International Journal of Tuberculosis and Lung Disease
Volume 3, Issue 8, 1999, Pages 689-694

Drug-resistant pulmonary tuberculosis in Israel, a society of immigrants: 1985-1994 (Article)

Sosna J. , Shulimzon T. , Roznman J. , Lidgi M. , Lavy A. , Ben-Dov I.Z. , Ben-Dov I.*
  • a Department of Radiology, Haddasha University Medical Center, Jerusalem, Israel
  • b Pulmonary Institute, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
  • c Department of Radiology, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel
  • d Shmuel Haroffe Medical Center, Department of Respiratory Diseases, Beer Jackob, Israel
  • e Ministry of Health, Mycobacterium Reference Laboratory, Tel-Aviv, Israel
  • f Haddasah Hebrew Univ. Medical School, Jerusalem, Israel
  • g Pulmonary Institute, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel, Pulmonary Institute, Tel-Hashomer Medical Center, Tel-Aviv University, Tel-Hashomer, 52621, Israel

Abstract

SETTING AND OBJECTIVES: Drug-resistant tuberculosis was uncommon in Israel until 1985, when the waves of immigration began. We studied the incidence and clinical course of resistant pulmonary tuberculosis nationwide, DESIGN: Isolates of Mycobacterium tuberculosis between 1985 and 1994 were surveyed, Data on 150 patients with resistance and 110 patients with drug- sensitive disease were reviewed. Ethnic origin, type of resistance, radiological findings and outcome were analysed. RESULTS: In total, 16.7% of the isolates showed resistance to at least one drug; 58% had resistance to multiple drugs. In 67% of the patients the resistance was primary. Most patients were immigrants from the former USSR and from Ethiopia; none were Israeli-born Jews. Mortality with resistance was 10%, and was highest (14%) with multiple drug resistance. Mortality among drug-resistant cases was lowest (3%) among Ethiopian Jews. Cavities and extensive disease were more common with drug resistance. CONCLUSION: Drug resistance has become relatively common in Israel due to immigration from the former USSR and Ethiopia. It is more extensive radiologically and carries a poorer outcome.

Author Keywords

Outcome Mortality Primary and secondary resistance Radiographic findings

Index Keywords

Israel bacterium isolation immigration human controlled study Mycobacterium tuberculosis priority journal ethnology Treatment Outcome male female tuberculosis Article drug sensitivity major clinical study multidrug resistance adult isoniazid thorax radiography ethambutol rifampicin pyrazinamide mortality
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032768801&partnerID=40&md5=52384a80f630c5e2636e3ad265fb0aaf
ISSN: 10273719
Cited by: 6
Original Language: English