Respiratory Care |

Are Primary MDR and XDR Tuberculosis a New Version of Tuberculosis in Romania? FREE TO VIEW

Oana Arghir, MD; Gilda Popescu, MD
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Clinical Hospital Of Pulmonology, Constanta, Romania

Chest. 2014;146(4_MeetingAbstracts):914A. doi:10.1378/chest.1994753
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SESSION TITLE: Respiratory Infections Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To assess the impact of Primary Multiple Drug Resistant (MDR) and Extensively Drug Resistant (XDR) Tuberculosis (TB) on epidemiological trend of TB in Romania from January 2010 to December 2013.

METHODS: An epidemiological survey on the prevalence of primary anti-tuberculosis drug resistance was conducted on Pulmonary TB cases annually diagnosed in Romania, from January 2010 to December 2013. Mycobacterial isolates were tested for sensitivity to first and second-line anti tuberculosis drugs and drug resistance profile was monitoring. Surveillance of computerized national data was collected from 42 counties and 6 sectors of Bucharest by TB Surveillance Unit of Pneumology «Marius Nasta» Institute, Bucharest, Romania. The case detection rate of primary and acquired drug resistance was determined.

RESULTS: From 2010 to 2013, in Romania, the number of newly TB cases annually registered decreased from 21,078 to 16,817; TB prevalence decreased from 40,030 to 34,071 cases but the prevalence of MDR-TB increased from 3.88% to 4.23%; 1976 cases of Pumonary TB disease were identified with MDR strains of Mycobacterium tuberculosis, respectively 111 with XDR profile of resistance. Almost a half of notificated TB cases were investigated by drug sensitivity testing. The structure of MDR-TB reveals a progressive trend of Primary MDR TB strains from 20.20% (116/574) in 2010 to 22.82% (76/333) in 2013. Primary XDR-TB cases have the tendency to decreased from 7 to 1. The effectiveness of therapy in patients with Pulmonary MDR-TB was reported as treatment success rate of 59% to 75%, failure rate of 10% to 16%, abandon from 8% to 13% and death outcome from 7% to 13%.

CONCLUSIONS: The prevalence of MDR is low but the progresive ascendent trend of primary MDR TB strains represents a red fleg for the burden of tuberculosis in Romania.

CLINICAL IMPLICATIONS: Possible outbreaks of MDR and XDR-TB may represent a turning point in TB epidemics. Primary MDR-TB and the most severe XDR-TB are difficult or impossible to be treated and may lead the way to a broken barrier of the health frontier among human comunities.

DISCLOSURE: The following authors have nothing to disclose: Oana Arghir, Gilda Popescu

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