hiv infection and geographically bound transmission of drug-resistant tuberculosis, argentina

Emerging Infectious Disease HIV Infection and Geographically Bound Transmission of Drug-Resistant Tuberculosis, Argentina Viviana Ritacco, Beatriz López, Marta Ambroggi, Domingo Palmero, Bernardo Salvadores, Elida Gravina, Eduardo Mazzeo, Susana Imaz, Lucía Barrera, and National TB Laboratory Network Author affiliations: Instituto Nacional de Enfermedades Infecciosas ANLIS “Dr. Carlos G. Malbrán,” Buenos Aires, Argentina (V. Ritacco, B. López, E. Mazzeo, L. Barrera); Hospital “Dr. F.J. Muñiz,” Buenos Aires (M. Ambroggi, D. Palmero); Programa Provincial de Tuberculosis, Santa Fe, Argentina (B. Salvadores); Hospital Zonal General Agudos “Dr. Diego Paroissien,” La Matanza, Argentina (E. Gravina); and Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni” ANLIS “Dr Carlos G Malbran,” Santa Fe (S. Imaz) Emerg Infect Dis 2012 Nov; 18(11): DOI: 10.3201/eid1811.120126
November 10, 2012

During 2003–2009, the National Tuberculosis (TB) Laboratory Network in Argentina gave 830 patients a new diagnosis of multidrug-resistant (MDR) TB and 53 a diagnosis of extensively drug- resistant (XDR) TB. HIV co-infection was involved in nearly one third of these cases. Strain genotyping showed that 7 major clusters gathered 56% of patients within restricted geographic areas. The 3 largest clusters corresponded to epidemic MDR TB strains that have been undergoing transmission for >10 years. The indigenous M strain accounted for 29% and 40% of MDR and XDR TB cases, respectively. Drug-resistant TB trends in Argentina are driven by spread of a few strains in hotspots where the rate of HIV infection is high. To curb transmission, the national TB program is focusing stringent interventions in these areas by strengthening infection control in large hospitals and prisons, expediting drug resistance detection, and streamlining information-sharing systems between HIV and TB programs. Read more...

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