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Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014
An outbreak of isoniazid-resistant tuberculosis first identified in London has now been ongoing for 20 years, making it the largest drug-resistant outbreak of tuberculosis documented to date worldwide. We identified culture-confirmed cases with indistinguishable molecular strain types and extracted...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Centre for Disease Prevention and Control (ECDC)
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356435/ https://www.ncbi.nlm.nih.gov/pubmed/28251890 http://dx.doi.org/10.2807/1560-7917.ES.2017.22.8.30467 |
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author | Smith, Catherine M Trienekens, Suzan C M Anderson, Charlotte Lalor, Maeve K Brown, Tim Story, Alistair Fry, Hannah Hayward, Andrew C Maguire, Helen |
author_facet | Smith, Catherine M Trienekens, Suzan C M Anderson, Charlotte Lalor, Maeve K Brown, Tim Story, Alistair Fry, Hannah Hayward, Andrew C Maguire, Helen |
author_sort | Smith, Catherine M |
collection | PubMed |
description | An outbreak of isoniazid-resistant tuberculosis first identified in London has now been ongoing for 20 years, making it the largest drug-resistant outbreak of tuberculosis documented to date worldwide. We identified culture-confirmed cases with indistinguishable molecular strain types and extracted demographic, clinical, microbiological and social risk factor data from surveillance systems. We summarised changes over time and used kernel-density estimation and k-function analysis to assess geographic clustering. From 1995 to 2014, 508 cases were reported, with a declining trend in recent years. Overall, 70% were male (n = 360), 60% born in the United Kingdom (n = 306), 39% white (n = 199), and 26% black Caribbean (n = 134). Median age increased from 25 years in the first 5 years to 42 in the last 5. Approximately two thirds of cases reported social risk factors: 45% drug use (n = 227), 37% prison link (n = 189), 25% homelessness (n = 125) and 13% alcohol dependence (n = 64). Treatment was completed at 12 months by 52% of cases (n = 206), and was significantly lower for those with social risk factors (p < 0.05), but increased over time for all patients (p < 0.05). The outbreak remained focused in north London throughout. Control of this outbreak requires continued efforts to prevent and treat further active cases through targeted screening and enhanced case management. |
format | Online Article Text |
id | pubmed-5356435 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | European Centre for Disease Prevention and Control (ECDC) |
record_format | MEDLINE/PubMed |
spelling | pubmed-53564352017-03-24 Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 Smith, Catherine M Trienekens, Suzan C M Anderson, Charlotte Lalor, Maeve K Brown, Tim Story, Alistair Fry, Hannah Hayward, Andrew C Maguire, Helen Euro Surveill Surveillance and Outbreak Report An outbreak of isoniazid-resistant tuberculosis first identified in London has now been ongoing for 20 years, making it the largest drug-resistant outbreak of tuberculosis documented to date worldwide. We identified culture-confirmed cases with indistinguishable molecular strain types and extracted demographic, clinical, microbiological and social risk factor data from surveillance systems. We summarised changes over time and used kernel-density estimation and k-function analysis to assess geographic clustering. From 1995 to 2014, 508 cases were reported, with a declining trend in recent years. Overall, 70% were male (n = 360), 60% born in the United Kingdom (n = 306), 39% white (n = 199), and 26% black Caribbean (n = 134). Median age increased from 25 years in the first 5 years to 42 in the last 5. Approximately two thirds of cases reported social risk factors: 45% drug use (n = 227), 37% prison link (n = 189), 25% homelessness (n = 125) and 13% alcohol dependence (n = 64). Treatment was completed at 12 months by 52% of cases (n = 206), and was significantly lower for those with social risk factors (p < 0.05), but increased over time for all patients (p < 0.05). The outbreak remained focused in north London throughout. Control of this outbreak requires continued efforts to prevent and treat further active cases through targeted screening and enhanced case management. European Centre for Disease Prevention and Control (ECDC) 2017-02-23 /pmc/articles/PMC5356435/ /pubmed/28251890 http://dx.doi.org/10.2807/1560-7917.ES.2017.22.8.30467 Text en This article is copyright of The Authors, 2017. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. |
spellingShingle | Surveillance and Outbreak Report Smith, Catherine M Trienekens, Suzan C M Anderson, Charlotte Lalor, Maeve K Brown, Tim Story, Alistair Fry, Hannah Hayward, Andrew C Maguire, Helen Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title | Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title_full | Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title_fullStr | Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title_full_unstemmed | Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title_short | Twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in England and Wales, 1995 to 2014 |
title_sort | twenty years and counting: epidemiology of an outbreak of isoniazid-resistant tuberculosis in england and wales, 1995 to 2014 |
topic | Surveillance and Outbreak Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356435/ https://www.ncbi.nlm.nih.gov/pubmed/28251890 http://dx.doi.org/10.2807/1560-7917.ES.2017.22.8.30467 |
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