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Volume 21, Number 3—March 2015
Research

Multidrug-Resistant Tuberculosis in Europe, 2010–2011

Gunar Günther, Frank van Leth, Sofia Alexandru, Neus Altet, Korkut Avsar, Didi Bang, Raisa Barbuta, Graham Bothamley, Ana Ciobanu, Valeriu Crudu, Manfred Davilovits, Martin Dedicoat, Raquel Duarte, Gina Gualano, Heinke Kunst, Wiel de Lange, Vaira Leimane, Cecile Magis-Escurra, Anne-Marie McLaughlin, Inge Muylle, Veronika Polcová, Emanuele Pontali, Christina Popa, Rudolf Rumetshofer, Alena Skrahina, Varvara Solodovnikova, Victor Spinu, Simon Tiberi, Piret Viiklepp, Christoph LangeComments to Author , and TBNET
Author affiliations: University of Namibia School of Medicine, Windhoek, Namibia (G. Günther, C. Lange); German Center for Infection Research, Research Center Borstel, Borstel, Germany (G. Günther, C. Lange); University of Amsterdam, Amsterdam, the Netherlands (F. van Leth); Institute of Phthisiopneumology, Chisinau, Moldova (S. Alexandru, A. Ciubanu, V. Crudu); Hospital Universitari Vall d’Hebron, Barcelona, Spain (N. Altet); Jordi Gol University, Barcelona (N. Altet); Asklepios Klinik Gauting, Gauting, Germany (K. Avsar); Statens Serum Institut, Copenhagen, Denmark (D. Bang); Herlev Hospital, Herlev, Denmark (D. Bang); Balti Municipal Hospital, Balti, Moldova (R. Barbuta); Homerton University Hospital, London, UK (G. Bothamley); National TB Reference Laboratory, Chisinau, Moldova (V. Crudu); Tartu University Lung Hospital, Tartu, Estonia (M. Danilovits); University of Warwick, Coventry, UK (M. Dedicoat); Heart of England Foundation Trust, Birmingham, UK (M. Dedicoat, H. Kunst); Vila Nova de Gaia/Espinho Medical School, Vila Nova de Gaia, Portugal (R. Duarte); Porto University, Porto, Portugal (R. Duarte); National Institute for Infectious Diseases L. Spallanzani, Rome, Italy (G. Gualano); Queen Mary University, London (H. Kunst); University Medical Center Groningen, Groningen, the Netherlands (W. de Lange); Riga East University Hospital, Riga, Latvia (V. Leimane); Radboud University Medical Centre, Nijmegen/Groesbeek, the Netherlands (C. Magis-Escurra); St. James's Hospital, Dublin, Ireland (A.-M. McLaughlin); University Medical Center St. Pieter, Brussels, Belgium (I. Muylle); Thomayer University Hospital, Prague, Czech Republic (V. Polcavá); Galliera Hospital, Genoa, Italy (E. Pontali); Marius-Nasta-Institut, Bucharest, Romania (C. Popa, V. Spinu); Otto Wagner Hospital, Vienna, Austria (R. Rumetshofer); Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus (A. Skrahina, Varvara Solodovnikova); Azienda Ospedaliera della Valtellina e della Valchiavenna E. Morelli Reference Hospital for MDR and HIV-TB, Sondalo, Italy (S. Tiberi); Barts Health National Health Service Trust, London (S. Tiberi); National Institute for Health Development, Tallinn, Estonia, (P. Viiklepp); Karolinska Institute, Stockholm, Sweden (C. Lange)

Main Article

Table 2

Drug resistance profiles for first-line and second-line drugs used for treatment of multidrug-resistant tuberculosis in TBNET study in Europe, 2010–2011*

Drug†
 Incidence of TB in region
 All MDR TB patients, 
n = 380
Low, n = 103†
Intermediate n = 86‡
High n = 191§
Tested
 Resistant
 Tested
 Resistant
 Tested
 Resistant
 Tested
 Resistant
First-line
Pyrazinamide 97 (94.2) 52 (53.6) 70 (81.4) 49 (71.0) 10 (5.2) 4 (40.0) 177 (45.0) 105 (59.7)
Ethambutol 99 (96.1) 50 (50.5) 85 (98.9) 55 (64.7) 187 (97.9) 115 (61.5) 371 (97.6) 220 (59.3)
Streptomycin
 93 (90.3)
 78 (83.9)
85 (98.9)
 82 (96.5)
187 (97.9)
 171 (91.4)
 365 (96.1)
 331 (90.7)
≥1 non–first line
 101 (97.1)
 66 (65.4)
86 (100)
 64 (74.4)
173 (86.4)
 64 (37.0)
 360 (94.7)
 194 (51.1)
Class II
Amikacin 95 (92.2) 17 (17.9) 85 (98.8) 25 (29.4) 1 (0.5) 0 181 (47.6) 42 (23.2)
Kanamycin 39 (37.9) 8 (20.5) 79 (91.9) 37 (46.8) 170 (89.0) 23 (13.5) 288 (75.8) 68 (23.6)
Capreomycin 88 (85.4) 15 (17.0) 84 (97.7) 26 (31.0) 94 (49.2) 4 (4.3) 266 (71.1) 45 (16.9)
≥1 second-line inj.
 100 (97.1)
 24 (24.0)
86 (100)
 42 (48.8)
170 (89.0)
 27 (15.9)
 356 (93.7)
 93 (26.1)
Class III
Ofloxacin 69 (67.0) 16 (23.2) 86 (100) 26 (30.2) 169 (88.5) 14 (8.3) 324 (85.3) 56 (17.3)
Levofloxacin 16 (15.5) 1 (6.2) 7 (8.1) 1 (14.3) 10 (5.2) 2 (20.0) 32 (8.4) 4 (12.5)
Moxiflocacin 61 (59.2) 14 (23.0) 12 (14.0) 3 (25.0) 0 73 (19.2) 17 (23.3)
≥1 fluoroquinolone
 96 (96.2)
 21 (21.9)
86 (100)
 26 (30.2)
170 (89.0)
 15 (8.8)
 352 (92.6)
 62 (17.6)
Class IV
ETO/PTO 98 (95.1) 47 (48.0) 86 (100) 36 (41.9) 170 (89.0) 36 (21.2) 354 (93.2) 119 (31.3)
PAS 54 (52.4) 10 (18.5) 68 (79.1) 10 (14.7) 175 (91.6) 2 (1.1) 295 (77.6) 22 (7.5)
DCS/TRD
 53 (51.5)
 6 (11.3)
69 (80.2)
 13 (18.8)
100 (52.4)
 5 (5.0)
 220 (57.9)
 23 (10.6)
Class V
Linezolid 62 (60.2) 2 (3.2) 6 (7.0) 0 1 (0.5) 0 69 (18.2) 2 (2.9)
Imipenem 0 0 0 0 0 0 0 0
Meropenem 1 (1.0) 1 (100) 0 0 0 0 1 (0.3) 1 (100)
AMX/CLV 0 0 0 0 0 0 0 0
Clarithromycin 17 (16.5) 3 (17.7) 0 0 0 0 17 (4.5) 3 (17.6)

*Values are no. (%) samples. Unweighted analysis was used. TB, tuberculosis; MDR TB, multidrug-resistant tuberculosis; inj, injectable; ETO/PTO, ethionamide/prothionamide; PAS, para-aminosalicylic acid; DCS/TRD, cycloserine/terizidone; AMX/CLV, amoxicillin/clavulanic acid.
†Austria, Belgium, Czech Republic, Denmark, Germany, Great Britain, Ireland, Netherlands, Italy, and Spain.
‡Belarus, Estonia, Latvia, and Portugal.
§Moldova and Romania.

Main Article

1Additional contributors from TBNET are listed at the end of this article.

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Page updated: February 18, 2015
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