Ten years of prospective surveillance of Mycobacterium tuberculosis drug resistance in France (1995-2004)

¹ Université Pierre et Marie Curie-Paris6, Laboratoire de Bactériologie-Hygiène; and Centre National de Réference des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, APHP Groupe Hospitalier Pitié-Salpêtrière, France
² Laboratoire de Bactériologie, Hôpital Haut Lévêque, Pessac, Bordeaux, France
³ See list at the end of the text

^* To whom correspondence should be addressed. E-mail: jrobert{at}chups.jussieu.fr.

	Abstract

Drug resistance surveillance and trend monitoring of resistance rates bring some insights in tuberculosis control. We report the characteristics of tuberculosis and drug resistance during a 10-year prospective surveillance of culture-positive tuberculosis in France

Data collected from 1995 to 2004 through a sentinel network of laboratories of university hospital comply with international recommendations for surveillance of drug resistance. Susceptibility tests results were performed in each laboratory.

Data on 13,283 patients were collected during the 10-year period, 49% were French-born, 10% HIV-coinfected, and 8% previously treated. As expected, previously treated and HIV-coinfected patients were more likely to harbour resistant strains and especially rifampicin-resistant strains. Among new patients, the mean resistance rate to at least one drug was 8.8%, and there was an upward trend in resistance to isoniazid+rifampicin (0.8% to 1%; P=0.02) related to the increase in the proportion of foreign-born patients (38% to 53%). Among previously treated patients, the mean resistance rate to one drug was 20.6%, and there was no significant time trend in resistance rates.

The sentinel network provided valuable data on trends regarding the characteristics of tuberculosis and on drug resistance rates and reinforced the interest of analyzing data by country of birth and history of treatment.