Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-03T05:16:55.405Z Has data issue: false hasContentIssue false
  • English
  • Français

A bacteriological survey of tuberculosis due to the human tubercle bacillus (Mycobacterium tuberculosis) in South-East England: 1984–91

Published online by Cambridge University Press:  15 May 2009

M. D. Yates  and
J. M. Grange
M. D. Yates
Affiliation:
Public Health Laboratory Service, South East Regional Tuberculosis Centre, Dulwich Hospital, East Dulwich Grove, London SE22 8QF
J. M. Grange*
Affiliation:
Department of Microbiology, National Heart and Lung Institute, Royal Brompton Hospital, Sydney Street, London SW3 6NP
*
*Correspondence and requests for reprints.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The occurrence and nature of bacteriologically confirmed tuberculosis due to Mycobacterium tuberculosis in South-East England in the period 1984–91 is reported and compared with the results of a study for 1977–83. Registered new cases reached a low of 1028 in 1988 but increased to 1252 in 1991. This appeared to be due to a halt in the previous decline in new cases of European patients, a small increase in the number of Indian subcontinent (ISC) patients and an increase in patients from Africa. A total of 122 patients, mostly of European ethnic origin, were known to be HIV positive. As in the 1977–83 study, disease in the ISC group affected younger patients than in the European group, tubercle bacilli were more frequently isolated from a non-pulmonary site in the ISC group (45%) than in the European group (19%) and there was a higher incidence of the South Indian variant of M. tuberculosis in the former group (17%) than in the latter (9%). The overall incidence of drug resistance has not altered significantly since the 1977–83 study but 46 strains resistant to 3 or more drugs were isolated from 4099 ISC patients, compared with 3 of 4594 strains from European patients. Six of the 122 isolates from HIV positive patients were drug-resistant but none was multi-drug resistant.

The slight rise in registered bacteriologically proven cases of tuberculosis, the presence of multi-drug resistant strains, the occurrence of HIV-related tuberculosis and reports of the emergence of multi-drug-resistant HIV-related tuberculosis in other countries strongly indicate the need for continued careful surveillance.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 3 , June 1993 , pp. 609 - 619
Copyright
Copyright © Cambridge University Press 1993

References

REFERENCES

1.Report of a Working Group. Tuberculosis elimination in the countries of Europe and other industrialized countries. Europ Respir J 1991; 4: 1288–95.CrossRefGoogle Scholar
2.Medical Research Council Tuberculosis and Chest Disease Unit. National survey of tuberculosis notifications in England and Wales in 1983: characteristics of disease. Tubercle 1987; 68: 19–32.CrossRefGoogle Scholar
3.Grange, JM, Yates, MD. Collins, CH. Subdivision of Mycobacterium tuberculosis into five variants for epidemiological purposes: a seven year study of the ‘Classical’ and ‘Asian’ types of the human tubercle bacillus in South-East England. J Hyg 1985; 94: 9–21.CrossRefGoogle Scholar
4.Nisar, M, Narula, M, Beeching, N, Davies, PDO. HIV -related tuberculosis in England and Wales. Tubercle Lung Dis 1992; 73: 200–2.CrossRefGoogle ScholarPubMed
5.Festenstein, F. Grange, JM. Tuberculosis and the acquired immune deficiency syndrome. J Appl Bacteriol 1991; 71: 19–30.CrossRefGoogle ScholarPubMed
6.Collins, CH, Grange, JM, Yates, MD. Organization and practice in tuberculosis bacteriology. London: Butterworths, 1985.Google Scholar
7.Collins, CH, Yates, MD, Grange, JM. Subdivision of Mycobacterium tuberculosis into five variants for epidemiological purposes: methods and nomenclature. J Hyg 1982: 89: 235–42.CrossRefGoogle ScholarPubMed
8.Yates, MD. Collins, CH. Grange, JM. A study of the relationships between the resistance of Mycobacterium tuberculosis to isonicotinic acid hydrazide (isoniazid) and thiophen-2-carboxylic acid hydrazide. Tubercle 1984; 65: 295–9.CrossRefGoogle ScholarPubMed
9.Shafer, R. Chirgwin, K. Glatt, A. Dahdouh, M, Landesman, S. Suster, B. HIV prevalence, immunosuppression, and drug resistance in patients with tuberculosis in an area endemic for AIDS. AIDS 1991; 5: 399–405.CrossRefGoogle Scholar
10.Yates, MD. Grange, JM. Tuberculosis due to Mycobacterium boris in South-East England: 1977–1987. Epidemiol Infect 1988; 101: 225–9.CrossRefGoogle Scholar
11.Grange, JM, Yates, MD. Tuberculosis due to Mycobacterium africanum in South-East England: 1977–1987. Epidemiol Infect 1989; 103: 127–32.CrossRefGoogle Scholar
12.Rieder, HL. Misbehaviour of a dying epidemic: a call for less speculation and better surveillance. Tubercle Lung Dis 1992: 73: 181–3.CrossRefGoogle Scholar