This study aimed to evaluate the programmatic outcomes of patients receiving individualised antibiotic therapy for MDR-TB in the city of Sydney, in New South Wales, Australia. Some cases were reported in a recent study looking at the outcomes of MDR-TB diagnosed in Australia between 1998 and 2012. 16 Methodology Study design and settingThis retrospective cohort study included patients treated at the seven chest clinics at tertiary hospitals in Sydney, the most populous city in Australia. The country has a low annual incidence of TB, with the Commonwealth Department of Health reporting a rate of 5.8 cases per 100,000 population in 2018. 17 MDR-TB comprises

BackgroundContacts of an individual with active tuberculosis (TB) disease, have a higher risk of developing latent TB infection (LTBI) or active TB disease. Contact tracing is a public health measure that seeks to identify exposed contacts, screen them for co-prevalent TB, and consider prophylactic treatment to prevent progression from LTBI to active TB disease. The investigators sought to determine the prevalence of LTBI and active TB disease amongst MDR-TB contacts in New South Wales (NSW).MethodologyA retrospective cohort study was performed among the contacts of patients diagnosed with MDR-TB between 2000 and 2016, inclusive, at seven chest clinics. Medical records were used to identify eligible contacts. Outcomes of screening and prophylactic treatment regimens offered to MDR-TB contacts with LTBI were characterised. Collected data included demographic information, screening tests results, and initial management.ResultsA total of 247 MDR-TB contacts of 55 MDR-TB patients were identified. LTBI was identified in 105 (42.5%) contacts. Preventive treatment was received by 20 (32.3%) contacts with LTBI, in the form of various regimens, ranging from one to three antimicrobials, with various doses and durations. One contacts with LTBI, untreated, were noted to have progressed to active TB disease during the study period, according to clinic notes.ConclusionContacts of MDR-TB have a high prevalence of LTBI. Management of these contacts varies substantially in NSW, reflecting a lack of definitive evidence for preventive therapy. Further research is required to determine the optimal management of this population.