Twenty-five years of tuberculosis in a French university hospital: A laboratory perspective

J. Robert, D. Trystram, C. Truffot-Pernot, E. Cambau, V. Jarlier, J. Grosset

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the impact of recent changes in the epidemiology of tuberculosis in France and other industrialised countries on the primary trends of tuberculosis case rates in a French university hospital. DESIGN: Descriptive study of all 4549 culture-positive tuberculosis cases hospitalised at Pitie-Salpetriere Hospital between 1972 and 1996. RESULTS: From 1972, there was a decline of 5% per year in the tuberculosis case rate, which levelled off in 1983. The proportion of tuberculosis patients who were human immunodeficiency virus (HIV) positive increased from 2% in 1983 to 28% in 1990, and thereafter remained stable. The proportion of foreign-born tuberculosis patients also increased, from 40% in 1972 to 55% in 1985. These two changes affected drug resistance patterns. Drug resistance was more common among foreign-born than among French-born patients, whether previously treated or not. Resistance to rifampicin and multidrug resistance among previously untreated patients was highly related to HIV co-infection. Extra- pulmonary sites of tuberculosis were more often smear-positive in HIV- positive than in non-HIV-positive patients (22.8% vs 12.6%), and bacteraemia was diagnosed almost exclusively in HIV-positive patients. CONCLUSION: The changes in clinical and bacteriological tuberculosis patterns at the hospital level over the last 25 years have paralleled those observed at national and international level in industrialised countries, including a slowing in the decrease in the case rate, due in part to the HIV epidemic, a higher proportion of foreign-born patients and an increase in drug resistance.

Original languageEnglish (US)
Pages (from-to)504-512
Number of pages9
JournalInternational Journal of Tuberculosis and Lung Disease
Volume4
Issue number6
StatePublished - Jun 1 2000

Keywords

  • Drug resistance
  • Epidemiology
  • HIV infection
  • M. tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Robert, J., Trystram, D., Truffot-Pernot, C., Cambau, E., Jarlier, V., & Grosset, J. (2000). Twenty-five years of tuberculosis in a French university hospital: A laboratory perspective. International Journal of Tuberculosis and Lung Disease, 4(6), 504-512.