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Migrations do not modify Mycobacterium tuberculosis resistance rates: a 20-year retrospective study

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Abstract

Tuberculosis (TB) caused by resistant strains is becoming a public health concern also in high-income countries. In Pavia province, Northern Italy, the prevalence of foreign-born has increased in recent years. Nevertheless, it is unclear if this has modified epidemiology and resistance patterns of Mycobacterium tuberculosis. We retrospectively collected data on all the Mycobacterium tuberculosis strains isolated by culture in the microbiology reference laboratory of the province of Pavia from 01/01/1998 to 31/12/2017. Overall, 919 patients were identified, 320 were foreign-born (34.8%). The proportion of cases due to foreign-born patients increased during the study period as did resistance to isoniazid (INH) (p = 0.01), while resistance to rifampicin (RIF) did not (p = 0.8). INH and RIF resistance were comparable among Italian and foreign-born patients (7.9% vs 9.7% for INH and 4% vs 5% for RIF, respectively). Twenty-height (3.05%) patients harboured MDR strains. Prevalence of MDR strains was not different between Italians and foreign-born patients (2.8% vs 3.4%, p = 0.6). During the study period the proportion of TB cases due to foreign-born patients and INH resistance increased. This increase was equal among Italian and foreign-born patients. Migrants in our area are not a driver of resistance to anti-mycobacterial drugs.

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Abbreviations

EE:

Eastern Europe

EPTB:

Extrapulmonary tuberculosis

FSU:

Former Soviet Union

MDR:

Multidrug-resistant

XDR:

Extensively drug-resistant

MGIT:

Mycobacteria Growth Indicator Tube

INH:

Isoniazid

PZA:

Pyrazinamide

RIF:

Rifampicin

STR:

Streptomycin

EMB:

Ethambutol

TB:

Tuberculosis

WHO:

World Health Organization

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Authors and Affiliations

  1. UO Malattie Infettive I, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 2, 27100, Pavia, Italy

    Elena Seminari, Andrea Lombardi & Andrea Schimmenti

  2. SC Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Vincenza Monzillo, Daniela Barbarini & Piero Marone

  3. SC Biometria e Statistica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Luigia Scudeller

  4. SC Direzione Medica di Presidio, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Alba Muzzi

Authors
  1. Elena Seminari
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  2. Vincenza Monzillo
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  3. Andrea Lombardi
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  4. Daniela Barbarini
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  5. Luigia Scudeller
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  6. Andrea Schimmenti
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  7. Alba Muzzi
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  8. Piero Marone
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Contributions

ES, LS, AM and PM participated in study design. LS and AS conducted the statistical analysis. MV and DB performed microbiologic analysis, ES, AS, AM, AL drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Elena Seminari.

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Seminari, E., Monzillo, V., Lombardi, A. et al. Migrations do not modify Mycobacterium tuberculosis resistance rates: a 20-year retrospective study. Eur J Clin Microbiol Infect Dis 39, 1083–1087 (2020). https://doi.org/10.1007/s10096-020-03820-z

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  • DOI: https://doi.org/10.1007/s10096-020-03820-z

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