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Database study of antibiotic resistant tuberculosis in the United Kingdom, 1994-6

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7182.497 (Published 20 February 1999) Cite this as: BMJ 1999;318:497
  1. Charles Irish, senior registrar in communicable disease control (charles@bhha.demon.co.uk)a,
  2. Josephine Herbert, Mycobacterial Resistance Network coordinatorb,
  3. Diane Bennett, consultant epidemiologistb,
  4. Clare Gilham, statisticianc,
  5. Francis Drobniewski, directord,
  6. Rhian Williams, clinical scientiste,
  7. E Grace Smith, consultant medical microbiologistf,
  8. John G Magee, head of unitg,
  9. Brian Watt, directorh,
  10. Maureen Chadwick, principal biomedical scientisti,
  11. John M Watson, consultant epidemiologistb
  1. aBrent and Harrow Health Authority, Harrow, Middlesex HA1 3EX
  2. bPublic Health Laboratory Service Communicable Disease Surveillance Centre, London NW9 5EQ
  3. cPublic Health Laboratory Service, Statistics Unit, London NW9 5EQ
  4. dPublic Health Laboratory Service Mycobacterium Reference Unit, King's College Hospital, London SE22 8QF
  5. eRegional Centre for Mycobacteriology, Cardiff Public Health Laboratory, University Hospital of Wales, Cardiff CF4 4XW
  6. fRegional Centre for Mycobacteriology, Birmingham Public Health Laboratory, Birmingham Heartlands Hospital, Birmingham B9 5ST
  7. gRegional Centre for Mycobacteriology, Newcastle Public Health Laboratory, General Hospital, Newcastle upon Tyne NE4 6BE
  8. hScottish Mycobacteria Reference Laboratory, City Hospital, Edinburgh EH10 5SB
  9. iDepartment of Microbiology, Royal Brompton Hospital, London SW3 6NP
  1. Correspondence to: Dr Irish, Brent and Harrow Health Authority, Grace House, Harrow, Middlesex HA1 3EX
  • Accepted 6 October 1998

The global increase in tuberculosis which has occurred in the 1980s and 1990s, and the associated re-emergence of resistance to antituberculous drugs, has focused attention on recent trends in resistance in Europe and the United States.13 In the United Kingdom overall drug resistance levels have been low.4 A surveillance system, the UK Mycobacterial Resistance Network (MYCOBNET), was established in 1994 by the Public Health Laboratory Service to record drug resistance in laboratory isolates of tuberculosis. We used data from this network to examine resistance among people with newly diagnosed tuberculosis.

Subjects, methods, and results

We analysed the data on initial isolates of Mycobacterium tuberculosis complex referred to United Kingdom reference laboratories5 during 1994 to 1996. Initial isolates were defined as the first positive culture from a person from whom no positive culture had been recorded during the past 12 months. Since M bovis isolates are intrinsically resistant to pyrazinamide …

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