MULTIDRUG-RESISTANT TUBERCULOSIS IN THE FLORENCE PROVINCE FROM 1992 TO 1995

SETTING: Epidemiological data on the frequency of drug-resistant tuber culosis is not available in Italy. OBJECTIVES: Evaluation of the rate of multidrug-resistant tuberculosis in the Province of Florence, Italy . DESIGN: Retrospective analysis of all sensitivity tests performed wi th the Bactec method on initial mycobacterial isolates, from 1 January 1992 to 31 December 1995, in the Province of Florence. RESULTS: The f ollowing rates of resistance were found in the 433 samples tested: iso niazid + rifampicin 2.5%, at least one drug 13.8%, isoniazid 10.G%, ri fampicin 3.6%, streptomycin 3.6%, pyrazinamide 1.7% and ethambutol 0.6 %. Resistance was higher in foreign-born individuals from high prevale nce countries than in the Italian-born population, whereas resistance to streptomycin was more frequent in the latter. The yearly rates of r esistance showed no significant variation in the period examined. Clin ical data were available in 231 patients: the rate of resistance to at least one drug and to isoniazid + rifampicin were 10.8% and 0%, respe ctively, in never treated patients, and 28.5% and 7.1%, respectively, in previously treated patients. CONCLUSION: These data show higher mul tidrug resistance rates than those found in other European countries s uch as England and Wales, France and Switzerland. This result suggests the need to establish official guidelines for the correct treatment o f tuberculosis in Italy, in order to prevent the onset of drug resista nce, and to establish a national surveillance system for mycobacterial resistance.