Abstract

MDR TB Transmission, Singapore

Highlights

  • To the Editor: Over the past decade, the proportion of pulmonary multidrug-resistant tuberculosis (MDR TB) cases among Singaporeborn patients remained low, whereas that among foreign-born patients was 10 times higher [1,2]

  • The sputum smear had 3+ acid-fast bacilli (AFB); mutations of the rpoB and katG genes were indicated by testing with GenoType MTDRplus (Hain Lifescience, Nehren, Germany)

  • Antiretroviral treatment (ART) given 1 month after HIV diagnosis resulted in fever 7 days later

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Summary

Introduction

To the Editor: Over the past decade, the proportion of pulmonary multidrug-resistant tuberculosis (MDR TB) cases among Singaporeborn patients remained low, whereas that among foreign-born patients was 10 times higher [1,2]. The index case-patient was a 34-year-old Burmese man (patient A) arrested 10 months after entering Singapore. When the abnormal radiograph results became known, the man was isolated within the prison. Mycobacterium tuberculosis complex (MTC) grew from sputum in 9 days; phenotypic drug-susceptibility testing (DST) demonstrated resistance to rifampin, isoniazid, streptomycin, and ethambutol and susceptibility to pyrazinamide, ethionamide, kanamycin, and ofloxacin.

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Conclusion
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