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Special Article

Global Trends in Resistance to Antituberculosis Drugs

Marcos A. Espinal, M.D., Dr.P.H., Adalbert Laszlo, Ph.D., Lone Simonsen, Ph.D., Fadila Boulahbal, Ph.D., Sang Jae Kim, Sc.D., Ana Reniero, Ph.D., Sven Hoffner, Ph.D., Hans L. Rieder, M.D., M.P.H., Nancy Binkin, M.D., M.P.H., Christopher Dye, D.Phil., Rosamund Williams, Ph.D., and Mario C. Raviglione, M.D. for the World Health Organization–International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance

N Engl J Med 2001; 344:1294-1303April 26, 2001

Abstract

Background

Data on global trends in resistance to antituberculosis drugs are lacking.

Methods

We expanded the survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung Disease to assess trends in resistance to antituberculosis drugs in countries on six continents. We obtained data using standard protocols from ongoing surveillance or from surveys of representative samples of all patients with tuberculosis. The standard sampling techniques distinguished between new and previously treated patients, and laboratory performance was checked by means of an international program of quality assurance.

Results

Between 1996 and 1999, patients in 58 geographic sites were surveyed; 28 sites provided data for at least two years. For patients with newly diagnosed tuberculosis, the frequency of resistance to at least one antituberculosis drug ranged from 1.7 percent in Uruguay to 36.9 percent in Estonia (median, 10.7 percent). The prevalence increased in Estonia, from 28.2 percent in 1994 to 36.9 percent in 1998 (P=0.01), and in Denmark, from 9.9 percent in 1995 to 13.1 percent in 1998 (P=0.04). The median prevalence of multidrug resistance among new cases of tuberculosis was only 1.0 percent, but the prevalence was much higher in Estonia (14.1 percent), Henan Province in China (10.8 percent), Latvia (9.0 percent), the Russian oblasts of Ivanovo (9.0 percent) and Tomsk (6.5 percent), Iran (5.0 percent), and Zhejiang Province in China (4.5 percent). There were significant decreases in multidrug resistance in France and the United States. In Estonia, the prevalence in all cases increased from 11.7 percent in 1994 to 18.1 percent in 1998 (P<0.001).

Conclusions

Multidrug-resistant tuberculosis continues to be a serious problem, particularly among some countries of eastern Europe. Our survey also identified areas with a high prevalence of multidrug-resistant tuberculosis in such countries as China and Iran.

Media in This Article

Table 1Prevalence of Drug Resistance among New Cases of Tuberculosis, According to Geographic Site, 1996–1999.
Table 2Prevalence of Drug Resistance among Previously Treated Cases of Tuberculosis, According to Geographic Site, 1996–1999.
Article

A survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung Disease in 35 geographic sites revealed that drug-resistant tuberculosis was ubiquitous.1,2 That survey did not include temporal changes in the prevalence of resistance to antituberculosis drugs, since data were available for only one year from each of the sites surveyed. In some countries with high burdens of tuberculosis, such as China, India, and Russia, surveys were conducted only in one administrative unit, if at all.3 The global survey has now been expanded to assess trends and provide a more representative estimate of the global magnitude of the problem of drug-resistant tuberculosis.

Methods

Methods previously described are summarized here,1,2 and changes and new developments are described in detail. The new surveillance projects or surveys were conducted between 1996 and 1999. Data on temporal changes are from geographic sites that provided data for at least two time points between 1994 and 1999. Standard methods of surveillance were used.4 Surveillance of drug resistance adhered to three principles: the samples of patients with tuberculosis in each country or region (e.g., state or province) were representative of that geographic site; recommended microbiologic methods were used by national laboratories that were monitored by an international system of proficiency testing; and in almost all countries, new cases were distinguished from previously treated cases.

New cases of tuberculosis were defined as incident cases in patients who, in response to direct questioning, denied having had previous antituberculosis treatment or having been treated for one month or more and, in countries where adequate documentation was available, for whom there was no evidence of a history of such treatment. Drug resistance among new cases was defined as the presence of resistant strains of Mycobacterium tuberculosis in new cases of tuberculosis. Drug resistance among previously treated cases was defined as the absence of a response in patients with tuberculosis who had already received antituberculosis therapy for one month or more (as documented in the tuberculosis registry or in medical records or by the account of the patient) and who had begun a retreatment regimen. Previously treated patients included patients who had a relapse after having completed successful treatment in the past, patients in whom treatment failed, patients who returned to a health care provider after having discontinued treatment, and patients with chronic tuberculosis who had positive sputum smears after the completion of two fully supervised courses of treatment. These definitions are presented elsewhere.5 Multidrug resistance was defined as resistance to at least isoniazid and rifampin.

Interlaboratory monitoring of the proficiency of testing for susceptibility to isoniazid, rifampin, streptomycin, and ethambutol has been conducted annually since 1994 within a network of 23 supranational reference laboratories. The methods used by the participating laboratories to test drug susceptibility include the absolute-concentration method, the resistance-ratio method, and the proportion method and its variants, including the BACTEC 460 radiometric culture method.1,6,7 Descriptions of the methods and the early results of this program of proficiency testing have been published elsewhere.7

For each survey, the target population consisted of all registered patients in the survey area with sputum-smear–positive cases of tuberculosis. All newly registered patients with such cases were eligible for inclusion. In most countries, the survey area was the entire country. The calculation of the required sample size for surveys followed standard guidelines for the surveillance of drug resistance in tuberculosis.4 The required sample size was calculated on the basis of the expected prevalence of resistance to rifampin among new cases of tuberculosis, which, in turn, was estimated on the basis of data from previous studies or from the national tuberculosis programs. In countries that were conducting surveillance of drug resistance, all registered patients with tuberculosis were enrolled for testing. Sites that provided data for two or more time points conducted their surveillance or surveys in similar populations of patients with new cases of tuberculosis and sampled them over time. Similar protocols, including similar sampling techniques and similar populations sampled between surveys, were used to ensure the comparability of populations.

Testing of drug susceptibility was performed by the national reference laboratory, which was linked to one supranational reference laboratory for the validation of data. The results for a subsample of all strains tested were validated and confirmed by the supranational laboratory.

Statistical Analysis

The software packages Epi Info (version 6.04, Centers for Disease Control and Prevention, Atlanta) and SPSS for Windows (version 7.5.2, SPSS, Chicago) were used for the analyses. Median values were calculated for the prevalence of drug resistance among new cases, among previously treated cases, for individual drugs, and for pertinent combinations. Data on prevalence are from the latest year of surveillance or survey in each participating site. The analysis of trends focused on drug resistance found in new cases and previously treated cases. The standard chi-square test and Fisher's exact test were used for the comparison of two data points (proportions), and the chi-square test for trends was used for the comparison of three or more data points. The coverage of the global project was estimated with the use of data on tuberculosis notification that were reported to the World Health Organization,8-12 and the population figures used for 1997 were those estimated by the United Nations Population Division.13 In the case of geographic sites for which data on the prevalence in two or more years were reported, only the latest one was used in the calculation of coverage. When surveys were conducted in administrative units of large countries (states, provinces, or oblasts), only the tuberculosis cases and populations of these administrative units were used in the calculation of coverage.

Results

Prevalence

Between 1996 and 1999, patients were surveyed in 58 geographic sites, in 54 of which there was drug-resistant tuberculosis among new cases and in 48 of which there was drug-resistant tuberculosis among previously treated cases. Australia, Belgium, Canada, and Israel reported drug resistance but did not distinguish between new and previously treated cases. The surveillance and surveys conducted in this phase of the global project tested a total of 61,415 patients with tuberculosis (median per geographic site, 661; range, 41 [Northern Ireland] to 12,675 [United States]). These geographic sites accounted for approximately 610,000 of the 3.3 million cases of tuberculosis reported to the World Health Organization in 1997 (18 percent) and 1.5 billion of the world's 5.8 billion inhabitants (26 percent). Proficiency testing in 1998 by the supranational reference laboratories of susceptibility to the four drugs for which the national laboratories tested showed an overall sensitivity of 98 percent and an overall specificity of 95 percent.

Among new cases of tuberculosis, the prevalence of resistance to at least one drug ranged from 1.7 percent in Uruguay to 36.9 percent in Estonia (median, 10.7 percent) (Table 1Table 1Prevalence of Drug Resistance among New Cases of Tuberculosis, According to Geographic Site, 1996–1999.). The prevalence of multidrug-resistant tuberculosis ranged from 0 percent in eight sites to 14.1 percent in Estonia (median, 1.0 percent). The prevalence of multidrug-resistant tuberculosis was also high in Henan Province, China (10.8 percent), Latvia (9.0 percent), the Russian oblasts of Ivanovo (9.0 percent) and Tomsk (6.5 percent), Iran (5.0 percent), and Zhejiang Province, China (4.5 percent). The prevalence of resistance to a single drug ranged from 1.3 percent in the Czech Republic to 17.9 percent in Sierra Leone (data not shown). Resistance to all four drugs for which testing was conducted ranged from 0 percent in 24 sites to 8.5 percent in Estonia (data not shown).

Among previously treated cases of tuberculosis, the prevalence of resistance to at least one drug ranged from 0 percent in Finland to 93.8 percent in Uruguay (median, 23.3 percent) (Table 2Table 2Prevalence of Drug Resistance among Previously Treated Cases of Tuberculosis, According to Geographic Site, 1996–1999.). The prevalence of multidrug-resistant tuberculosis among previously treated cases ranged from 0 percent in four sites to 48.2 percent in Iran (median, 9.3 percent). The median prevalence of resistance to a single drug was 11.3 percent, and the median prevalence of resistance to all four drugs was 1.8 percent (data not shown).

Temporal Changes

Data from two or more years were available from 28 of the 58 geographic sites. Of these sites, 24 provided data on new cases of tuberculosis, 20 provided data on previously treated cases, and 4 did not distinguish between the two types of cases. Table 3Table 3Trends in Drug Resistance among New and Previously Treated Cases of Tuberculosis. shows trends among new and previously treated cases. Among countries with data available for three or more years, there was a statistically significant upward trend in the prevalence of resistance to any drug among new cases in Estonia, from 28.2 percent in 1994 to 36.9 percent in 1998 (P=0.01 for the trend across three data points), and in Denmark, from 9.9 percent in 1995 to 13.1 percent in 1998 (P=0.04 for the trend across four data points). Of the sites with data available for two years, Peru, New Zealand, and Germany had significant increases in the proportions of drug-resistant tuberculosis among new cases, whereas Barcelona (Spain) and Switzerland had significant decreases. Although no significant increases occurred in Latvia, Estonia, and the Russian oblast of Ivanovo, a high prevalence of multidrug-resistant tuberculosis (9.0 percent or higher in all sites) was still found among new cases in the most recent year of surveillance. France and the United States reported significant decreases.

Among previously treated cases, there was no evidence of an increase in the prevalence of resistance to at least one drug. There were, in fact, statistically significant decreases in Cuba, England and Wales, Peru, and the Republic of Korea. In Estonia, the prevalence of multidrug-resistant tuberculosis among previously treated cases increased from 19.2 percent in 1994 to 37.8 percent in 1998 (P=0.04). The prevalence of multidrug-resistant tuberculosis among all cases increased in Estonia from 11.1 percent in 1994 to 18.1 percent in 1998 (P<0.001, data not shown).

Discussion

We attempted to quantify global trends in resistance to antituberculosis drugs by means of standard epidemiologic and microbiologic methods. Our findings indicate that multidrug-resistant tuberculosis continues to be a serious problem in countries of eastern Europe — especially Estonia, Latvia, and Russia. Such findings suggest the continued creation and increased circulation of drug-resistant strains due to poor tuberculosis control, which poses a threat to other countries. Trends in the Russian oblast of Ivanovo confirm that the situation is critical, and the high prevalence of drug resistance found in the newly surveyed oblast of Tomsk, in Siberia, shows that the problem exists in other parts of the country and may be widespread throughout Russia. There are newly identified areas with a high prevalence of multidrug-resistant tuberculosis in heavily populated countries such as China and Iran, which indicates that the creation of highly resistant strains of M. tuberculosis is not limited to one part of the world.

Since multidrug-resistant tuberculosis is associated with higher rates of failure and death than is drug-susceptible tuberculosis14 and is more difficult and expensive to treat,15 great pressure is being put on the health care systems of these countries. They should immediately adopt or expand programs of tuberculosis control by making use of proven and cost-effective interventions such as the directly-observed-treatment, short-course strategy of the World Health Organization.16 The use of second-line drugs to cure multidrug-resistant tuberculosis and to reduce further transmission should be considered, but only as part of well-structured programs of tuberculosis control. Trials to assess the feasibility and cost effectiveness of the use of second-line drugs in settings with limited resources are currently being conducted as part of a new international initiative to manage multidrug-resistant tuberculosis.17

There is, however, reassuring news from this phase of the global project. There were no significant increases in the prevalence of multidrug-resistant tuberculosis among new cases in Botswana, Chile, Cuba, Czech Republic, Denmark, England and Wales, Finland, France, Germany, Nepal, the Netherlands, New Zealand, Northern Ireland, the Republic of Korea, Peru, Scotland, Sierra Leone, Spain (Barcelona), Sweden, Switzerland, and the United States. Many of these areas have been able to maintain high cure rates for tuberculosis.18-22

In the Americas, all the countries that were surveyed for the first time in this phase of the project — including Canada, Chile, Colombia, Mexico, Nicaragua, Uruguay, and Venezuela — showed no signs of a serious problem. Most African countries surveyed — even those with a high incidence of human immunodeficiency virus–related tuberculosis — were not seriously affected by multidrug-resistant tuberculosis.23,24 This low prevalence could be the result of various factors, including the recent introduction of rifampin in these countries, the use of rifampin-free treatment regimens in the continuation phase of therapy, and the growing use of direct observation of treatment.25,26 Lack of access to treatment may also contribute to the low prevalence of multidrug-resistant tuberculosis. Several countries in Africa with a very high incidence of tuberculosis — including the Democratic Republic of Congo, Ethiopia, and Nigeria — have not yet been surveyed.27 Thus, more data are needed to produce a balanced picture of drug resistance in Africa.

In western Europe, multidrug-resistant tuberculosis is not a major public health problem. Among new cases in Denmark and Germany, there were increases in the prevalence of resistance to at least one drug. An increase in the transmission of strains resistant to streptomycin and isoniazid has been reported among persons in Denmark who are 25 to 54 years of age.28 A higher prevalence of drug resistance among immigrants has also increased the overall prevalence in these countries.28,29 The increase in the prevalence of multidrug-resistant tuberculosis in Australia could be due to a large influx of immigrants from neighboring countries where the prevalence is high.30

The two most populous countries, China and India, account for an estimated 3.1 million of the world's estimated 8.0 million incident cases of tuberculosis (39 percent).31 It has been estimated that 75 percent of the cases worldwide occur in five countries in Asia. The spread of multidrug-resistant tuberculosis in Asia could seriously hamper global efforts to control tuberculosis. The high prevalence of drug-resistant tuberculosis in this region emphasizes the need for a rapid expansion of the directly-observed-treatment, short-course strategy, which is being used for only 44 percent of the population of this region.27 Management of multidrug resistance will require the wise use of second-line drugs.

Our data have some limitations. First, more information on the magnitude of drug-resistant tuberculosis is needed from countries with the highest rates of incidence of the disease.31 Of the 22 countries with the highest incidence rates (which account for an estimated 80 percent of all new cases annually), only 11 have relevant data available. It is therefore necessary to continue expanding surveillance efforts in these countries. Second, selection bias and misclassification of previously treated cases as new cases cannot be completely ruled out in some of the participating sites. Third, for some sites, apparent decreases in the prevalence of multidrug-resistant tuberculosis among previously treated cases could be related to sampling bias between surveys. For surveys of drug resistance, the required sample size is normally calculated only for new cases, because the proportion of patients with previously treated cases is usually a small fraction of the total number of patients registered for treatment in the geographic site.

A paradox was observed in countries that have had good tuberculosis-control programs for many years. In countries such as Uruguay and Cuba, almost all previously treated patients had drug-resistant tuberculosis, but there were only small numbers of such patients. Therefore, a very small number of drug-resistant, previously treated cases should not be regarded as a sign of the failure of a control program.32 Finally, several sites provided data for only two time points, which can only suggest a trend.

Despite such limitations, we attempt to present follow-up data on the magnitude of drug resistance around the world. The 58 new sites recruited to the study represent a 65 percent increase in the number of countries that have been surveyed.1 The follow-up data confirm that the prevalence of multidrug-resistant tuberculosis is still alarmingly high in some countries in eastern Europe. Newly surveyed areas with a high prevalence have also been identified, suggesting that drug resistance is not limited to eastern Europe.

Measures to manage multidrug-resistant tuberculosis are urgently needed, but these will be successful only if the management of drug-susceptible tuberculosis, which accounts for the large majority of cases, is also successful.33 Thus, if proper case management of drug-susceptible tuberculosis with first-line treatment regimens cannot be guaranteed,34-36 the use of second-line drugs should be discouraged. The undisciplined use of both first- and second-line drugs will lead to the further spread of untreatable disease.

Supported by a grant from the United States Agency for International Development.

We are indebted to the national authorities in the participating countries and the institutions that hosted the national and international laboratories; to Dr. Eduardo Netto for his help with the analysis; and to Corazon Dolores and Zahra Ali-Piazza for secretarial assistance.

Source Information

From the Communicable Diseases Cluster, World Health Organization, Geneva (M.A.E., L.S., C.D., R.W., M.C.R.); the International Union against Tuberculosis and Lung Disease, Paris (A.L., H.L.R.); the Laboratory Centre for Disease Control, Ottawa, Ont., Canada (A.L.); the Institut Pasteur, Algiers, Algeria (F.B.); the Korean Institute of Tuberculosis, Seoul, Republic of Korea (S.J.K.); the Instituto Panamericano de Protección de Alimentos y Zoonosis, Buenos Aires, Argentina (A.R.); the Swedish Institute for Infectious Disease Control, Stockholm (S.H.); and the Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta (N.B.).

Address reprint requests to Dr. Espinal at Communicable Diseases Control, Prevention, and Eradication, World Health Organization, 20 Ave. Appia, 1211 Geneva, Switzerland, or at .

Other members of the group are listed in the Appendix.

Appendix

The following members of the World Health Organization–International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance also participated in the study:Australia — D. Dawson, W. Chew, F. Haverkort, R. Lumb, A. Sievers; Belgium — M. Fauville Dufaux, M. Wanlin, M. Uydebrouck, F. Portaels; Botswana — M. Mwasekaga, T. Kenyon, E. Talbot; Canada — H. Njoo, P. Nault; Central African Republic (Bangui) — E. Kassa-Kelembho; Chile — P. Valenzuela, S. Piffardi; China (Beijing) — D. Hong-jin, W. Sumin, Z. Ben; China (Guangdong Province) — Z. Qiu, Q. Ming, L. Hong-qiao; China (Henan Province) — W. Guobin, P. Vili, Z. Guolong, Z. Li; China (Shandong Province) — Z. Sheng, G. Xiang, Z. Guo; China (Zhejiang Province) — L.. Qun, W. Xiaomeng, H. Haibo; Colombia — C. Leon Franco, M. Irinirida, C. Sierra, N. Naranjo, M. Garzon; Cuba — J. Valdivia, E. Montoro, A. Marrero Figueroa; Czech Republic — M. Havelková, O. OšŤádal; Denmark — V. Thomsen, S. Glisman; Estonia — A. Krüüner, K. Vink, M. Danilovich; Finland — M. Viljanen, M. Kokki, P. Ruutu; France — J. Grosset, V. Vincent, B. Carbonnelle, J. Robert; Germany — M. Forßohm, S. Ruesch-Gerdes, K. Feldmann, G. Bretzel; Guinea — B. Mamadou Dian, O. Younoussa Sow, D. Aliomou; Hong Kong Special Administrative Region of China — M. Kai, M. Cheuk; India (Tamil Nadu State) — C. Paramasivan, K. Bhaskaran, P. Venkataraman, T. Frieden; Iran — M.-R. Masjedi, A.-A. Velayati, M. Bahadori, S. Javad Tabatabaii; Israel — D. Chemtob, O. Dreazen; Italy — G. Migliori, G. Besozzi, A. Cassone, G. Orefici, L. Fattorini, E. Iona; Japan — C. Abe; Latvia — J. Leimans, V. Leimane, D. Mihalovska; Malaysia — I. Kuppusamy, D. Padmini, S. Ramayah; Mexico — A. Santaella-Solis, S. Balandrano Campos, A. Flisser Steinbruch, R. Granich; Morocco — S.-E. Ottmani, J. Mahjour, P. Chaulet; Mozambique — A. MacArthur, P. Perdigao, S. Gloyd; Nepal — D. Singh Bam, P. Malla, I. Smith; the Netherlands — B. van Klingeren, C. Lambregts-van Weezenbeek, N. Kalisvaart; New Caledonia — P. Duval; New Zealand — M. Brett, R. Vaughan, M. Carr, C. Tocker; Nicaragua — L. Chacon, J. Cruz; Norway — E. Heldal, N. Brattås, P. Sandven; Oman — A. Ahmed Ba Omar, S. Al-Awan, S. Al-Busaidy, J. George; Peru — L. Vàsquez Campos, J. Portocarrero Céliz, P. Suarez; Poland — Z. Zwolska, K. Roszkowski; Puerto Rico — O. Joglar; Republic of Korea — G.-H. Bai; Russia (Ivanovo Oblast) — A. Khomenko (deceased), M. Stoyunin, N. Katulina, I. Danilova, V. Golyshevskaya; Russia (Tomsk Oblast) — A. Sloutsky, A. Goldfarb, T. Healing, M. Kimerling; Sierra Leone — L. Westman, A. George; Singapore — J. Yap, I. Snodgrass; Slovakia — M. Svejnochová, E. Rajecová, L. Chovan; Slovenia — M. Žolnir-Dovč, J. Sorli, D. Eržen; South Africa — K. Weyer; Spain (Barcelona) — N. Martin-Casabona; Sweden — G. Källenius, V. Romanus; Switzerland — P. Helbling, G. Pfyffer, J.-P. Zellweger; Thailand — V. Payanandana, D. Rienthong, S. Rienthong, L. Ratanavichit, H. Sawert; Uganda — F. Adatu, M. Aziz, H.-U. Wendl-Richter, T. Aisu; United Kingdom — J. Watson, F. Drobniewski, J. Herbert, P. Christie, B. Watt, B. Smyth, M. Crowe; United States — E. McCray, I. Onorato, B. Metchock, K. Laserson, A. Pablos-Méndez, D. Cohn, E. Brenner; Uruguay — V. Cuesta Aramburu, C. Rivas; Venezuela — R. Armengol, A. Guilarte, L. Albina Vázquez de Salas; World Health Organization — P. Nunn, R. Rodriguez, A. Seita, L. Blanc, D. Il Ahn.

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Citing Articles

  1. 1

    Abida Shaheen, Muzammil Hasan Najmi, Waseem Saeed, Zia-Ur-Rehman Farooqi. (2012) Pharmacokinetics of standard dose regimens of rifampicin in patients with pulmonary tuberculosis in Pakistan. Scandinavian Journal of Infectious Diseases1-6
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    Trent Mortensen, Shujie Shen, FenAnn Shen, Marie K. Walsh, Ronald C. Sims, Charles D. Miller. (2012) Investigating the Effectiveness of St John's Wort Herb as an Antimicrobial Agent against Mycobacteria. Phytotherapy Researchn/a-n/a
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    C. H. LIU, H. M. LI, L. LI, Y. L. HU, Q. WANG, N. YANG, S. WANG, B. ZHU. (2011) Anti-tuberculosis drug resistance patterns and trends in a tuberculosis referral hospital, 1997–2009. Epidemiology and Infection 139:12, 1909-1918
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    Liaqat Ali Chaudhry, Nagamani Rambhala, Ali Saad Al-Shammri, Jaffar A. Al-Tawfiq. (2011) Patterns of antituberculous drug resistance in Eastern Saudi Arabia: A 7-year surveillance study from 1/2003 to 6/2010. Journal of Epidemiology and Global Health
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    Jee-Hyun Yoon, Ji-Sun Nam, Kyung-Jin Kim, Yeonim Choi, Hyeyoung Lee, Sang-Nae Cho, Young-Tae Ro. (2011) Molecular characterization of drug-resistant and -susceptible Mycobacterium tuberculosis isolated from patients with tuberculosis in Korea. Diagnostic Microbiology and Infectious Disease
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    CHIH-WEI LIN, IH-JEN SU, JIA-RU CHANG, YIH-YUAN CHEN, JANG-JIH LU, HORNG-YUNN DOU. (2011) Recombinant BCG coexpressing Ag85B, CFP10, and interleukin-12 induces multifunctional Th1 and memory T cells in mice. APMISno-no
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    Xiu-fen Yang, Jun Xu, Kai Ma. (2011) Choroidal Tuberculoma in an Immunocompetent Young Patient. Chinese Medical Sciences Journal 26:3, 194-196
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    Chih-Cheng Lai, Wei-Lun Liu, Che-Kim Tan, Yu-Chuang Huang, Kuei-Pin Chung, Meng-Rui Lee, Po-Ren Hsueh. (2011) Differences in drug resistance profiles of Mycobacterium tuberculosis isolates causing pulmonary and extrapulmonary tuberculosis in a medical centre in Taiwan, 2000–2010. International Journal of Antimicrobial Agents 38:2, 125-129
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    X. Yang, L. Bao, Y. Deng. (2011) A novel recombinant Mycobacterium bovis bacillus Calmette-Guerin strain expressing human granulocyte macrophage colony-stimulating factor and Mycobacterium tuberculosis early secretory antigenic target 6 complex augments Th1 immunity. Acta Biochimica et Biophysica Sinica 43:7, 511-518
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    Amitabha Chakroborty. (2011) Drug-resistant tuberculosis: an insurmountable epidemic?. Inflammopharmacology 19:3, 131-137
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    Jenn-Tyang Chang, Horng-Yunn Dou, Chia-Liang Yen, Ying-Hsun Wu, Ruay-Ming Huang, Huey-Juan Lin, Ih-Jen Su, Chi-Chang Shieh. (2011) Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance. Journal of the Formosan Medical Association 110:6, 372-381
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    W. Wang, J. Wang, Q. Zhao, N. D. Darling, M. Yu, B. Zhou, B. Xu. (2011) Contribution of rural-to-urban migration in the prevalence of drug resistant tuberculosis in China. European Journal of Clinical Microbiology & Infectious Diseases 30:4, 581-586
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    U.S. Ezhil Arivudainambi, Thangarajan Durai Anand, Vellasamy Shanmugaiah, Chandran Karunakaran, Ayyappan Rajendran. (2011) Novel bioactive metabolites producing endophytic fungus Colletotrichum gloeosporioides against multidrug-resistant Staphylococcus aureus. FEMS Immunology & Medical Microbiology 61:3, 340-345
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    Jorge Zazueta-Beltran, Nidia León-Sicairos, Secundino Muro-Amador, Adrian Flores-Gaxiola, Jorge Velazquez-Roman, Hector Flores-Villaseñor, Adrian Canizalez-Roman. (2011) Increasing drug resistance of Mycobacterium tuberculosis in Sinaloa, Mexico, 1997–2005. International Journal of Infectious Diseases 15:4, e272-e276
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    Hiroki Ando, Tomoe Kitao, Tohru Miyoshi-Akiyama, Seiya Kato, Toru Mori, Teruo Kirikae. (2011) Downregulation of katG expression is associated with isoniazid resistance in Mycobacterium tuberculosis. Molecular Microbiology 79:6, 1615-1628
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    Mercedes Macías Parra, Jesús Kumate Rodríguez, José Luís Arredondo García, Yolanda López-Vidal, Mauricio Castañón-Arreola, Susana Balandrano, Nalin Rastogi, Pedro Gutiérrez Castrellón. (2011) Mycobacterium tuberculosis Complex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico. Tuberculosis Research and Treatment 2011, 1-9
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    Mi Hee Jang, Go Eun Choi, Bo-Moon Shin, Seon Ho Lee, Sung-Ryul Kim, Chulhun L. Chang, Jeong-Man Kim. (2011) Comparison of an Automated Repetitive Sequence-based PCR Microbial Typing System with IS 6110 -Restriction Fragment Length Polymorphism for Epidemiologic Investigation of Clinical Mycobacterium tuberculosis Isolates in Korea. The Korean Journal of Laboratory Medicine 31:4, 282
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    Khadijo Osman, Naveed Ahmed Khan. (2010) A novel in vivo model to screen antimicrobial compounds. International Journal of Antimicrobial Agents 36:3, 288-289
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    Giovanni Battista Migliori, Keertan Dheda, Rosella Centis, Peter Mwaba, Matthew Bates, Justin O’Grady, Michael Hoelscher, Alimuddin Zumla. (2010) Review of multidrug-resistant and extensively drug-resistant TB: global perspectives with a focus on sub-Saharan Africa. Tropical Medicine & International Health 15:9, 1052-1066
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    Nazia Bibi, Sheraz Ahmad. K. Tanoli, Sadia Farheen, Nighat Afza, Salman Siddiqi, Ying Zhang, Shahana U. Kazmi, Abdul Malik. (2010) In vitro antituberculosis activities of the constituents isolated from Haloxylon salicornicum. Bioorganic & Medicinal Chemistry Letters 20:14, 4173-4176
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    K. Touray, I. M. Adetifa, A. Jallow, J. Rigby, D. Jeffries, Y. B. Cheung, S. Donkor, R. A. Adegbola, P. C. Hill. (2010) Spatial analysis of tuberculosis in an Urban West African setting: is there evidence of clustering?. Tropical Medicine & International Health 15:6, 664-672
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    Go Eun Choi, Mi Hee Jang, Eun Ju Song, Seok Hoon Jeong, Jae-Seok Kim, Wee Gyo Lee, Young Uh, Kyoung Ho Roh, Hye Soo Lee, Jong Hee Shin, Nam Hee Ryoo, Young Ree Kim, Joseph Jeong, Jee Hee Kim, Sun Min Lee, Jongyoun Yi, Sang Hyun Hwang, Hyung Hoi Kim, Eun Yup Lee, Chulhun L. Chang, Moon-Bum Kim, Yeong Dae Kim. (2010) IS 6110 -Restriction Fragment Length Polymorphism and Spoligotyping Analysis of Mycobacterium tuberculosis Clinical Isolates for Investigating Epidemiologic Distribution in Korea. Journal of Korean Medical Science 25:12, 1716
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    Young Soo Heo, Won Woong Shin, Yong Ju Kim, Hae Jun Song, Chil Hwan Oh. (2010) Annular Lupus Vulgaris Mimicking Tinea Cruris. Annals of Dermatology 22:2, 226
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    Farahnoosh Doustdar, Azar Dokht Khosravi, Parissa Farnia. (2009) Mycobacterium tuberculosis Genotypic Diversity in Pyrazinamide-Resistant Isolates of Iran. Microbial Drug Resistance 15:4, 251-256
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    Weigang Wu, Qixin Zheng, Xiaodong Guo, Jianhua Sun, Yudong Liu. (2009) A programmed release multi-drug implant fabricated by three-dimensional printing technology for bone tuberculosis therapy. Biomedical Materials 4:6, 065005
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    Giovanni Battista Migliori, Morgan D'  Arcy Richardson, Giovanni Sotgiu, Christoph Lange. (2009) Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in the West. Europe and United States: Epidemiology, Surveillance, and Control. Clinics in Chest Medicine 30:4, 637-665
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    Said H. Abbadi, G. Abdel Sameaa, G. Morlock, R.C. Cooksey. (2009) Molecular identification of mutations associated with anti-tuberculosis drug resistance among strains of Mycobacterium tuberculosis. International Journal of Infectious Diseases 13:6, 673-678
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    I. Suárez-García, A. Rodríguez-Blanco, J. L. Vidal-Pérez, M. A. García-Viejo, M. J. Jaras-Hernández, O. López, A. Noguerado-Asensio. (2009) Risk factors for multidrug-resistant tuberculosis in a tuberculosis unit in Madrid, Spain. European Journal of Clinical Microbiology & Infectious Diseases 28:4, 325-330
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    Pattanawadee UTTAWICHAI, Tsukasa IGARASHI, Seiji KAWANA. (2009) Case of lupus vulgaris diagnosed 50 years after onset. The Journal of Dermatology 36:2, 103-105
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    G. Ferrara, B. Bleck, L. Richeldi, J. Reibman, L. M. Fabbri, W. N. Rom, R. Condos. (2008) Mycobacterium tuberculosis Induces CCL18 Expression in Human Macrophages. Scandinavian Journal of Immunology 68:6, 668-674
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    Farahnoosh Doustdar, Azar Dokht Khosravi, Parissa Farnia, Mohammad Reza Masjedi, Ali Akbar Velayati. (2008) Molecular Analysis of Isoniazid Resistance in Different Genotypes of Mycobacterium tuberculosis Isolates from Iran. Microbial Drug Resistance 14:4, 273-279
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    Edward D Chan, Michael D Iseman. (2008) Multidrug-resistant and extensively drug-resistant tuberculosis: a review. Current Opinion in Infectious Diseases 21:6, 587-595
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    Tanjore S. Balganesh, Pedro M. Alzari, Stewart T. Cole. (2008) Rising standards for tuberculosis drug development. Trends in Pharmacological Sciences 29:11, 576-581
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    Beth Temple, Irene Ayakaka, Sam Ogwang, Helen Nabanjja, Susan Kayes, Susan Nakubulwa, William Worodria, Jonathan Levin, Moses Joloba, Alphonse Okwera, Kathleen D. Eisenach, Ruth McNerney, Alison M. Elliott, Peter G. Smith, Roy D. Mugerwa, Jerrold J. Ellner, Edward C. Jones‐López. (2008) Rate and Amplification of Drug Resistance among Previously‐Treated Patients with Tuberculosis in Kampala, Uganda. Clinical Infectious Diseases 47:9, 1126-1134
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    A. Apt, T. K. Kondratieva. (2008) Tuberculosis: Pathogenesis, immune response, and host genetics. Molecular Biology 42:5, 784-793
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    J. Sheng, J. Li, G. Sheng, H. Yu, H. Huang, H. Cao, Y. Lu, X. Deng. (2008) Characterization of rpoB mutations associated with rifampin resistance in Mycobacterium tuberculosis from eastern China. Journal of Applied Microbiology 105:3, 904-911
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    Carlos Acuna‐Villaorduna, Anna Vassall, German Henostroza, Carlos Seas, Humberto Guerra, Lucy Vasquez, Nora Morcillo, Juan Saravia, Richard O’Brien, Mark D. Perkins, Jane Cunningham, Luis Llanos‐Zavalaga, Eduardo Gotuzzo. (2008) Cost‐Effectiveness Analysis of Introduction of Rapid, Alternative Methods to Identify Multidrug‐Resistant Tuberculosis in Middle‐Income Countries. Clinical Infectious Diseases 47:4, 487-495
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    W. Weber, R. Schoenmakers, B. Keller, M. Gitzinger, T. Grau, M. Daoud-El Baba, P. Sander, M. Fussenegger. (2008) A synthetic mammalian gene circuit reveals antituberculosis compounds. Proceedings of the National Academy of Sciences 105:29, 9994-9998
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    E. Augustynowicz-Kopeć, T. Jagielski, M. Kozińska, A. Zabost, M. Klatt, Z. Zwolska. (2008) Molecular analysis of drug-resistant Mycobacterium tuberculosis isolates collected in central Poland. Clinical Microbiology and Infection 14:6, 605-607
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    Payam TABARSI, Azar NOORAKI, Mehdi MIRSAEIDI, Majid AMIRI, Parvaneh BAGHAEI, Parisa FARNIA, Mehdi KAZEMPOUR, Hassan HEIDARNAZHAD, Narges ALIPANAH, Davood MANSOURI, Mohammad R. MASJEDI. (2008) Representative drug susceptibility patterns for guiding design of re-treatment regimens for multidrug-resistant tuberculosis in Iran. Respirology 13:1, 108-111
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    Youn Hyoung Nam, Sang Hyun Lee, Young Chang Ahn, Min Ho Cho, Won Cheoul Jang, Su-Min Park, Pil Seung Kwon, Jong Wan Kim. (2008) Detection of Rifampin Resistant Mycobacterium tuberculosis complex using Denaturing HPLC. The Korean Journal of Laboratory Medicine 28:2, 95
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    F. Drobniewski, S. Rüsch-Gerdes, S. Hoffner. (2007) Antimicrobial susceptibility testing of Mycobacterium tuberculosis (EUCAST document E.DEF 8.1) − Report of the Subcommittee on Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis of the European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Clinical Microbiology and Infection 13:12, 1144-1156
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    R. Vignesh, P. Balakrishnan, E.M. Shankar, K.G. Murugavel, S. Hanas, A.J. Cecelia, S.P. Thyagarajan, S. Solomon, N. Kumarasamy, K.H. Mayer. (2007) High rate of acquired resistance to tuberculosis among HIV-infected subjects of Chennai, South India. Journal of Infection 55:6, e141-e142
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    Elena Vicente, José María Cuadrado, Francisco Mariano Jover, Coral Martín. (2007) Meningitis por Mycobacterium tuberculosis multirresistente de curso fatal: otra cuestión que tener en cuenta. Enfermedades Infecciosas y Microbiología Clínica 25:9, 605-606
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    S.-L. Zhang, J.-G. Shen, P.-H. Xu, D.-X. Li, Z.-Q. Sun, L. Li, Z.-R. Yang, Q. Sun. (2007) A novel genotypic test for rapid detection of multidrug-resistant Mycobacterium tuberculosis isolates by a multiplex probe array. Journal of Applied Microbiology 103:4, 1262-1271
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    Ángel Domínguez-Castellano, Alfonso del Arco, Jesús Canueto-Quintero, Antonio Rivero-Román, José María Kindelán, Ricardo Creagh, Felipe Díez-García. (2007) Guía de práctica clínica de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI) sobre el tratamiento de la tuberculosis. Enfermedades Infecciosas y Microbiología Clínica 25:8, 519-534
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    Alberto Matteelli, Giovanni Battista Migliori, Daniela Cirillo, Rosella Centis, Enrico Girard, Mario Raviglione. (2007) Multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis : epidemiology and control. Expert Review of Anti-infective Therapy 5:5, 857-871
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    V. Bartu. (2007) Multidrug-resistant tuberculosis in the Czech Republic: strategy and therapeutic outcomes. European Journal of Clinical Microbiology & Infectious Diseases 26:8, 603-605
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    P. Pazarli, T. Karagoz, O. Yazicioglu Mocin, D. Duman, G. Akel. (2007) Drug resistance in pulmonary tuberculosis in Turkey. European Journal of Clinical Microbiology & Infectious Diseases 26:6, 431-433
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    Jose A. Castro-Rodriguez, Javier Mallol, Rosa Andrade, Mónica Muñoz, Ivanna Azzini. (2007) Comparison of tuberculin skin test response after three modalities of neonatal BCG vaccination. Transactions of the Royal Society of Tropical Medicine and Hygiene 101:5, 493-496
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    Gerd Laifer, Andreas F. Widmer, Mathew Simcock, Stefano Bassetti, Andrej Trampuz, Reno Frei, Michael Tamm, Manuel Battegay, Ursula Fluckiger. (2007) TB in a Low-Incidence Country: Differences Between New Immigrants, Foreign-Born Residents and Native Residents. The American Journal of Medicine 120:4, 350-356
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    Biswajit Chakrabarti, Peter DO Davies. (2007) Key issues in multidrug-resistant tuberculosis. Future Microbiology 2:1, 51-61
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    Xizhong Zhang, Maziar Divangahi, Patricia Ngai, Michael Santosuosso, James Millar, Anna Zganiacz, Jun Wang, Jonathan Bramson, Zhou Xing. (2007) Intramuscular immunization with a monogenic plasmid DNA tuberculosis vaccine: Enhanced immunogenicity by electroporation and co-expression of GM-CSF transgene. Vaccine 25:7, 1342-1352
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    Jae Chol Choi, Song Yong Lim, Gee Young Suh, Man Pyo Chung, Hojoong Kim, O Jung Kwon, Nam Yong Lee, Young Kil Park, Gil Han Bai, Won-Jung Koh. (2007) Drug Resistance Rates of Mycobacterium tuberculosis at a Private Referral Center in Korea. Journal of Korean Medical Science 22:4, 677
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    Mohamed Abdel Aziz, Abigail Wright, Adalbert Laszlo, Aimé De Muynck, Françoise Portaels, Armand Van Deun, Charles Wells, Paul Nunn, Leopold Blanc, Mario Raviglione. (2006) Epidemiology of antituberculosis drug resistance (the Global Project on Anti-tuberculosis Drug Resistance Surveillance): an updated analysis. The Lancet 368:9553, 2142-2154
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    Jaime E. Ollé-Goig. (2006) Editorial: The treatment of multi-drug resistant tuberculosis ? a return to the pre-antibiotic era?. Tropical Medicine and International Health 11:11, 1625-1628
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    Myung Jin Chung, Kyung Soo Lee, Won-Jung Koh, Tae Sung Kim, Eun Young Kang, Sung Mok Kim, O Jung Kwon, Seonwoo Kim. (2006) Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. European Radiology 16:9, 1934-1941
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    Tom G Connell, Molebogeng X Rangaka, Nigel Curtis, Robert J Wilkinson. (2006) QuantiFERON-TB Gold: state of the art for the diagnosis of tuberculosis infection?. Expert Review of Molecular Diagnostics 6:5, 663-677
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    S. Lee, D.H. Kong, S.H. Yun, K.R. Lee, K.P. Lee, S.G. Franzblau, E.Y. Lee, C.L. Chang. (2006) Evaluation of a modified antimycobacterial susceptibility test using Middlebrook 7H10 agar containing 2,3-diphenyl-5-thienyl-(2)-tetrazolium chloride. Journal of Microbiological Methods 66:3, 548-551
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    MAYSAA EL-SAYED ZAKI, NADIA HASSANIN. (2006) DNA SEQUENCE ANALYSIS OF rpoB GENE MUTATIONS IN RIFAMPICIN-RESISTANT MYCOBACTERIUM TUBERCULOSIS. Journal of Rapid Methods and Automation in Microbiology 14:3, 237-248
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    M. Aragó Galindo, A. Belda Mira, A. Albert Contell, B. Serra Sanchís, I. Amorós Quiles, J. Prat Fornells, R. Escoms Trullenque, C. González. (2006) Resistencias de Mycobacterium tuberculosis en el área del Hospital de Sagunto desde 1999 al 2004. Revista Clínica Española 206:8, 376-381
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    Dana D Staat, Michael E Klepser. (2006) International Adoption: Issues in Infectious Diseases. Pharmacotherapy 26:9, 1207-1220
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    D.W. MacPherson, B.D. Gushulak. (2006) Balancing prevention and screening among international migrants with tuberculosis: Population mobility as the major epidemiological influence in low-incidence nations. Public Health 120:8, 712-723
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    M. Tato, E. Gómez-G. de la Pedrosa, R. Cantón, I. Gómez-García, J. Fortún, P. Martín-Davila, F. Baquero, E. Gomez-Mampaso. (2006) In vitro activity of linezolid against Mycobacterium tuberculosis complex, including multidrug-resistant Mycobacterium bovis isolates. International Journal of Antimicrobial Agents 28:1, 75-78
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    H. R. van Doorn, P. E. W. de Haas, K. Kremer, C. M. J. E. Vandenbroucke-Grauls, M. W. Borgdorff, D. van Soolingen. (2006) Public health impact of isoniazid-resistant Mycobacterium tuberculosis strains with a mutation at amino-acid position 315 of katG: a decade of experience in The Netherlands. Clinical Microbiology and Infection 0:0, 060620063646004-???
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    Thuzar Han. (2006) Effectiveness of standard short-course chemotherapy for treating tuberculosis and the impact of drug resistance on its outcome. International Journal of Evidence-Based Healthcare 4:2, 101-117
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    R. Hernàndez Pando, L.D. Aguilar, E. Infante, A. Cataldi, F. Bigi, C. Martin, B. Gicquel. (2006) The use of mutant mycobacteria as new vaccines to prevent tuberculosis. Tuberculosis 86:3-4, 203-210
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    Ernesto Montoro, Dihadenys Lemus, Miguel Echemendía, Luisa Armas, Edilberto González-Ochoa, María J. Llanes, José A. Valdivia. (2006) Drug-resistant tuberculosis in Cuba. Results of the three global projects. Tuberculosis 86:3-4, 319-323
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    J. Barberán. (2006) Mujer de 58 años con lesión supurativa persistente no dolorosa en mano derecha. Medicine - Programa de Formación Médica Continuada Acreditado 9:56, 3681-3682
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    Óscar Sanz-Peláez, José A. Caminero-Luna, José L. Pérez-Arellano. (2006) Tuberculosis e inmigración en España. Evidencias y controversias. Medicina Clínica 126:7, 259-269
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    Ruiru Shi, Koji Otomo, Hiroyuki Yamada, Taiga Tatsumi, Isamu Sugawara. (2006) Temperature-mediated heteroduplex analysis for the detection of drug-resistant gene mutations in clinical isolates of Mycobacterium tuberculosis by denaturing HPLC, SURVEYOR nuclease. Microbes and Infection 8:1, 128-135
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    Gabriel M. Aisenberg, Kalen Jacobson, Roy F. Chemaly, Kenneth V. Rolston, Isaam I. Raad, Amar Safdar. (2005) Extrapulmonary tuberculosis active infection misdiagnosed as cancer. Cancer 104:12, 2882-2887
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    J. Esteban, A. Ortiz, M. S. Jiménez. (2005) Usefulness of E-test strips for testing susceptibility of Mycobacterium tuberculosis complex strains. European Journal of Clinical Microbiology & Infectious Diseases 24:12, 856-857
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    Xing Tang, Sheldon L. Morris, John J. Langone, Larry E. Bockstahler. (2005) Microarray and allele specific PCR detection of point mutations in Mycobacterium tuberculosis genes associated with drug resistance. Journal of Microbiological Methods 63:3, 318-330
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    Nikolai Menner, Ingo Günther, Helmut Orawa, Andreas Roth, Indal Rambajan, Jutta Wagner, Helmut Hahn, Shamdeo Persaud, Ralf Ignatius. (2005) High frequency of multidrug-resistant Mycobacterium tuberculosis isolates in Georgetown, Guyana. Tropical Medicine & International Health 10:12, 1215-1218
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    Young Kil Park, Sonya Shin, Sungweon Ryu, Sang Nae Cho, Won-Jung Koh, O Jung Kwon, Young Soo Shim, Woo Jin Lew, Gill Han Bai. (2005) Comparison of drug resistance genotypes between Beijing and non-Beijing family strains of Mycobacterium tuberculosis in Korea. Journal of Microbiological Methods 63:2, 165-172
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    A ALANIS. (2005) Resistance to Antibiotics: Are We in the Post-Antibiotic Era?. Archives of Medical Research 36:6, 697-705
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    T BREWER, S HEYMANN. (2005) Long Time Due: Reducing Tuberculosis Mortality in the 21 Century. Archives of Medical Research 36:6, 617-621
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    Mohamed Abdel Aziz, Abigail Wright. (2005) The World Health Organization/International Union against Tuberculosis and Lung Disease Global Project on Surveillance for Anti‐Tuberculosis Drug Resistance: A Model for Other Infectious Diseases. Clinical Infectious Diseases 41:s4, S258-S262
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    Emília Valadas, Francisco Antunes. (2005) Tuberculosis, a re-emergent disease. European Journal of Radiology 55:2, 154-157
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    Luís Curvo-Semedo, Luísa Teixeira, Filipe Caseiro-Alves. (2005) Tuberculosis of the chest. European Journal of Radiology 55:2, 158-172
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    Jennifer J Furin, John L Johnson. (2005) Recent advances in the diagnosis and management of tuberculosis. Current Opinion in Internal Medicine 4:4, 394-399
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    Gunes Senol, Berna Komurcuoglu, Ali Komurcuoglu. (2005) Drug resistance of Mycobacterium tuberculosis in Western Turkey: a retrospective study from 1100-bed teaching hospital. Journal of Infection 50:4, 306-311
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    Marcos Burgos, Leah C. Gonzalez, E. Antonio Paz, Effie Gournis, L. Masae Kawamura, Gisela Schecter, Philip C. Hopewell, Charles L. Daley. (2005) Treatment of Multidrug‐Resistant Tuberculosis in San Francisco: An Outpatient‐Based Approach. Clinical Infectious Diseases 40:7, 968-975
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    Roderick J Hay. (2005) Cutaneous infection with Mycobacterium tuberculosis: how has this altered with the changing epidemiology of tuberculosis? editorial review. Current Opinion in Infectious Diseases 18:2, 93-95
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    (2005) Footprints. New England Journal of Medicine 352:5, 516-517
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    L. Bozeman, W. Burman, B. Metchock, L. Welch, M. Weiner, . (2005) Fluoroquinolone Susceptibility among Mycobacterium tuberculosis Isolates from the United States and Canada. Clinical Infectious Diseases 40:3, 386-391
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    Vaira Leimane, Vija Riekstina, Timothy H Holtz, Evija Zarovska, Vija Skripconoka, Lorna E Thorpe, Kayla F Laserson, Charles D Wells. (2005) Clinical outcome of individualised treatment of multidrug-resistant tuberculosis in Latvia: a retrospective cohort study. The Lancet 365:9456, 318-326
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    Lee Jia, Joseph E Tomaszewski, Colleen Hanrahan, Lori Coward, Patricia Noker, Gregory Gorman, Boris Nikonenko, Marina Protopopova. (2005) Pharmacodynamics and pharmacokinetics of SQ109, a new diamine-based antitubercular drug. British Journal of Pharmacology 144:1, 80-87
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    Suhail Ahmad, Esther Fares. (2005) Genotypic Diversity among Isoniazid-Resistant Isolates of <i>Mycobacterium tuberculosis</i> from Rashid Hospital in Dubai, United Arab Emirates. Medical Principles and Practice 14:1, 16-21
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    I. C. SHAMPUTA, L. RIGOUTS AND, F. PORTAELS. (2004) Molecular genetic methods for diagnosis and antibiotic resistance detection of mycobacteria from clinical specimens. APMIS 112:11-12, 728-752
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    Phillip Onyebujoh, Graham A. W. Rook. (2004) Focus: Tuberculosis. Nature Reviews Microbiology 2:12, 930-932
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    Ted Cohen, Mercedes C. Becerra, Megan B. Murray. (2004) Isoniazid Resistance and the Future of Drug-Resistant Tuberculosis. Microbial Drug Resistance 10:4, 280-285
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