DRUG SUSCEPTIBILITY OF MYCOBACTERIUM-TUBERCULOSIS ISOLATES FROM RECENT HAITIAN MIGRANTS - CORRELATION WITH CLINICAL-RESPONSE

Between November 1991 and June 1993, similar to 11,000 Haitian migrant s were screened for active tuberculosis and human immunodeficiency vir us type 1 (HIV-1) infection at the U.S. Naval Base in Guantanamo Bay, Cuba. Cultures of specimens from 37 of these patients yielded Mycobact erium tuberculosis; eight (22%) of these isolates were resistant to st andard medications, including isoniazid (22%), rifampin (0), ethambuto l (3%), and streptomycin (3%). Two isolates (5.4%) were resistant to t wo drugs simultaneously. All but one of 340 patients who were treated for presumptive active tuberculosis and who were followed up for about 1 month had a favorable initial clinical response to a standard four- drug regimen. Among 259 HIV-1-infected patients who had normal finding s on screening chest radiographs and who received prophylaxis with iso niazid, there were 1.8 incident cases of active tuberculosis per 100 p erson-years; this rate was 76% lower than that (reported by others) am ong HIV-1-infected Haitian patients who were not treated with isoniazi d. No serious toxic effects due to standard four-drug regimens or to p rophylaxis with isoniazid were observed. These data suggest that stand ard empirical therapeutic interventions for tuberculosis are adequate and well tolerated in Haitian migrants.