Outbreak of isoniazid-resistant tuberculosis in an immigrant community in Spain

Arch Bronconeumol. 2016 Jun;52(6):289-92. doi: 10.1016/j.arbres.2015.07.014. Epub 2015 Nov 12.
[Article in English, Spanish]

Abstract

Background: Tuberculosis (TB) remains a major public health problem. In 2013, 9 million new cases of active TB were estimated globally and the proportion of reported new cases with multi-drug resistance (MDR) was 3.5%.

Methods: Contact tracing of a case of pulmonary tuberculosis was performed in a Bolivian patient. Diagnostic tests were performed according to national and local protocols.

Results: An outbreak of tuberculosis in an immigrant community was detected, with 5 cases originating from one index case. Genotyping and drug susceptibility testing of the sputum samples determined Mycobacterium tuberculosis resistant to isoniazid (KatG-msp unmutated/inhA 5RBS CT). Active case finding revealed a total of 39 contacts with an incidence of latent infection of 71.43%.

Conclusions: The present study confirms the importance of active case finding through contact tracing as well as rapid laboratory diagnosis to achieve improvements in early detection of TB. Early diagnosis of the patient, compliance with appropriate treatment protocols and monitoring of drug resistance are considered essential for the prevention and control of TB.

Keywords: Brote; Contact tracing; Drug-resistant tuberculosis; Estudio de contactos; Immigration; Infección tuberculosa latente; Inmigración; Latent tuberculosis; Outbreak; Tuberculosis resistente.

MeSH terms

  • Adult
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • BCG Vaccine
  • Bolivia / ethnology
  • Contact Tracing
  • Disease Outbreaks*
  • Emigrants and Immigrants*
  • Female
  • Humans
  • Interferon-gamma Release Tests
  • Isoniazid / pharmacology
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / epidemiology
  • Male
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification
  • Spain / epidemiology
  • Tuberculin Test
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / transmission
  • Tuberculosis, Pleural / drug therapy
  • Tuberculosis, Pleural / epidemiology
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / epidemiology*
  • Tuberculosis, Pulmonary / transmission

Substances

  • Antitubercular Agents
  • BCG Vaccine
  • Isoniazid