Epidemiological and microbiological characteristics of reported cases with multidrug-resistant tuberculosis in the Republic of Bulgaria for the period 2007-2009

A retrospective study of all patients with multidrug-resistant tuberculosis (MDR-TB) registered and reported in Bulgaria during the period 2007-2009 was performed. Aim: To make epidemiological and microbiological characteristics of all cases with culture confirmed MDR-TB recorded and reported in the country during the above-mentioned period. Materials and methods: Case-based data for all TB patients recorded and reported by the regional TB health facilities for the period 2007-2009, data sent by the microbiological laboratories for TB diagnosis, and TB registries of the NRL-TB at the NCIPD were examined. Results: According to the case-based data, a total of 149 MDR-TB patients (age range 18-87) were recorded and reported during the period 2007-2009, representing 5.3% of all tested with DST. Out of all MDR-TB cases, 107 (72%) were male. Fifty-six patients (38%) were new, and 93 cases (62%) were previously treated. Out of all registered MDR-TB patients, 88.6% were confirmed by the NRL-TB. Conclusion: The case-based registries provide exact clinical, microbiological and epidemiological information, avoiding case duplication during the reporting period. The frequency of MDR-TB among previously treated TB cases is higher, mainly among the relapses and the defaulters after previous treatment. Active investigation among the contacts of MDR-TB cases and among targeted groups of TB patients (defaulters, failure of treatment, chronic cases), and confirmation of the resistance by the NRL-TB is needed, in order to provide timely and appropriate treatment of all confirmed MDR-TB cases.