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Volume 11, Number 3—March 2005

Letter

Mycobacterium tuberculosis Drug Resistance, Abkhazia

Manuela Pardini*1, Elisabetta Iona*1, Francis Varaine†, Hayk Karakozian†, Herchanik Arzumanian‡, Lara Brunori*, Graziella Orefici*, Lanfranco Fattorini*Comments to Author , and the LONG-DRUG Study Group
Author affiliations: *Istituto Superiore di Sanità, Rome, Italy; †Médecins Sans Frontières, Paris, France; ‡Guliripchi Tuberculosis Hospital, Sukhumi, Abkhazia

Main Article

Table

First-line and second line antituberculosis drug resistance in 447 Mycobacterium tuberculosis strains collected in Abkhazia from September 2000 to April 2004*

No. new cases (%) No. previously treated cases (%) Total no. (%)
Total tested 246 (100) 201 (100) 447 (100)
Any first-line resistance 88 (35.8) 115 (57.2) 203 (45.4)
Monoresistance
H only 31 (12.6) 28 (13.9) 59 (13.2)
S only 20 (8.1) 11 (5.5) 31 (6.9)
R only 1 (<1) 1 (<1) 2 (<1)
E only 2 (<1) 1 (<1) 3 (<1)
Any drug resistance
Any H resistance 65 (26.4) 102 (50.7) 167 (37.4)
Any S resistance 51 (20.7) 80 (39.8) 131 (29.3)
Any R resistance 13 (5.3) 52 (25.9) 65 (14.5)
Any E resistance 14 (5.7) 35 (17.4) 49 (11)
H and R resistance
MDR† 12 (4.9) 51 (25.4) 63 (14.1)
HRES only 7 (2.8) 24 (11.9) 31 (6.9)
HRS only 4 (1.6) 22 (10.9) 26 (5.8)
HRE only 0 3 (1.5) 3 (<1)
HR only 1 (<1) 2 (<1) 3 (<1)
H + other resistances
HS only 17 (6.9) 16 (8) 33 (7.4)
HES only 3 (1.2) 7 (3.5) 10 (2.2)
HE only 2 (<1) 0 2 (<1)
R + other resistances (RE, RS, or RES only) 0 0 0
Total tested to second-line drugs 88 (100) 115 (100) 203 (100)
Any second-line resistance 14 (15.9) 41 (35.7) 55 (27.1)
KM 4 (4.5) 25 (21.7) 29 (14.3)
ETH 7 (8) 19 (16.5) 26 (12.8)
CM 3 (3.4) 6 (5.2) 9 (4.4)
PAS 2 (2.3) 4 (3.5) 6 (3)
OFL 0 3 (2.6) 3 (1.5)
CS 0 0 0
Total MDR strains resistant to second-line drugs‡ 3 (25) 27 (52.9) 30 (47.6)
MDR + KM 2 (16.7) 10 (19.6) 12 (19)
MDR + ETH 0 5 (9.8) 5 (7.9)
MDR + KM + ETH 0 5 (9.8) 5 (7.9)
MDR + others§ 1 (8.3) 7 (13.7) 8 (12.7)

*H, isoniazid; S, streptomycin; R, rifampin; E, ethambutol; KM, kanamycin; ETH, ethionamide; CM, capreomycin; PAS, p-aminosalicylic acid; OFL, ofloxacin; CS, cycloserine.
†MDR, multidrug resistant (resistant to at least H and R).
‡Values in parenthesis are the percentages of MDR strains.
§For new cases: MDR + KM + CM + PAS (1 strain); for previously treated cases: MDR + KM + CM (2 strains), MDR + KM + PAS (1 strain), MDR + KM + ETH + CM (1 strain), MDR + ETH + OFL (1 strain), MDR + PAS (1 strain), MDR + PAS + CM (1 strain).

Main Article

1These authors contributed equally to this study.

2The members of the LONG-DRUG study group are Marco Rinaldo Oggioni, Francesca Meacci, and Claudia Trappetti (Dipartimento di Biologia Molecolare, Siena Italy); Francesco Checchi and Maryline Bonnet (Epicentre, Paris, France); Graziella Orefici, Lanfranco Fattorini, and Manuela Pardini (Istituto Superiore di Sanità, Rome, Italy); Peter W. Andrew, Mike Barer, and Hasan Yesilkaya (University of Leicester, Leicester, United Kingdom); Heinz Rinder (LGL, Oberschleiβheim, Germany); Sabine Rüsch-Gerdes and Stefan Niemann (Research Centre Borstel, Borstel, Germany); Germano Orrù (University of Cagliari, Cagliari, Italy); Francis Varaine (Médecins Sans Frontières, Paris, France); and Thierry Jarosz, (3Es, Paris, France).

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