Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014.

摘要: An outbreak of isoniazid-resistant tuberculosis first identified in London has now been ongoing for 20 years, making it the largest drug-resistant documented to date worldwide. We culture-confirmed cases with indistinguishable molecular strain types and extracted demographic, clinical, microbiological social risk factor data from surveillance systems. summarised changes over time used kernel-density estimation k-function analysis assess geographic clustering. From 1995 2014, 508 were reported, a declining trend recent years. Overall, 70% male (n = 360), 60% born United Kingdom (n = 306), 39% white (n = 199), 26% black Caribbean (n = 134). Median age increased 25 years 5 42 last 5. Approximately two thirds reported factors: 45% drug use (n = 227), 37% prison link (n = 189), 25% homelessness (n = 125) 13% alcohol dependence (n = 64). Treatment was completed at 12 months by 52% (n = 206), significantly lower those factors (p < 0.05), but all patients (p < 0.05). The remained focused north throughout. Control this requires continued efforts prevent treat further active through targeted screening enhanced case management.