Setting: Fourteen countries of the European Union (EU).
Objective: To explore determinants of resistance to isoniazid and rifampicin (multidrug-resistant tuberculosis [MDR-TB]) among tuberculosis (TB) patients in the EU.
Design: Pooled TB case notification data for 2003 from the-Baltic States (Estonia, Latvia, Lithuania) and Austria, Belgium, the Czech Republic, Denmark, Finland, Germany, Luxembourg, The Netherlands, Slovenia, Sweden and the UK were investigated using bivariate and multivariable analysis.
Results: Of 12,109 cases with data, MDR-TB occurred in 709 cases, 91% of whom were from countries of the former Soviet Union (FSU), including the Baltic States. At multivariable analysis, MDR-TB was strongly associated with previous treatment in both Baltic and non-Baltic countries (adjusted OR 9.5 and 6.4, respectively), and inversely related to age >64 years (OR 0.4 and 0.2). In non-Baltic countries, MDR-TB was more strongly related to origin from the FSU (OR 19.7, reference non-Baltic EU) than from other regions (up to OR 2.3). Among cases pooled from all countries, provenance from the FSU was very strongly linked to MDR-TB in both previously untreated (OR 24.9) and previously treated (OR 53.7) cases.
Conclusion: Within a context of increasing mobility, public health workers should be aware of a higher risk for MDR-TB among patients from the FSU as well as among patients previously treated for TB.