Abstract
Although acquired multidrug-resistant (MDR)-tuberculosis (TB) is known to arise after inadequate treatment, transmission of MDR-TB has not been characterized well. We investigated risk factors for primary MDR-TB in Viet Nam.
In Hanoi, 543 previously untreated patients with smear-positive pulmonary TB were recruited. Sputum was collected before treatment and drug sensitivity test and spoligotyping of the isolates were performed. Adjusted odds ratio (OR) was calculated to analyze factors for primary drug resistance.
Of 489 isolates, 298 (60.9%) were sensitive to all drugs tested. Resistance to isoniazid, rifampicin, streptomycin and ethambutol accounted for 28.2%, 5.0%, 28.2% and 2.9%, respectively. Proportion of MDR-TB was 4.6%, mostly determined by rifampicin resistance. Younger age (25-44 years old) and living in urban area were significantly associated with isoniazid resistance (adjusted OR=2.08, 95%CI 1.29-3.35 and OR=2.34, 95%CI 1.25-4.39), whereas no factors analyzed were statistically significant for rifampicin resistance. HIV co-infection was a risk factor for MDR-TB (adjusted OR=4.37, 95%CI 1.51-12.64). Of 22 MDR-TB isolates, 14 (63.6%) were classified as Beijing type and 6 (27.3%) were a Vietnamese type EAI4_VNM; These two types accounted for more than 90%.
MDR-TB in HIV prevalent area of a large city should be carefully monitored to avoid increasing risk.
- © 2011 ERS