PT  - JOURNAL ARTICLE
AU  - Daniela Homorodean
AU  - Iuliana Husar
AU  - Cristian Popa
AU  - Felicia Cojocaru
AU  - Elmira Ibraim
TI  - First second line anti-tuberculosis drug resistance survey in Romania
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 397
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/397.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/397.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: It's estimated that Romania notifies about 800 MDR-TB cases yearly. The first XDR-TB case has been reported in 2006.Aim and objectives: To assess the second line anti-TB drugs resistance among MDR-TB patients and provide recommendations for MDR-TB case management at country level.Methods: The survey included all MDR-TB patients diagnosed countrywide from October 1st 2009 to January 31st 2010. Indirect proportion method on Lowenstein Jensen media has been used to test susceptibility to Izoniazid, Rifampicin, Kanamycin and Ofloxacin in four reference laboratories. Both clinicians and laboratory specialists have been trained before the start of the survey. Quality assurance for each laboratoty was performed before and durring the survey.Results: The results were assessed for 756 MDR-TB cases. Of them, 394 (52.1%) show resistance to only INH and RMP, 211 (27.9%) to INH, RMP, KM and 66 (8.7%) to INH, RMP, OFX. XDR-TB has been observed in 85 cases (11.2%). Any resistance to KM was almost double than any resistance to OFX (296 and 151 respectively). In 28% of subjects no DST was performed before the survey. The most frequent MDR-TB cases were chronics (285-37.7%), followed by relapses (191-25.3%), new cases (101-13.4%), retreatments after failure (92-12.2%) and retreatments after default (80-10.6%). In 7 cases (0.9%) the category by treatment history was unknown. Out of 388 HIV tested MDR-TB patients 10 (2.6%) were positive.Conclusions: The XDR-TB rate among MDR-TB cases in Romania is 11.2%. In order to early detect drug-resistant cases it's necessary to test all strains from retreated TB cases and from new cases with high risk for MDR.