HomeDetailed information on TB-related drug resistance in Canada is collected through the Canadian Tuberculosis Laboratory Surveillance System (CTBLSS). Between 2009 and 2020, 20,546 individuals were reported with TB disease. Isolates from 81.6% (16,766) were subjected to susceptibility testing, of which 1,598 (9.5%) showed resistance to anti-TB drug(s) (Table 9). The majority of individuals reported with drug-resistant TB (83.2%; n = 1,329) had mono-resistance, primarily resistance to isoniazid (INH) (n = 1,072) or pyrazinamide (PZA) (n = 225). Multi- and polydrug resistance accounted for approximately 13% (n = 206) and 3.6% (n = 57) of all TB-resistant isolates, respectively. Extensively drug resistance has been very sporadic and limited to a maximum of one individual per year. These trends have been stable over time (Figure 17).
Table 9. Reported drug-resistant TB over time, CTBLSS: 2009-2020.
| 2009-2012 n (%) |
2013-2016 n (%) |
2017-2020 n (%) |
Overall n (%) |
|
|---|---|---|---|---|
| Mono-resistance TB | 433 (8.13) | 422 (7.63) | 474 (8.02) | 1,329 (7.93) |
| Isoniazid | 363 (6.81) | 333 (6.02) | 376 (6.36) | 1,072 (6.39) |
| Rifampin | 6 (0.11) | 10 (0.18) | 12 (0.20) | 28 (0.17) |
| Pyrazinamide | 61 (1.14) | 79 (1.43) | 85 (1.44) | 225 (1.34) |
| Ethambutol | 3 (0.06) | 0 (0.00) | 1 (0.02) | 4 (0.02) |
| Poly-resistance TB | 20 (0.38) | 16 (0.29) | 21 (0.36) | 57 (0.34) |
| Isoniazid + Pyrazinamide | 10 (0.19) | 10 (0.18) | 14 (0.24) | 34 (0.20) |
| Isoniazid + Ethambutol | 7 (0.13) | 5 (0.09) | 7 (0.12) | 19 (0.11) |
| Isoniazid + Ethambutol + Pyrazinamide | 3 (0.06) | 1 (0.02) | 0 (0.00) | 4 (0.02) |
| Multidrug-resistance TB | 64 (1.20) | 73 (1.32) | 69 (1.17) | 206 (1.23) |
| Extensively drug-resistance TB | 3 (0.06) | 2 (0.04) | 1 (0.02) | 6 (0.04) |
| Total isolates tested | 5,329 (100) | 5,529 (100) | 5,908 (100) | 16,766 (100) |
In general, poly- and multidrug-resistance were found almost exclusively in isolates from foreign-born individuals, while mono-resistance (dominated by INH-resistance) was detected in individuals from all population groups. Additional details on TB drug resistance in Canada are available in Chapter 8: Drug-Resistant Tuberculosis.
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