesof the strains isolated. The immigrant population,due to the high frequency with which resistanceis shown to isoniazid, must be treated initially with apattern of four drugs until the result of the biogram is available(AU)