Creation of multiple drug-resistant mycobacterium tuberculosis in a patient failing to comply with chemotheraphy in Trinidad and Tobago - abstract

ABSTRACT

The presence of a multiple drug-resistant strain of Mycobacterium tuberculosis in Trinidad and Tobago was confirmed in 1996 in a sputum sample from a 36-year-old male. In September 1990 smear microscopy was positive for AFB3+. Three consecutive sputum samples taken on the 5th, 7th and 8th of July, 1993 from the same patient was positive for AFB3+ and M. tuberculosis, identified by culture, was resistant to isoniazid (28 percent). This was the first laboratory confirmed case of isoniazid resistant M. tuberculosis. In 1996, M. tuberculosis was cultured from the sputum of the same patient and bacilli were resistant to isoniazid (now 60.3 percent), rifampicin and streptomycin. Treatment records of the patients revealed habitual self-deferral with resumption coinciding with worsening of his clinical condition. The patient works in the mass transport industry and a large -part of the travelling public may have been exposed to a MDR M. tuberculosis strain. This has potentially perilous consequences for Trinidad and Tobago.(AU)