An outbreak of multidrug-resistant tuberculosis among refugees in Austria, 2005-2006

• Published in: The international journal of tuberculosis and lung disease Vol. 12; no. 10; pp. 1190 - 1195
• Main Authors: SCHMID, D, FRETZ, R, ALLERBERGER, F, KUO, H-W, RUMETSHOFER, R, MEUSBURGER, S, MAGNET, E, HÜRBE, G, INDRA, A, RUPPITSCH, W, PIETZKA, A. T
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.10.2008; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adult; Antitubercular Agents - administration & dosage; Austria - epidemiology; Biological and medical sciences; Disease Outbreaks; Female; Genotype; Human immunodeficiency virus; Humans; Incidence; Infant; Male; Medical sciences; Miru; Miscellaneous; Multidrug-Resistant; Mycobacterium; Outbreak; Pneumology; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Refugees; Spoligotyping; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Multidrug-Resistant - genetics; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - epidemiology; Tuberculosis, Pulmonary - genetics; Austria; Europe; Refugee; spoligotyping; Mycobacterial infection; multidrug-resistant; 2006; 2005; Multiple resistance; Bacteria; Genetics; outbreak; Public health; Pneumology; Epidemic; Human; Treatment resistance; Typing; Genotype; Infection; Tuberculosis; Mycobacterium tuberculosis; Mycobacteriales; Bacteriosis; Mycobacteriaceae; Actinomycetes; MIRU
• ISSN: 1027-3719; 1815-7920

SETTING: In 2005-2006, the Austrian reference laboratory for tuberculosis (TB) identified multidrug-resistant (MDR) isolates from four cases of TB showing genotypes indistinguishable from each other.OBJECTIVE: To clarify the chain of transmission of this MDR-TB strain.DESIGN: An epidemiological case series investigation by reviewing TB notification reports and hospital discharge letters.RESULTS: The 38-year-old primary case of the MDR-TB cluster had initially been identified as a case of non-MDR pulmonary TB in June 2004, 7 months after being detained for illegal immigration. In March 2005, he was lost to follow-up for 4 months. In June 2005, he presented with pulmonary and laryngeal TB due to MDR-TB. After discharge, the case was again lost to follow-up until April 2006, when he was readmitted with recurrent MDR-TB. A three-case cluster of pulmonary MDR-TB sharing the same strain as the primary case was detected in April 2006: the index case's 5-month-old daughter and a 25-year-old friend with a 6-month-old son.CONCLUSION: As MDR-TB has originated in the human immunodeficiency virus seronegative community in Austria, there is a clear need to implement national guidelines for the management of drug-resistant TB in Austria.