Primary drug resistance in pulmonary tuberculosis in Great Britain: Second national survey, 1963

A second national survey in Great Britain was conducted in 1963 to determine the prevalence of primary drug resistance to isoniazid, streptomycin and PAS and to compare the results with the national survey of 1955–56. A sample of 125 chest clinics was selected by a random process. Specimens of sputum from 1,292 newly-diagnosed patients were cultured for tubercle bacilli at a central laboratory. Of the 911 positive cultures obtained, 894 were Myco. tuberculosis, 2 Myco. bovis and 15 anonymous mycobacteria. After excluding the patients with anonymous mycobacteria, the prevalence of primary drug resistance to isoniazid, streptomycin and PAS alone or in combination was 4·1%. Resistance to only 1 drug occurred in 3·0% of patients, to 2 drugs in 0·9% and to all 3 drugs in 0·2%. The total resistance to isoniazid was 1·7%, to streptomycin 3·0% and to PAS 0·8%. Most single drug resistance was to streptomycin. Most double drug resistance was to isoniazid and streptomycin. The prevalence of primary drug resistance was statistically significantly higher among immigrants than among the British and Irish patients. The prevalence was higher among the recently arrived immigrants than among immigrants who had been in Great Britain for 5 or more years. A comparison of the findings between the 2 national surveys shows that there has been no change in prevalence over the 7-year period. Patients from countries other than Britain and Ireland comprised 10·0% of the bacteriologically confirmed patients with tuberculosis in the survey. The significance of these findings has been discussed in relation to the problem of the origin of primary drug resistance and of its importance. On a effectué en Grande-Bretagne, en 1963, une deuxième enquête sur la fréquence de la résistance primaire à l’isoniazide, à la streptomycine, et au PAS, et on a comparé les résultats à ceux de l’enquête de 1955–56. 125 services de pneumologie furent échantillonnés au hazard. Un laboratoire central rechercha le bacille tuberculeux par culture à partir d’échantillons d’expectoration provenant de 1,292 malades nouvellement diagnostiqués. Sur les 911 cultures positives, 894 étaient du Myco. tuberculosis, 2 du Myco. bovis, et 15 des mycobactéries anonymes. Après avoir exclu les malades porteurs de mycobactéries anonymes, la fréquence de la résistance primaire à l’isoniazide, à la streptomycine et au PAS était de 4,1%. La résistance à une seule drogue survint chez 3,0% des malades, à 2 drogues chez 0,9%, et aux