CONTINUING SURVEY OF TUBERCULOSIS PRIMARY DRUG-RESISTANCE IN UNITED-STATES - MARCH 1975 TO NOVEMBER 1977 - UNITED-STATES PUBLIC-HEALTH-SERVICE COOPERATIVE STUDY

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Abstract
This is the 1st report of a continuing survey of tuberculosis primary drug resistance conducted by the Center for Disease Control (CDC) in cooperation with 16 public health laboratories located throughout the USA. Between March 1975 and Nov. 1977, 3219 cultures of Mycobacterium tuberculosis were tested at the CDC for susceptibility to 10 antituberculosis drugs. These cultures were obtained from different patients initially believed to have newly diagnosed, previously untreated tuberculosis. Altogether, 344 cultures contained organisms resistant to 1 or more of the drugs, but 73 (21.2%) were eliminated from analysis when an in-depth investigation revealed that the patients from whom these cultures were obtained received previous treatment. On the basis of the remaining 3146 cultures, the average primary drug resistance rate was 8.6%, but rates varied markedly (3.4-18.7%) among the various geographic areas. Asians and Hispanics had the highest over-all resistance rates, 20.7% and 15.0%, respectively. Younger persons had significantly higher resistance rates than did older persons. Of the 271 cultures containing resistant organisms, 68.6% showed single-drug resistance, 17% were resistant to 2 drugs and 14.4% were resistant to 3 or more drugs. The specific drugs to which organisms were most frequently resistant were streptomycin (5.1%), isoniazid (4.4%) and p-aminosalicylic acid (1.3%). Resistance to rifampin and ethambutol was 0.3% and 0.7%, respectively.

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