Abstract
Drug-resistant strains of tuberculosis (TB) pose a serious threat to TB prevention and control efforts. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) was created in 1998 to monitor emerging trends and patterns in TB drug resistance in Canada. To present a descriptive overview of TB drug resistance data collected through the CTBLSS for the years 2006 to 2016 in Canada, with a focus on 2016. The CTBLSS is an isolate-based surveillance system designed to collect data on TB drug resistance across Canada. Each year, data are collected and analyzed by the Public Health Agency of Canada (PHAC) and then validated by the submitting laboratory. In 2016, anti-tuberculosis drug susceptibility test results were reported for 1,452 isolates. The proportion of TB drug-resistant strains remained relatively stable with 108 (7.4%) of the isolates classified as monoresistant, five (0.3%) isolates as polyresistant and 17 (1.2%) as multidrug-resistant TB (MDR-TB) strains. In 2016, there were no extensively drug-resistant TB (XDR-TB) isolates identified. Males accounted for 792 (54.5%) of all reported isolates and 64 (49.2%) of the resistant strains and females accounted for 11 (64.7%) of the MDR-TB strains. Between 2006 and 2016, individuals between 15 and 44 years of age comprised 47.4% of all reported isolates, 54.0% of isolates showing any resistance and 72.3% of MDR-TB strains. TB drug resistance levels have been relatively low and stable over the past 11 years and have remained below the global average since national surveillance began. However, with growing worldwide concern about drug resistance and the emergence of XDR-TB, the CTBLSS will remain vital to the monitoring of TB drug resistance in Canada.
Highlights
Tuberculosis (TB), an airborne infectious disease caused by the bacterium Mycobacterium tuberculosis, remains a major cause of morbidity and mortality in many parts of the world
With growing worldwide concern about drug resistance and the emergence of XDR-TB, the Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) will remain vital to the monitoring of TB drug resistance in Canada
All participating laboratories tested for resistance to the four first-line antibiotics except for the Public Health and Microbiology Reference Laboratory in British Columbia, which did not routinely test for resistance to pyrazinamide
Summary
Tuberculosis (TB), an airborne infectious disease caused by the bacterium Mycobacterium tuberculosis, remains a major cause of morbidity and mortality in many parts of the world. While the majority of TB cases are caused by strains that are susceptible to the best available TB drugs, drug resistance is a major concern for TB control. Drug-resistant strains of tuberculosis (TB) pose a serious threat to TB prevention and control efforts It has not been a major public health issue in Canada, drug resistance has the potential to become one as Canadians frequently travel abroad and many individuals immigrate to Canada from countries with high TB rates and associated drug resistance. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) was created in 1998 to monitor emerging trends and patterns in TB drug resistance in Canada
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