Abstract
Long-term hospitalization of patients with tuberculosis in high-burden countries for M. tuberculosis drug-resistance may increase the risk for nosocomial acquaintance of multidrug-resistant tuberculosis.
Scope: To assess the proportion of possible transmission of MDR bacilli during inpatient treatment.
Method: We analyzed 76/173 (42.2%) patients with non-MDR M. tuberculosis strains at baseline with a MDR-TB diagnosis during the follow-up period, for which M. tuberculosis DNA was available from both time points. Genotyping could be applied for 67/76 (88.1%) pairs of pre-treatment (non-MDR) strains and follow-up (MDR) strains of M. tuberculosis.
Results: Overall, the majority of the 67 patients (n=50, 74.6%) had a different strain in the follow-up sample when compared to the baseline isolate and in just 17 cases (25,4%) we observed identical genotyping patterns.
The highest proportion (27/67, 40.3%) of follow-up MDR isolates was associated with a specific URAL 163-15, followed by Beijing strains.
Conclusion: Nosocomial transmission of MDR strains of M. tuberculosis appears to be an important cause of TB treatment failure in hospitals in the Republic of Moldova evaluated in this study. To decrease risk of nosocomial M. tuberculosis transmission, strong infection control measures should be enforced. Strengthening the ambulatory treatment sector can avoid unnecessary hospital admissions and may allow for early discharge from hospitals when patients are not regarded to be infectious anymore.
- Copyright ©ERS 2015