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Multidrug-resistant tuberculosis poses challenge.

ABSTRACT AS THE NUMBER of reports of multidrug-resistant tuberculosis mounts, the Public Health Service is becoming increasingly concerned.Since a report from hospitals in New York and Florida (JAMA. 1991; 266:1483-1485), additional outbreaks are reported from at least 13 states. "We don't yet know the extent of it," says Dixie E. Snider, Jr, MD, director, Division of Tuberculosis Elimination, Centers for Disease Control, Atlanta, Ga. Federal officials met there with health authorities from 46 states.What is happening in New York apparently is the tip of what one expert calls a "fairly scary issue." Samuel W. Dooley, MD, the division's assistant director for science, says: "There are dramatic changes in tuberculosis in the United States and worldwide. The principal factor is the acquired immunodeficiency syndrome epidemic."About 5% to 10% of normally healthy persons infected with the tuberculosis bacillus go on to develop active disease, says the division's Donald E. Klopanoff.