RESUMEN
SETTING: Foreign-born persons in the United States represent a growing proportion of the nation's tuberculosis (TB) cases. OBJECTIVE: To characterize drug resistance patterns in foreign-born TB patients from the three most common birth countries. DESIGN: A descriptive analysis of national TB surveillance data for 1993-1997. TB case reports for foreign-born persons who were at least 15 years old and born either in Mexico (6221), the Philippines (3624), or Vietnam (3351) were included. RESULTS: Among those with no prior history of TB, the proportions with isoniazid-resistant TB and MDR-TB (resistance to at least isoniazid and rifampin) were 9.2% and 1.6% for persons from Mexico, 13.7% and 1.4% for those from the Philippines, and 17.8% and 1.4% for those from Vietnam. Levels of isoniazid resistance and MDR-TB did not change during the 5-year study period. Levels of isoniazid resistance decreased with older age for persons with no prior TB from all three countries; however, rates of MDR-TB did not vary with age. Persons with <1 year of residence in the US were more likely to have MDR-TB; however, duration of residence in the US was not associated with isoniazid resistance. CONCLUSION: Increased drug resistance in younger and more recent arrivals suggests that vigorous efforts to prevent further development of MDR-TB in the three countries are essential.
Asunto(s)
Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Adolescente , Adulto , Anciano , Distribución de Chi-Cuadrado , Femenino , Humanos , Modelos Logísticos , Masculino , México/etnología , Persona de Mediana Edad , Filipinas/etnología , Vigilancia de la Población , Factores de Riesgo , Factores de Tiempo , Estados Unidos/epidemiología , Vietnam/etnologíaRESUMEN
The associations between dental charts and the probability of cross-contamination were examined by swabbing contaminated charts and plating the specimens on agar medium to be analyzed. Laboratory analysis of the agar plates revealed, that out of the twenty-one charts tested, fifteen were positive for bacterial growth, therefore, contaminated charts are a viable vector for cross-contamination. Further barrier techniques need to be implemented, which in turn would decrease the contamination potential for the spread of infection.