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Isoniazid-Resistant TB on the Rise in United Kingdom

Drug-resistant cases increased from 1998 to 2005, possibly due to increase in cases acquired abroad

FRIDAY, May 2 (HealthDay News) -- The proportion of tuberculosis cases resistant to isoniazid in England, Wales and Northern Ireland rose between 1998 and 2005, due to larger numbers of patients from other nations who may have acquired their resistance abroad, according to research published May 1 in BMJ Online First.

Michelle E. Kruijshaar, Ph.D., of the Health Protection Agency in London, U.K., and colleagues analyzed data from national systems that track tuberculosis cases and drug susceptibility. They included 28,620 culture-confirmed cases for analysis.

During these years, the percentage of cases resistant to any first-line drug rose from 5.6 to 7.5 percent, the investigators found. The proportion of cases resistant to isoniazid rose from 5 to 7 percent; rifampicin resistance increased from 1.0 to 1.2 percent and multidrug resistance increased from 0.8 to 0.9 percent. The rise in isoniazid resistance is likely related to increasing numbers of individuals from sub-Saharan Africa and the Indian subcontinent with drug-resistant disease, the authors report.

"Recent efforts have revitalized research into new diagnostics for tuberculosis, some of which identify Mycobacterium tuberculosis and give isoniazid and rifampicin sensitivities within 24 hours. These will greatly reduce the time that patients are treated with inappropriate regimens, with direct implications for the health of patients and onward transmission," write the authors of an accompanying editorial. "Treating patients with regimens that contain insufficient drugs to which the strain is sensitive will promote further resistance."

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