TY - JOUR T1 - Drug-resistant tuberculosis among foreign-born persons in Italy JF - European Respiratory Journal JO - Eur Respir J SP - 497 LP - 500 DO - 10.1183/09031936.00021012 VL - 40 IS - 2 AU - Lanfranco Fattorini AU - Alessandro Mustazzolu AU - Giovanni Piccaro AU - Manuela Pardini AU - Perla Filippini AU - Federico Giannoni AU - Giovanni Battista Migliori AU - Giovanni Sotgiu AU - Emanuele Borroni AU - Daniela Maria Cirillo AU - the Italian Multicentre Study on Resistance to Antituberculosis Drugs (SMIRA) Group Y1 - 2012/08/01 UR - http://erj.ersjournals.com/content/40/2/497.abstract N2 - To the Editors:Over the last few years, drug-resistant tuberculosis (TB) has emerged as an important threat to public health in industrialised countries. In Italy, the most recent data on resistance to the first-line drugs (FLDs) streptomycin (S), isoniazid (H), rifampicin (R) and ethambutol (E) were reported for the period 1998–2001 [1]. These studies determined the prevalence of resistance among new cases and previously treated cases, but no information was available on the contribution of immigration, which plays an important role on TB epidemiology in low-incidence countries [2].In the last decade, while the notified incidence of TB in Italy was stable at approximately seven cases per 100,000 people annually, the proportion of foreign-born persons (FBPs) with TB increased from 22% in 1999 to 46% in 2008 [3]. In the same period, the proportion of African-born persons with TB decreased from 51% to 30%, whereas the proportion of European cases increased from 16% to 33%, most of them being born in Eastern Europe, including Former Soviet Union (FSU) countries.Eastern European countries are among those with the highest TB rates caused by multidrug-resistant (MDR) Mycobacterium tuberculosis strains (i.e. resistant to at least H and R) and extensively drug-resistant (XDR) strains (i.e. MDR strains resistant to any fluoroquinolone and to at least one injectable second-line drug (SLD): kanamycin (KM), capreomycin (CM), amikacin (AK)) [4].Reliable drug susceptibility testing (DST) is essential to diagnose TB caused by drug-resistant strains. In Italy, a network of laboratories coordinated by the World Health Organization (WHO) Supranational Reference Laboratory (SRL) in Rome performs drug susceptibility proficiency testing for S, H, R, E (five rounds from 1997 to 2010) and SLD (KM, AK, CM and ofloxacin (OFL)) (one round in 2010) [5].In order to understand … ER -