Tuberculosis in Australia: bacteriologically confirmed cases and drug resistance, 2006 a report of the Australian Mycobacterium Reference Laboratory Network.

Abstract

In 2006, the Australian Mycobacterium Reference Laboratory Network identified 905 bacteriologically confirmed cases of disease caused by members of the Mycobacterium tuberculosis complex. The annual reporting rate was 4.4 cases per 100,000 population. Of the 905 isolates, 903 were Mycobacterium tuberculosis and two were Mycobacterium bovis. Fourteen children aged under 10 years (male n = 5, female n = 9) had bacteriologically confirmed tuberculosis. A total of 100 (11.1%) isolates of M. tuberculosis were resistant to at least one first-line anti-tuberculosis agent. Resistance to at least H and R (defined as multi-drug resistant--MDR) was detected in 22 (2.4%) M. tuberculosis isolates. Of the 22 MDR-TB isolates, 17 were from the respiratory tract (sputum n = 11 bronchoscopy n = 5, nasogastric aspirate n = 1), three from lymph node, one from a sacral mass, and one sterile site fluid. Smear-positive specimens from the MDR-TB cases were found in sputum (n = 6), lymph node (n = 2), and one each of bronchoscopy and nasogastric aspirate specimens. The country of birth was known for all 100 cases with a drug-resistant isolate; 10 of whom were born in Australia. The 90 overseas-born cases with drug-resistant disease were from 27 countries. Two Australian-born cases had MDR-TB; one had worked extensively in the Philippines; the other was a contact of a known MDR-TB case. No cases of extensively drug-resistant TB (XDR-TB) were identified in 2006. However, an on-going review of laboratory data identified one case of XDR-TB in 2004.