RT Journal Article
SR Electronic
T1 Monitoring the quality of laboratories and the prevalence of resistance to antituberculosis drugs: Italy, 1998–2000
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 129
OP 134
DO 10.1183/09031936.03.00047402
VO 21
IS 1
A1 G.B. Migliori
A1 R. Centis
A1 L. Fattorini
A1 G. Besozzi
A1 C. Saltini
A1 G. Orefici
A1 C. Piersimoni
A1 A. Gori
A1 A. Cassone
A1 the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) Study Group
YR 2003
UL http://erj.ersjournals.com/content/21/1/129.abstract
AB In 1998 a network of 20 regional tuberculosis (TB) laboratories (the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) network) was established in Italy to implement proficiency testing and to monitor the prevalence of drug resistance nationwide. The network managed 30% of all TB cases reported in Italy each year. The aim of the present report is to describe: 1) the accuracy of drug-susceptibility testing in the network; 2) the prevalence of drug resistance for the period 1998–2000. Data were collected from the network laboratories. Sensitivity to streptomycin and ethambutol increased from the first survey (1998–1999) to the second survey (2000) from 87.7 to 91.9%. Specificity, predictive values for resistance and susceptibility, efficiency and reproducibility were consistent in both surveys. In previously untreated cases, the prevalence of multidrug-resistance was the same in both surveys (1.2%), while a slight decrease from the first to the second survey was observed for monoresistance to rifampicin (from 0.8 to 0.4%) and isoniazid (from 2.9 to 2%). The significant association found between isoniazid resistance and immigration is a useful indicator for both clinicians managing individual tuberculosis cases and public health services planning control strategies. This study was supported by grants from Istituto Superiore di Sanità, Rome, (National Tuberculosis Project), from the WHO and from AIPO, Grant No. TBC1.