TY - JOUR T1 - Multidrug and Extensively Drug-resistant Tuberculosis in Canada 1997–2008: Demographic and Disease Characteristics A1 - Minion, Jessica A1 - Gallant, Victor A1 - Wolfe, Joyce A1 - Jamieson, Frances A1 - Long, Richard Y1 - 2013/01/09 N2 - Setting Nationwide Canadian public health surveillance. Objective Description of demographic features and disease characteristics of drug-resistant tuberculosis (TB) in Canada over a 12 year period. Design Continuous surveillance of all cases of culture-confirmed TB in Canada. Demographic and microbiologic features were analyzed and comparisons between drug-susceptible, multidrug-resistant (MDR), and drug-resistant not-MDR were made. Cases of extensively drug resistant TB are described. Results 15,993 cases of culture-confirmed TB were reported during the study period. There were 5 cases of XDR-TB, 177 cases of MDR-TB, and 1,234 cases of first-line drug resistance not-MDR. The majority of drug-resistant cases were reported in foreign-born individuals, with drug-resistant cases diagnosed earlier post-arrival in Canada compared to drug-susceptible cases. In MDR-TB isolates, there was a high rate of drug-resistance to other first- and second-line drugs, making reliable empiric therapeutic recommendations for MDR-TB difficult. There was a statistically significant association between both MDR and drug-resistance not-MDR, and the risk of a negative treatment outcome (defined as treatment failure, absconded, or treatment ongoing >3 yrs). Conclusion Drug-resistance complicates TB management even in developed nations with well-established TB control programs. The predominantly international origin of drug-resistant cases highlights the need for global strategies to combat TB. JF - PLOS ONE JA - PLOS ONE VL - 8 IS - 1 UR - https://doi.org/10.1371/journal.pone.0053466 SP - e53466 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pone.0053466 ER -