United Kingdom: Cases of Drug-Resistant TB Have Doubled, Study Shows

Cases of drug-resistant TB almost doubled between 1998 and 2005, according to a Health Protection Agency study of 28,620 infections in England, Wales, and Northern Ireland. The authors of the study, published in the British Medical Journal, cited as reasons behind the increase immigration from India and sub-Saharan Africa and inadequate control measures for prisoners and drug users.

From 1998 to 2005, drug-resistant TB rose from 5.6 percent of all the TB cases to 7.9 percent. Infections resistant to at least one TB drug rose from 170 cases in 1998 to 336 in 2005, and multidrug-resistant cases grew from 23 to 39 during the same time.

Outside London, resistance to isoniazid increased significantly, especially among patients from India and the sub-Sahara.

In London, an outbreak of more than 300 resistant cases was found to have originated in 1999 among prison inmates and drug users. "The outbreak is still continuing, suggesting that control measures are insufficient," the authors wrote.

"The problem with drug-resistant tuberculosis is that it is still relatively uncommon but increasing," said Peter Davies, lead clinician at the National Multidrug-Resistant Tuberculosis Service. "Individual clinicians will have very little experience in managing cases."

The full report, "Increasing Antituberculosis Drug Resistance in the United Kingdom: Analyses of National Surveillance Data," was published on the British Medical Journal's Web site 2008;doi:10.1136/bmj.39546.573067.25).

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