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Volume 13, Number 3—March 2007


Worldwide Emergence of Extensively Drug-resistant Tuberculosis

N. Sarita Shah*1Comments to Author , Abigail Wright†, Gill-Han Bai‡2, Lucia Barrera§2, Fadila Boulahbal¶2, Nuria Martín-Casabona#2, Francis Drobniewski**2, Chris Gilpin††2, Marta Havelkovᇇ2, Rosario Lepe§§2, Richard Lumb¶¶2, Beverly Metchock*2, Françoise Portaels##2, Maria Filomena Rodrigues***2, Sabine Rüsch-Gerdes†††2, Armand Van Deun##2, Veronique Vincent‡‡‡2, Kayla Laserson*, Charles Wells*, and J. Peter Cegielski*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †World Health Organization, Geneva, Switzerland; ‡Korean Institute of Tuberculosis, Seoul, Republic of Korea; §National Institute of Infectious Diseases, Buenos Aires, Argentina; ¶Institut Pasteur d’Algérie, Alger, Algeria; #Hospital Universitaris Vall d’Hebron, Barcelona, Spain; **Health Protection Agency, London, United Kingdom; ††Prince Charles Hospital, Brisbane, Queensland, Australia; ‡‡National Institute of Public Health, Scrobarova, Czech Republic; §§Institute of Public Health of Chile, Providencia Santiago, Chile; ¶¶Institute of Medical and Veterinary Science, Adelaide, South Australia, Australia; ##Institute of Tropical Medicine, Antwerp, Belgium; ***National Institute of Health, Porto, Portugal; †††National Reference Center for Mycobacteria, Borstel, Germany; ‡‡‡Institut Pasteur, Paris, France; 1Current affiliation: Albert Einstein College of Medicine, Bronx, New York, USA; 2Member: World Health Organization/International Union against Tuberculosis and Lung Diseases Network of Supranational Reference Laboratories

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Table 2

Second-line–drug resistance patterns for Mycobacterium tuberculosis isolates, 2000–2004 (N = 17,690)*†

PatternOther 13 SRLs‡Republic of Korea SRL‡
(n = 5,751)(n = 11,939)
No. testedNo. (%) resistantNo. testedNo. (%) resistant
Any resistance5,7511,237 (21.5)11,939849 (7.1)
Aminoglycosides§5,620489 (8.7)11,939227 (1.9)
Capreomycin4,347197 (4.5)11,939122 (1.0)
Fluoroquinolones5,580298 (5.3)11,939524 (4.4)
Thioamides5,131556 (10.8)11,939259 (2.2)
Cycloserine2,71570 (2.6)11,93980 (0.7)
Para-aminosalicylic acid3,571262 (7.3)11,939403 (3.4)

*SRLs, Supranational Reference Laboratories.
†Not all isolates were tested for each second-line–drug class (with the exception of the Republic of Korea SRL), so results are reported as a proportion of isolates tested to the specified class of drugs.
‡Cells are not mutually exclusive.
§Other than streptomycin (e.g., kanamycin, amikacin).

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