Doctors in the United Kingdom are being warned that the changing population structure is causing a rise in the number of cases of drug resistant tuberculosis.

A study published on bmj.com shows that cases of tuberculosis in England, Wales and Northern Ireland has been on the increase with more than 8,000 cases reported in 2006.

It adds that it is particularly concerning that the figures show an increasing transmission of drug resistant tuberculosis among difficult to treat, marginalised groups in urban areas such as London, and the problems this could create for tuberculosis control.

Research in to 28,620 confirmed cases of tuberculosis between 1998 and 2005 showed that the proportion of cases resistant to any first line drug had increased from 5.6 per cent to 7.9 per cent.

Within this there was an increasing proportion of isoniazid resistance (6.9 per cent) and small increases in rifampicin resistance (1.2 per cent) and multidrug resistance (0.9 per cent).

Analyses of the origin of patients showed an increase in the number of cases in people from Sub-Saharan Africa and the Indian subcontinent that researchers believe could be related.

Dr Michelle Kruijshaar and colleagues involved in the research said the analysis highlights the importance of early case detection by clinicians, rapid testing of susceptibility to drugs, additional support services to ensure that patients complete treatment and more help with tuberculosis control in countries with high incidence.

The report authors add that the levels of drug resistant tuberculosis seen in the UK are similar to those in other Western European countries - and suggest that most multidrug resistance cases occur due to problems with patient management rather than as a result of transmission within the UK.

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