TY - JOUR 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 SP - 129 LP - 134 DO - 10.1183/09031936.03.00047402 VL - 21 IS - 1 AU - G.B. Migliori AU - R. Centis AU - L. Fattorini AU - G. Besozzi AU - C. Saltini AU - G. Orefici AU - C. Piersimoni AU - A. Gori AU - A. Cassone AU - the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) Study Group Y1 - 2003/01/01 UR - http://erj.ersjournals.com/content/21/1/129.abstract N2 - 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. ER -