Drug resistant tuberculosis is a major public health concern, particularly in New York City, which has one of the highest rates of tuberculosis in the country. It is more common in foreign-born, HIV infected patients, and injection drug users. Recent report from New York City Health Department indicates that approximately 16 percent of the mycobacterium tuberculosis isolates from the city are resistant to one or more anti-tuberculosis drugs. This study was done to determine the prevalence of drug resistant mycobacterial tuberculosis infection among Asian patients admitted to a community hospital in Queens County, New York.
Patients admitted to Flushing Hospital, from May 1999 to April 2002, with positive cultures for mycobacterium tuberculosis are included in the study. Pertinent data were collected by review of the medical records.
A total of 47 patients were admitted with a positive mycobacterial culture during the study period. Majority of the patients were Asians (72%). Majority of the patients (approximately 80%) gave no prior history of being diagnosed or treated for tuberculosis. The overall prevalence of resistance to one or more anti-tuberculosis drug was 25%. None of the patients were tested positive for HIV. Lung was the most common site of infection (91% among Asians and 60% among non-Asians). Among Asians, INH was the most commonly observed resistant drug (prevalence rate of 20.5%) followed by Rifampin and Streptomycin (3% each). There was one patient with MDRTB who had history of previous tuberculosis and treatment. In contrast, the prevalence of INH resistant tuberculosis among non-Asians was 15%. There were no cases of MDRTB in non-Asians.
The prevalence of INH resistant tuberculosis is highest (20.5%) among Asians in our study, who also has the highest incidence case rate (39.0 per 100,000) in New York City. None of our patients were tested positive for HIV.
Patients of Asian origin with tuberculosis have a significantly high rate of drug resistance and need to be investigated further.
M.M. Ramzan, None.