Tuberculosis: Drug resistance in Canada 2015

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Organization: Public Health Agency of Canada

Date published: 2017-04-03

Acknowledgements

The Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control at the Public Health Agency of Canada would like to acknowledge the members of the Canadian Tuberculosis Laboratory Technical Network and their teams as well as colleagues at the National Microbiology Laboratory for their contribution to and participation in the Canadian Tuberculosis Laboratory Surveillance System.

Table of Contents

List of Figures

List of Tables

List of Appendices

Acronyms and Abbreviations

AK
Amikacin
Alta.
Alberta
B.C.
British Columbia
BCG
Bacillus Calmette-Guérin
CCDIC
Centre for Communicable Diseases and Infection Control
CI
Confidence interval
CLSI
Clinical and Laboratory Standards Institute
CM
Capreomycin
CTBLSS
Canadian Tuberculosis Laboratory Surveillance System
CTLTN
Canadian Tuberculosis Laboratory Technical Network
EMB
Ethambutol
ETH
Ethionamide
INH
Isoniazid
KM
Kanamycin
LIN
Linezolid
M. africanum
Mycobacterium africanum
M. bovis
Mycobacterium bovis
M. canetti
Mycobacterium canetti
M. caprae
Mycobacterium caprae
M. microti
Mycobacterium microti
M. pinnipedii
Mycobacterium pinnipedii
M. tuberculosis
Mycobacterium tuberculosis
Man.
Manitoba
MDR-TB
Multidrug-resistant tuberculosis
MOX
Moxifloxacin
MTBC
Mycobacterium tuberculosis complex
N.B.
New Brunswick
N.L.
Newfoundland and Labrador
NRCM
National Reference Centre for Mycobacteriology
N.S.
Nova Scotia
Nvt.
Nunavut
N.W.T.
Northwest Territories
OFL
Ofloxacin
Ont.
Ontario
PAS
Para-aminosalicylic acid
P.E.I.
Prince Edward Island
PHAC
Public Health Agency of Canada
ProvLab
Provincial Laboratory of Public Health (Alberta)
PZA
Pyrazinamide
Que.
Quebec
RBT
Rifabutin
RMP
Rifampin
Sask.
Saskatchewan
SM
Streptomycin
TB
Tuberculosis
XDR-TB
Extensively drug-resistant tuberculosis
Y.T.
Yukon

Introduction

Drug-resistant strains of tuberculosis (TB) pose a threat to Canadian TB prevention and control efforts. Although drug-resistant TB is not a major problem in Canada, it has the potential to become one because Canadians frequently travel abroad and many individuals immigrate to Canada from countries with high TB rates and associated drug resistance.

The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) was created in 1998 as part of Canada’s response to a growing worldwide concern about TB drug resistance. It was established by the Health Canada Division of Tuberculosis Prevention and Control in collaboration with the Canadian Tuberculosis Laboratory Technical Network (CTLTN) and participating laboratories. The CTBLSS was designed to monitor emerging trends and patterns in TB drug resistance in Canada and is currently managed by the Centre for Communicable Diseases and Infection Control (CCDIC) within the Public Health Agency of Canada (PHAC).

This report is part of an annual surveillance report series that describes data collected through the CTBLSS. Specifically, this report provides details on TB drug resistance in Canada for the period 2005 to 2015, with a focus on 2015.

The data presented in this report are intended to inform public health action as well as policy and program development and assessment.

Background

Patterns of drug resistance

TB drug resistance is identified through susceptibility testing of clinical specimens collected from individuals with culture-positive TB.Footnote 1 People with TB are said to have drug-resistant TB if the strain of Mycobacterium tuberculosis causing their disease is resistant to one or more of the four first-line drugs: isoniazid, rifampin, pyrazinamide or ethambutol. The following resistance patterns are described in this report:

  • Monoresistance – defined as resistance to one first-line anti-tuberculosis drug only (isoniazid, rifampin, ethambutol or pyrazinamide).
  • Polyresistance (other patterns) – defined as resistance to more than one first-line anti- tuberculosis drug, not including the isoniazid and rifampin combination.
  • Multidrug-resistant tuberculosis (MDR-TB) – defined as resistance to isoniazid and rifampin with or without resistance to other anti-tuberculosis drugs.
  • Extensively drug-resistant TB (XDR-TB) – defined as resistance to isoniazid and rifampin and any fluoroquinolone and at least one of the three injectable second-line drugs (amikacin, capreomycin or kanamycin).Footnote 2

TB drug resistance testing standards in Canada

The mission of the CTLTN is to promote excellence, standardization and quality assurance in mycobacteriology services. The CTLTN is a pan-Canadian network of technical and scientific heads of provincial and territorial TB laboratories (see Appendix I: Participating Laboratories of the Canadian Tuberculosis Laboratory Technical Network (CTLTN)).

The goals of the CTLTN are to:

  • standardize laboratory methodologies;
  • improve biosafety operational practices and physical requirements;
  • implement biosafety guidelines;
  • participate in national surveillance and proficiency programs; and
  • exchange services and information about new technologies.

Laboratory testing methods in Canada, including drug selection and the critical concentrations used for routine drug susceptibility testing, follow recommended laboratory standards.Endnote i,Footnote 3,Footnote 4 Participating CTLTN laboratories perform routine susceptibility testing of Mycobacterium tuberculosis complex (MTBC) isolates against first-line anti-tuberculosis drugs using fluorometric proportion method BACTEC® MGIT 960. Table 1 provides a list of recommended first-line and second-line anti-tuberculosis drugs and the recommended critical concentrations to be used for testing.Footnote 3,Footnote 4

Second-line drug susceptibility testing varies across jurisdictions. Typically, however, isolates are tested for resistance to amikacin, kanamycin, capreomycin, ethionamide, linezolid, ofloxacin, moxifloxacin, para-aminosalicylic acid and rifabutin.

Methods

Overview of the Canadian Tuberculosis Laboratory Surveillance System

The CTBLSS is an isolate-based surveillance system designed to collect data on TB drug resistance from across Canada. Each year, drug susceptibility test results for isolates tested in the previous calendar year are voluntarily submitted to PHAC by provincial TB laboratories for inclusion in the CTBLSS. Not all provinces and territories, however, have the capacity to perform drug susceptibility testing. Those without the capacity prepare the isolates and forward them to other provincial laboratories for testing. In some instances, the laboratory that tests the sample sends the results to PHAC on behalf of the originating province or territory. For further details on provincial/territorial laboratory drug susceptibility testing capacity, please refer to Appendix II.

Data are submitted to PHAC either through the manual completion of a standard reporting form (Appendix III: M. tuberculosis Complex Antimicrobial Susceptibility Reporting Form) or electronically. Standardized data recoding procedures are applied to all data to create a national dataset. The following information is submitted to PHAC:

  • the date the isolate or specimen was received at the laboratory;
  • the isolate or specimen identification number provided by the laboratory;
  • the province where the isolate was tested;
  • the province/territory from which the isolate originated;
  • the sex of the individual from whom the isolate was collected;
  • the date of birth or age at time of testing of the individual from whom the isolate was collected;
  • the name(s) of the drug(s) tested;
  • the concentration at which the drug(s) was (were) tested; and
  • drug susceptibility result (sensitive/resistant/not done).

Data are submitted for confirmed cases of MTBC demonstrated on culture, including M. tuberculosis, M. africanum, M. canetti, M. caprae, M. microti, M. pinnipedii or M. bovis. Results may be submitted at the species level or for MTBC only without species identification. Some laboratories also submit results for the M. bovis Bacillus Calmette-Guérin (BCG) strain, a complication of TB vaccination often found in immunocompromised patients. These results are excluded from this report because this strain is not infectious.

All participating laboratories test for resistance to the first-line antibiotics isoniazid, ethambutol and rifampin. Although the Canadian Tuberculosis Standards (7th edition) recommends that laboratories perform drug susceptibility testing to pyrazinamideFootnote 1, British Columbia does not routinely test for resistance to this drug. If resistance to any first-line drug is detected, British Columbia will subsequently test the isolate for resistance to pyrazinamide.

Results of second-line drug susceptibility testing are submitted for isolates showing resistance to isoniazid and rifampin. To rule out XDR-TB, laboratories are asked to report results for at least one of the fluoroquinolones (ofloxacin, moxifloxacin or levofloxacin) and at least one of the injectable agents (amikacin, kanamycin and capreomycin).

Tabulation and presentation of results

This report provides an overview of TB drug resistance in Canada for the period 2005 to 2015. Data are presented by province/territory and by age group and sex where feasible. Data from 2015 (the most recent reporting year for which data are available) are highlighted as are important trends over time.

The data presented in this report were extracted from the CTBLSS database on February 28, 2016 and have been validated by the reporting laboratories. Results from cultures that grow in a given year are included in the statistics for that calendar year; otherwise the results are reflected in the subsequent year’s report. For example, if a specimen was received by the laboratory on December 20, 2015 and the culture did not grow M. tuberculosis until January 2016, these results would be reflected in the 2016 report.

Samples submitted to the laboratory for drug susceptibility testing may be collected at the time of the individual’s diagnosis or at any time during treatment. Depending on the treatment duration, an individual may be tested multiple times over several years until cured or until the prescribed treatment is completed. If two specimens are confirmed to be from the same individual in a given calendar year, only the most recent susceptibility result is retained. Therefore, the number of isolates described in this report is not equal to the number of culture-positive cases reported through the case-based surveillance system over the same time period where each individual with culture-positive TB is only reported once in the year of diagnosis.

No statistical procedures were used for comparative analyses in this report, nor were any statistical techniques applied to account for missing data. Data in tables with small cell sizes (n £ 5) were not suppressed, since disclosure is not deemed to pose any risk of identifying individuals. These procedures are consistent with PHAC’s Directive for the collection, use and dissemination of information relating to public health.Footnote 5

Results

In 2015, anti-tuberculosis drug susceptibility test results for 1,352 isolates were reported to PHAC. Of these, 13 (1.0%) isolates were identified as M. bovis BCG and were excluded from further analyses. Of the remaining 1,339 isolates analyzed, 788 (58.8%) were reported as MTBC where the species was known (772 were M. tuberculosis, ten were M. africanum and six were M. bovis) and 551 (41.2%) were MTBC of an unknown species (data not shown). Figure 1 shows the number of MTBC isolates tested by province or territory of origin. Table 2 provides a breakdown of the number of isolates by reporting and originating province or territory.

Figure 1: Number of Mycobacterium tuberculosis complex isolates tested by province or territory of origin, 2015
Figure 1
Figure 1 - Text Description
Figure 1: Number of Mycobacterium tuberculosis complex isolates tested by province or territory of origin, 2015
Province or territory of origin Number of reported isolates
Ont. 480
B.C. 231
Que. 185
Alta. 185
Man. 129
Sask. 50
Nvt. 35
N.L. 21
N.S. 7
N.B. 7
N.W.T 4
Y.T. 3
P.E.I. 2

For the period 2005 to 2015, drug susceptibility test results were reported for 14,776 isolates (Table 3). Of the results received during this period, 1,402 (9.5%) were resistant to one or more of the first-line drugs, 178 isolates (1.2%) were identified as multidrug-resistant and 7 (< 0.1%) were identified as extensively drug-resistant (Table 3).

Any first-line drug resistance

In 2015, rifampin and ethambutol sensitivity results were available for all 1,339 isolates tested, isoniazid sensitivity results were available for 1,336 of the 1,339Endnote ii isolates tested and 1,111 (83.0%) isolates were tested for resistance to pyrazinamide (Table 4). As a percentage of the isolates tested, 110 (8.2%) were resistant to isoniazid, 38 (3.4%) were resistant to pyrazinamide 24 (1.8%) were resistant to rifampin, and 10 (0.7%) were resistant to ethambutol (Figure 2 ).

Figure 2 : Percentage of isolates tested with any resistance to isoniazid, pyrazinamide, rifampin and ethambutol, 2015
Figure 2
Figure 2 - Text Description
Figure 2 : Percentage of isolates tested with any resistance to isoniazid, pyrazinamide, rifampin and ethambutol, 2015
Resistance pattern Drug resistance (%)
Any resistance to INH 8.2
Any resistance to PZA 3.4
Any resistance to RMP 1.8
Any resistance to EMB 0.7

Figure 3 shows the changes over time in the percentage of isolates resistant to each of the first-line drugs for the period 2005 to 2015. During this period of time, 8.0% (range: 6.7% to 9.2%) of all isolates tested were resistant to isoniazid (Table 4) whereas resistance shown to ethambutol, rifampin or pyrazinamide has remained below 4% (Figure 3).

Figure 3 : Percentage of isolates tested with any resistance to isoniazid, pyrazinamide, rifampin and ethambutol, 2005 to 2015
Figure 3
Figure 3 - Text Description
Figure 3 : Percentage of isolates tested with any resistance to isoniazid, pyrazinamide, rifampin and ethambutol, 2005 to 2015
  Any resistance to INH Any resistance to RMP Any resistance to EMB Any resistance to  PZA
2005 8.2 1.8 1.5 2.1
2006 7.3 1.7 0.9 1.5
2007 8.7 1.0 1.8 2.7
2008 7.5 1.4 1.0 2.1
2009 8.5 1.6 1.3 1.7
2010 7.9 1.4 0.8 2.4
2011 9.2 1.6 0.7 2.6
2012 7.9 0.7 0.3 2.4
2013 6.7 1.2 0.7 2.2
2014 7.8 1.7 0.4 2.6
2015 8.2 1.8 0.7 3.4

Monoresistance

In 2015, of the 139 TB isolates (10.4% of all isolates tested) reported to be resistant to at least one of the four first-line drugs (Table 4), the majority (n = 114; 82.0%) were monoresistant. Of these, 85 (74.6%) were isoniazid monoresistant, 27 (23.7%) were pyrazinamide monoresistant and 2 (1.8%) were rifampin monoresistant. No isolates were ethambutol monoresistant (Table 5 to Table 17; data not tabulated across tables).

For the period 2005 to 2015, 7.9% of all isolates tested were monoresistant, ranging from a high of 9.1% in 2012 to a low of 6.7% in 2013 (Table 4). During this time, 30 isolates (0.2% of all isolates tested) were identified as rifampin-monoresistant, which is an uncommon resistance patternFootnote 1. Of these, 16 (53.3%) originated from British Columbia; six (20.0%) from Ontario, three (10.0%) from Quebec, two (6.7%) from Alberta, and one (3.3%) each from Saskatchewan, Northwest Territories and Nunavut. On average, one to three rifampin-monoresistant isolates were reported each year from 2005 to 2015 (Table 5 to Table 17; data not tabulated across tables).

Polyresistant, multidrug-resistant and extensively drug-resistant TB

In 2015, after excluding isolates resistant to both isoniazid and rifampin, three isolates (0.2%) were resistant to two or more of the first-line drugs and were therefore classified as polyresistant (Table 4). Two of these were resistant to isoniazid and ethambutol and one was resistant to isoniazid and pyrazinamide.

For the period 2005 to 2015, 54 (0.4%) isolates were identified as polyresistant (Table 4). Of these, 26 (48.1%) were resistant to isoniazid and ethambutol, 21 (38.9%) were resistant to isoniazid and pyrazinamide, and one was resistant to ethambutol and pyrazinamide. The remaining six isolates were resistant to isoniazid, ethambutol, and pyrazinamide (Table 5 to Table 17; data not tabulated across tables)

With respect to first-line drug resistance, 22 (1.6%) isolates were isoniazid and rifampin resistant (identifying them as at least MDR-TB) in 2015. Of these, 11 (50.0%) were resistant to only isoniazid and rifampin. In addition to being isoniazid and rifampin resistant, three were also resistant to pyrazinamide, and one to ethambutol. Seven isolates were resistant to all four of the first-line drugs (Table 18).

To rule out XDR-TB, all 22 isolates resistant to both isoniazid and rifampin were subsequently tested for resistance to select second-line drugs. Of these, three isolates were resistant to at least one of the injectable agents (amikacin, capreomycin or kanamycin) but susceptible to the fluoroquinolones, and one isolate was resistant to a fluoroquinolone but susceptible to all of the injectable agents (Table 5 to Table 17; data not tabulated across tables). Because none of the 22 isoniazid- and rifampin-resistant isolates were resistant to both an injectable agent and a flouroquinolone, all 22 were classified as MDR-TB and none were classified as XDR-TB (Table 18).  Figure 4 presents patterns of TB drug resistance as a percentage of all isolates tested in 2015.

Figure 4 : Tuberculosis drug resistance patterns as a percentage of isolates tested, 2015
Figure 4
Figure 4 - Text Description
Figure 4 : Tuberculosis drug resistance patterns as a percentage of isolates tested, 2015
Resistance pattern Drug Resistance (%)
Monoresistant 8.5
Multidrug-resistant 1.6
Polyresistant 0.2
Extensively drug-resistant 0.0

For the period 2005 to 2015, 178 isolates were classified as MDR-TB, representing 1.2% of isolates tested over this time (Table 4) and seven isolates were classified as XDR-TB, representing less than 0.1% of the isolates tested. An average of 16 MDR-TB isolates were reported each year, ranging from a low of eight in 2012 (0.6% of all isolates tested in 2012) to a high of 22 in 2005 and in 2015 (1.6% of all isolates tested in each respective year).

Figure 5 shows the overall pattern of reported TB drug resistance as a percentage of isolates tested for the period 2005 to 2015. While there have been small fluctuations in the percentage of isolates showing various resistance patterns, there has been no notable change during this time.

Figure 5: Tuberculosis drug resistance patterns as a percentage of isolates tested, 2005 to 2015
Figure 5
Figure 5 - Text Description
Figure 5: Tuberculosis drug resistance patterns as a percentage of isolates tested, 2005 to 2015
Resistance pattern 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Monoresistant 7.7 7.7 8.8 6.9 7.4 6.9 9.0 9.1 6.7 7.8 8.5
Multidrug-resistant 1.6 1.1 0.9 1.1 1.4 1.3 1.4 0.6 1.0 1.3 1.6
Polyresistant 0.2 0.2 0.9 0.4 0.8 0.5 0.1 0.1 0.3 0.3 0.2
Extensively drug-resistant 0.0 0.1 0.0 0.1 0.0 0.1 0.1 0.1 0.1 0.1 0.0

Geographical distribution

In 2015, the majority (90.4%) of isolates originated from five provinces: Ontario, British Columbia, Quebec, Alberta and Manitoba. Saskatchewan accounted for fewer than 4% of reported isolates while the northern territories (Northwest Territories, Nunavut and Yukon) and the Atlantic provinces (New Brunswick, Newfoundland and Labrador, Nova Scotia and Prince Edward Island) together accounted for 5.9% of reported isolates Table 2 .

In 2015, all isolates from the Northwest Territories, Yukon, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island were susceptible to all first-line drugs tested. Of the 22 MDR-TB isolates, 14 originated from Ontario, two from each Alberta, British Columbia, and Quebec and one from each Manitoba and New Brunswick (Table 19).

For the period 2005 to 2015, all 178 MDR-TB isolates originated from seven provinces: Alberta, British Columbia, Manitoba, New Brunswick, Ontario, Quebec and Saskatchewan. Of the seven isolates identified as XDR-TB, five originated from Ontario, one from Manitoba and one from Quebec (Table 19).

Table 5 through Table 17 present complete resistance profiles for all the isolates tested for the period 2005 to 2015, by province and territory.

Demographic information

In 2015, age and/or date of birth was reported for all 1,339 individuals from whom isolates were collected (Table 20). Of the 139 drug-resistant isolates, none were from individuals under the age of 15 years. The majority of isolates with any resistance were collected from individuals between 15 and 34 years of age. Of the 22 MDR-TB isolates, 36.4% (n=8) were collected from individuals between 25 and 34 years of age.

In 2015, sex was known for 1,331 (99.4%) of the 1,339 individuals from whom isolates were collected (Table 20). Males accounted for 55.1% of all reported isolates. Females accounted for 54.0% of isolates showing any resistance, and males accounted for 54.5% of MDR-TB isolates.

Discussion

In many parts of the world, drug resistance is a major challenge to preventing and controlling TB. Eastern Europe and Central Asia continue to have the world’s highest proportion of MDR-TB cases.Footnote 6

Tuberculosis strains that are resistant to both isoniazid and rifampin pose a considerable challenge to treatment and prevention efforts because effective anti-tuberculosis drugs are limited. Data published by the World Health Organization show that, globally, in 2014 about 3.3% (95% CI: 2.2%–4.4%) of new TB cases and 20% (95% CI: 14%–27%) of previously treated TB cases were MDR-TB.Footnote 6 Although the data captured through the CTBLSS do not distinguish between isolates from new versus previously treated cases of TB, the fact that only 1.6% of isolates tested in 2015 were MDR-TB is a considerably lower finding than global estimates. In addition, the fact that only seven XDR-TB cases were identified over the period 2005 to 2015 indicates that XDR-TB in Canada is rare.

Strengths and limitations

The CTBLSS is the result of a successful collaboration between federal, provincial and territorial governments and the CTLTN. The primary objective of the CTBLSS is to monitor emerging trends and patterns in resistance to anti-tuberculosis drugs in Canada. This report presents detailed data on the extent of first- and second-line TB drug resistance in Canada, disaggregated by province/territory and, where feasible, by sex and/or age group. As the primary source of national data on TB drug resistance in Canada, the data within this report provide timely information for public health action, as well as policy and program development and assessment.

Prior to analysis and report preparation, all data were reviewed for errors, inconsistencies and completeness. Submitting laboratories were provided with a summary report of their data for review. Following validation by the reporting laboratories, the data were integrated into the CTBLSS database. Nevertheless, like most surveillance data, the data in this report are subject to possible coding, reporting and processing errors.

Previously published data may be updated based on late reporting or revisions from participating laboratories. Any revisions to previously reported data are reflected in subsequent reports. Therefore, the data presented in this report are considered the most up-to-date and replace those previously published in this report series.

Although efforts are made to ensure that multiple records for any one individual in a given year are removed, given the minimal identifying information available for each isolate (age and sex), it is possible that multiple records from one individual are included in the database. This bias is likely minimal given the validation process with the data providers.

Demographic and clinical data collected through the CTBLSS are limited. No data are collected on the ethnic origin, diagnostic/clinical status or the treatment outcome of the individual from whom the sample was collected. Additional demographic and clinical information would facilitate a more in-depth epidemiological assessment of drug resistance patterns in Canada. What’s more, differentiation between primary and acquired drug resistance and differing resistance patterns among new cases in comparison to re-treatment cases are not possible based on data collected through this surveillance system. However, the Tuberculosis in Canada report, which provides an overview of the overall number of reported active TB cases and corresponding incidence rates in Canada by select demographic and clinical characteristics, presents case-based (vs. isolate-based) data on primary and acquired drug resistance in Canada that are not presented here. Together, these two reports provide a more comprehensive overview of TB case and drug resistance surveillance data from a national perspective.

Typically, only MDR-TB isolates or other extensive resistance patterns will undergo select second-line drug sensitivity testing. Although the Clinical and Laboratory Standards Institute (CLSI) recommends that isoniazid-monoresistant isolates as well as other polyresistant, non-MDR isolates be tested for second-line drug resistance, this is not universally reported in Canada. Other isolates that are not MDR-TB may be resistant to fluoroquinolones because of the widespread use of these antibiotics for other respiratory infections. To some extent, this limits our understanding of the emergence of second-line drug resistance within Canada.

Conclusion

TB drug resistance is an important global public health concern, but it is not a significant problem in Canada. In 2015, 10.4% of all isolates tested were resistant to at least one of the four first-line drugs; the majority were resistant to only one drug (82.0%), and 1.6% were identified as MDR-TB and none as XDR-TB. TB drug resistance levels have been stable over the past 10 years and have remained below the global average since national surveillance began. However, with growing worldwide concern about resistance and the emergence of XDR-TB, the CTBLSS remains vital to the monitoring of TB drug resistance in Canada.

Appendices

Appendix I: Participating Laboratories of the Canadian Tuberculosis Laboratory Technical Network (CTLTN)

Alberta

Provincial Laboratory of Public Health

Edmonton/Calgary

Cary Shandro
Technologist Mycobacteriology

Dr. Greg Tyrrell
Clinical Microbiologist

Dr. Graham Tipples
Medical/Scientific Director

British Columbia

British Columbia Centre for Disease Control
Public Health Microbiology and Reference Laboratory

Vancouver

Dr. Mabel Rodrigues
Mycobacteriology/TB Laboratory, Team Lead

Dr. Mel Krajden
Medical Microbiologist/ Director, Laboratory Services

Manitoba

Diagnostics Services Manitoba
Health Sciences Centre

Winnipeg

Assunta Rendina
Charge Technologist, Mycobacteriology

Doug Swidinsky
Senior Technologist

Dr. Heather Adam
Clinical Microbiologist

New Brunswick

Department of Laboratory Medicine
Saint John Regional Hospital

Saint John

Hope MacKenzie
MLT3-Supervisor CL3 Lab

Dr. Duncan Webster
Medical Microbiologist/ Infectious Disease

Dr. Tarek Rahmeh
Laboratory Director

Newfoundland and Labrador

Newfoundland and Labrador Public Health Laboratory

St. John's

Sherry Baird

Tech II

Dr. George Zahariadis.
Director & Divisional Chief of the Public Health Laboratory and Microbiology Services

Northwest Territories

Stanton Territorial Hospital

Yellowknife

Sherrill Webber
Tech II, Microbiology

Carolyn Russell
Laboratory Supervisor

Cheryl Case
Manager
Therapeutic & Diagnostic Services

Nova Scotia

Department of Pathology & Laboratory Medicine
Queen Elizabeth II Health Sciences Centre

Halifax

Darlene McPhee (MLTC/ temporary supervisor)
Division of Medical Microbiology

Dr. David Haldane,
Director, Provincial Public Health Laboratory Network and Special Pathogens

Dr. Todd Hatchette
Director, Pathology and Laboratory Medicine

Nunavut

Qikiqtani General Hospital

Iqaluit

Sonia Marchand
Laboratory Health

Ontario

Public Health Ontario Laboratories
Public Health Ontario

Toronto

Kevin May
Operational Lead, Mycobacteriology

Dr. Frances Jamieson
Medical Microbiologist -TB and Mycobacteriology

Kirby Cronin
Laboratory Liaison Technical Officer (PHAC)

Alex Marchand-Austin
Manager, Laboratory Surveillance and Data Management

Quebec

Laboratoire de santé publique du Québec
Institut national de santé publique du Québec

Sainte-Anne-de-Bellevue

Hafid Soualhine
Head, Mycobacteriology & Aerobic Actinomycetes

Dr. Jean Longtin
Director

Saskatchewan

Saskatchewan Disease Control Laboratory

Regina

Rita Thomas
Technologist, TB/Bacteriology

Dr. David Farrell
Director of Bacteriology/ Associate Clinical Director

Dr. Paul Levett
Clinical Director

Dr. David Alexander
Microbiologist

Dr. Greg Horsman
Medical Director

Federal

National Microbiology Laboratory
Public Health Agency of Canada 

Winnipeg

Joyce Wolfe
Senior Expert Program Delivery

Kym Antonation
Chief, Bioforensics Assay Development and Diagnostics
National Microbiology Laboratory

Appendix II: Provincial/territorial laboratory drug susceptibility testing capacity

  • The British Columbia Public Health Microbiology and Reference Laboratory at the British Columbia Centre for Disease Control tests and reports first-line susceptibility results for British Columbia and Yukon.
  • The Provincial Laboratory of Public Health (ProvLab) in Alberta tests and reports results for Alberta and Northwest Territories.
  • Public Health Ontario Laboratories test and report results for Ontario and Nunavut.
  • The National Reference Centre for Mycobacteriology (NRCM)Endnote iii located in Manitoba does first-line susceptibility testing for Newfoundland and Labrador, Manitoba, New Brunswick, Nova Scotia and Prince Edward Island. In this case, the NRCM returns test results to the originating province and the originating province submits their results to PHAC.
  • All the remaining provinces conduct their own first-line testing and do not routinely report results for any other jurisdiction.
  • Four laboratories in Canada conduct second-line drug susceptibility testing: the ProvLab in Alberta, the Public Health Ontario Laboratories, the Laboratoire de santé publique du Québec and the NRCM.
  • The NRCM tests the susceptibility of isolates to second-line drugs for all provinces and territories that do not conduct such testing at their laboratories. Upon request, the NRCM also tests isolates submitted by any provincial laboratory to confirm resistance patterns. Results from testing done by NRCM are returned to the provincial laboratory that submitted the isolates and the provincial laboratory then reports the results to PHAC.

Appendix III: M. tuberculosis Complex Antimicrobial Susceptibility Reporting Form

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Organization: Public Health Agency of Canada

Date published: 2015-02-04

Appendix IV: Data Tables

TABLE 1:  Critical concentrations for routine testing of anti-tuberculosis drugs
ANTI-TUBERCULOSIS DRUGS CRITICAL CONCENTRATIONSTable 1 - Footnote * (mg/L) BACTEC®  960 COMMENTS
FIRST-LINE Isoniazid (INH) 0.1 When resistance to INH is 0.1 mg/L, tests are repeated with INH 0.4 mg/L to determine the level of resistance. Nevertheless, the isolate is reported as resistant using the 0.1 mg/L cut-off level.
Rifampin (RMP) 1.0 -
Ethambutol (EMB) 5.0 -
Pyrazinamide (PZA) 100.0 Routine testing is not performed for isolates from British Columbia.
SECOND-LINE Amikacin (AK) 1.0 -
Capreomycin (CM) 2.5 -
Ethionamide (ETH) 5.0 -
Kanamycin (KM) 2.5 -
Linezolid (LIN) 1.0 -
Moxifloxacin (MOX) 0.3 -
Ofloxacin (OFL) 2.0 -
Para-amino salicylic acid (PAS) 4.0 -
Rifabutin (RBT) 0.5 -
Streptomycin (SM) 1.0 -
TABLE 2: Total number of Mycobacterium tuberculosis complex isolates by reporting and originating province/territory, 2015
REPORTING PROVINCE/TERRITORY CANADA ORIGINATING PROVINCE/ TERRITORY
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. N.W.T Nvt.
Abbreviations: Alta.= Alberta; B.C.= British Columbia; Man.= Manitoba; N.B.= New Brunswick; N.L.= Newfoundland and Labrador; N.S.= Nova Scotia; Nvt.= Nunavut; N.W.T.= Northwest Territories; Ont.= Ontario; P.E.I.= Prince Edward Island; Que.= Quebec; Sask.= Saskatchewan; Y.T.= Yukon.
N.L. 21 21 0 0 0 0 0 0 0 0 0 0 0 0
N.S. 9 0 2 7 0 0 0 0 0 0 0 0 0 0
N.B. 7 0 0 0 7 0 0 0 0 0 0 0 0 0
Que. 183 0 0 0 0 183 0 0 0 0 0 0 0 0
Ont. 517 0 0 0 0 2 480 0 0 0 0 0 0 35
Man. 129 0 0 0 0 0 0 129 0 0 0 0 0 0
Sask. 50 0 0 0 0 0 0 0 50 0 0 0 0 0
Alta. 190 0 0 0 0 0 0 0 0 185 1 0 4 0
B.C. 233 0 0 0 0 0 0 0 0 0 230 3 0 0
TOTAL 1,339 21 2 7 7 185 480 129 50 185 231 3 4 35
TABLE 3: Total number of Mycobacterium tuberculosis complex isolates and number and percentage identified with any resistance, as multidrug  and as extensively drug resistant in Canada, 2005 to 2015
  TOTAL NUMBER OF REPORTED  MTBC ISOLATES RESISTANT TO ONE OR MORE FIRST-LINE DRUGS MULTIDRUG-RESISTANT TBTable 3 - Footnote * EXTENSIVELY DRUG-RESISTANT TBTable 3 - Footnote
NUMBER  PERCENT (%) NUMBER  PERCENT (%) NUMBER  PERCENT (%)
Abbreviations: MTBC= Mycobacterium tuberculosis complex 
2005 1,335 128 9.6 22 1.6 0 0.0
2006 1,389 126 9.1 15 1.1 1 0.1
2007 1,267 133 10.5 11 0.9 0 0.0
2008 1,356 116 8.6 15 1.1 1 0.1
2009 1,331 127 9.5 18 1.4 0 0.0
2010 1,279 112 8.8 17 1.3 1 0.1
2011 1,319 139 10.5 18 1.4 1 0.1
2012 1,404 139 9.9 8 0.6 1 0.1
2013 1,381 112 8.1 14 1.0 1 0.1
2014 1,376 131 9.5 18 1.3 1 0.1
2015 1,339 139 10.4 22 1.6 0 0.0
TOTAL 14,776 1,402 9.5 178 1.2 7 <0.1
TABLE 4: Overall pattern of reported tuberculosis drug resistance in Canada, 2005 to 2015
  2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 TOTAL
  n % n % n % n % n % n % n % n % n % n % n % n %
Total number of isolates tested 1,335 100.0 1,389 100.0 1,267 100.0 1,356 100.0 1,331 100.0 1,279 100.0 1,319 100.0 1,404 100.0 1,381 100.0 1,376 100.0 1,339 100.0 14,776 100.0
Isolates tested that were susceptible 1,207 90.4 1,263 90.9 1,134 89.5 1,240 91.4 1,204 90.5 1,167 91.2 1,180 89.5 1,265 90.1 1,269 91.9 1,245 90.5 1,200 89.6 13,374 90.5
Isolates showing any resistance to first-line drugs
Any resistance to isoniazid 109 8.2 101 7.3 110 8.7 102 7.5 113 8.5 101 7.9 122 9.2 111 7.9 93 6.7 107 7.8 110 8.2 1,179 8.0
Any resistance  to rifampin 24 1.8 24 1.7 13 1.0 19 1.4 21 1.6 18 1.4 21 1.6 10 0.7 17 1.2 24 1.7 24 1.8 215 1.5
Any resistance to ethambutol 20 1.5 12 0.9 23 1.8 13 1.0 17 1.3 10 0.8 9 0.7 4 0.3 10 0.7 6 0.4 10 0.7 134 0.9
Any resistance to pyrazinamideTable 4 - Footnote * 22 2.1 16 1.5 27 2.7 22 2.1 18 1.7 25 2.4 28 2.3 33 2.8 26 2.2 30 2.6 38 3.4 285 2.4
Total number isolates resistant to one or more first-line TB drugs 128 9.6 126 9.1 133 10.5 116 8.6 127 9.5 112 8.8 139 10.5 139 9.9 112 8.1 131 9.5 139 10.4 1,402 9.5
Monoresistant 103 7.7 107 7.7 111 8.8 94 6.9 98 7.4 88 6.9 119 9.0 128 9.1 93 6.7 108 7.8 114 8.5 1,163 7.9
Multidrug resistantTable 4 - Footnote 22 1.6 15 1.1 11 0.9 15 1.1 18 1.4 17 1.3 18 1.4 8 0.6 14 1.0 18 1.3 22 1.6 178 1.2
Polyresistant 3 0.2 3 0.2 11 0.9 6 0.4 11 0.8 6 0.5 1 0.1 2 0.1 4 0.3 4 0.3 3 0.2 54 0.4
Extensively drug resistantTable 4 - Footnote 0 0.0 1 0.1 0 0.0 1 0.1 0 0.0 1 0.1 1 0.1 1 0.1 1 0.1 1 0.1 0 0.0 7 <0.1
TABLE 5: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Alberta, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations: AK=amikacin;EMB=ethambutol; ETH=ethionamide; INH=isoniazid; KM=kanamycin; MOX=moxifloxacin; OFL=ofloxacin; PAS=para-aminosalicylic acid; PZA=pyrazinamide; RBT=rifabutin; RMP=rifampin; SM=streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 5 - Footnote * 129 100.0 104 100.0 98 100.0 134 100.0 159 100.0 107 100.0 156 100.0 163 100.0 154 100.0 181 100.0 185 100.0
Isolates susceptible to all first-line TB drugs 115 89.1 95 91.3 92 93.9 123 91.8 145 91.2 96 89.7 133 85.3 148 90.8 140 90.9 165 91.2 164 88.6
Monoresistant TB
INH 10 7.8 7 6.7 5 5.1 8 6.0 8 5.0 6 5.6 14 9.0 10 6.1 9 5.8 11 6.1 15 8.1
RMP 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 1 1.0 1 1.0 0 0.0 3 1.9 0 0.0 2 1.3 3 1.8 4 2.6 0 0.0 3 1.6
Subtotal - Monoresistant TB 10 7.8 8 7.7 6 6.1 8 6.0 12 7.5 6 5.6 16 10.3 13 8.0 13 8.4 12 6.6 18 9.7
Polyresistant
INH & EMB 0 0.0 0 0.0 0 0.0 1 0.7 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & EMB & PZA  0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0
INH & PZA  0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 1 0.9 0 0.0 1 0.6 0 0.0 0 0.0 1 0.5
Subtotal - Polyresistant 0 0.0 0 0.0 0 0.0 1 0.7 2 1.3 2 1.9 0 0.0 1 0.6 1 0.6 0 0.0 1 0.5
Multidrug-resistant TBTable 5 - Footnote
INH & RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB 1 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA 1 0.8 0 0.0 0 0.0 1 0.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0
INH & RMP & EMB & PZA & SM 1 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & OFL & MOX 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
INH & RMP & EMB & PZA & SM & OFL & MOX & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0
INH & RMP & EMB & PZA & SM & RBT 0 0.0 0 0.0 0 0.0 1 0.7 0 0.0 1 0.9 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM 0 0.0 1 1.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & ETH 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
INH & RMP & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 1.3 0 0.0 0 0.0 1 0.6 0 0.0
INH & RMP & PZA & SM & ETH 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & OFL & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM 1 0.8 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0
INH & RMP & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0
Subtotal - Multidrug-resistant TB 4 3.1 1 1.0 0 0.0 2 1.5 0 0.0 3 2.8 7 4.5 1 0.6 0 0.0 4 2.2 2 1.1
Extensively drug-resistant TBTable 5 - Footnote
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number isolates resistant to one or more first-line TB drugs 14 10.9 9 8.7 6 6.1 11 8.2 14 8.8 11 10.3 23 14.7 15 9.2 14 9.1 16 8.8 21 11.4
TABLE 6: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for British Columbia, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations: CM=capreomycin; EMB=ethambutol; ETH=ethionamide; INH=isoniazid; KM=kanamycin; MOX=moxifloxacin; OFL=ofloxacin; PAS=para-aminosalicylic acid; PZA=pyrazinamide; RBT=rifabutin; RMP=rifampin; SM=streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 6 - Footnote * Table 6 - Footnote 204 100.0 275 100.0 231 100.0 254 100.0 239 100.0 204 100.0 194 100.0 254 100.0 223 100.0 270 100.0 231 100.0
Isolates susceptible to all first-line TB drugs 182 89.2 257 93.5 210 90.9 230 90.6 215 90.0 185 90.7 170 87.6 231 90.9 204 91.5 235 87.0 199 86.1
Monoresistant TB
INH 11 5.4 7 2.5 13 5.6 18 7.1 22 9.2 16 7.8 21 10.8 21 8.3 19 8.5 25 9.3 27 11.7
RMP 2 1.0 6 2.2 0 0.0 3 1.2 1 0.4 0 0.0 1 0.5 0 0.0 0 0.0 2 0.7 1 0.4
EMB 4 2.0 3 1.1 4 1.7 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4
Subtotal - Monoresistant TB 17 8.3 16 5.8 17 7.4 21 8.3 23 9.6 18 8.8 22 11.3 21 8.3 19 8.5 27 10.0 29 12.6
Polyresistant
INH & EMB 1 0.5 0 0.0 2 0.9 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4
INH & PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 2 0.7 0 0.0
Subtotal - Polyresistant TB 1 0.5 0 0.0 2 0.9 0 0.0 1 0.4 0 0.0 1 0.5 0 0.0 0 0.0 2 0.7 1 0.4
Multidrug-resistant TBTable 6 - Footnote
INH & RMP 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & KM & CM & ETH & RBT 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & PAS 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & RBT 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & ETH & RBT & PAS 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & KM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & OFL & ETH & RBT & PAS 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & RBT 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & AK & KM & CM & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4
INH & RMP & EMB & SM & ETH & RBT 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0
INH & RMP & EMB & SM & ETH & RBT & PAS 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 1 0.4
INH & RMP & PZA & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0
INH & RMP & PZA & SM & RBT 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & RBT 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 0.7 0 0.0
INH & RMP & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.4 0 0.0
Subtotal - Multidrug-resistant TB 4 2.0 2 0.7 2 0.9 3 1.2 0 0.0 1 0.5 1 0.5 2 0.8 0 0.0 6 2.2 2 0.9
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 22 10.8 18 6.5 21 9.1 24 9.4 24 10.0 19 9.3 24 12.4 23 9.1 19 8.5 35 13.0 32 13.9
TABLE 7: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Manitoba, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations: AK=amikacin; CM=capreomycin; EMB=ethambutol; ETH=ethionamide; INH=isoniazid; KM=kanamycin;  MOX=moxifloxacin; OFL=ofloxacin; PAS=para-aminosalicylic acid; PZA=pyrazinamide; RBT=rifabutin; RMP=rifampin; SM=streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 7 - Footnote * 94 100.0 119 100.0 84 100.0 116 100.0 106 100.0 113 100.0 97 100.0 123 100.0 148 100.0 125 100.0 129 100.0
Isolates susceptible to all first-line TB drugs 92 97.9 113 95.0 75 89.3 111 95.7 99 93.4 99 87.6 90 92.8 113 91.9 144 97.3 120 96.0 125 96.9
Monoresistant TB
INH 2 2.1 6 5.0 7 8.3 4 3.4 4 3.8 10 8.8 5 5.2 10 8.1 4 2.7 5 4.0 3 2.3
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 1 1.2 0 0.0 1 0.9 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Monoresistant TB 2 2.1 6 5.0 8 9.5 4 3.4 5 4.7 11 9.7 5 5.2 10 8.1 4 2.7 5 4.0 3 2.3
Polyresistant
INH & EMB 0 0.0 0 0.0 1 1.2 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & PZA 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Polyresistant TB 0 0.0 0 0.0 1 1.2 0 0.0 2 1.9 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TBTable 7 - Footnote
INH & RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & AK & KM & CM & ETH & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & RBT 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.8
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 1 0.9 2 2.1 0 0.0 0 0.0 0 0.0 1 0.8
Extensively drug-resistant TBTable 7 - Footnote
INH & RMP & EMB & PZA & KM & OFL & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 2 2.1 6 5.0 9 10.7 5 4.3 7 6.6 14 12.4 7 7.2 10 8.1 4 2.7 5 4.0 4 3.1
TABLE 8: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for New Brunswick, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; ETH=ethionamide; INH=isoniazid;  PZA=pyrazinamide;  RBT=rifabutin; RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 8 - Footnote * 5 100.0 3 100.0 5 100.0 3 100.0 10 100.0 9 100.0 5 100.0 4 100.0 3 100.0 6 100.0 7 100.0
Isolates susceptible to all first-line TB drugs 4 80.0 3 100.0 5 100.0 3 100.0 10 100.0 7 77.8 5 100.0 3 75.0 2 66.7 6 100.0 5 71.4
Monoresistant TB
INH 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 33.3 0 0.0 0 0.0
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 25.0 0 0.0 0 0.0 1 14.3
Subtotal - Monoresistant TB 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 25.0 1 33.3 0 0.0 1 14.3
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TBTable 8 - Footnote
INH & RMP & PZA & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 14.3
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 25.0 1 33.3 0 0.0 2 28.6
TABLE 9: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Newfoundland and Labrador, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZA 6 100.0 11 100.0 5 100.0 5 100.0 10 100.0 9 100.0 5 100.0 5 100.0 11 100.0 6 100.0 21 100.0
Isolates susceptible to all first-line TB drugs 5 83.3 11 100.0 5 100.0 5 100.0 10 100.0 9 100.0 5 100.0 5 100.0 11 100.0 6 100.0 21 100.0
Monoresistant TB
INH 1 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Monoresistant TB 1 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 1 16.7 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TABLE 10: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Northwest Territories, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZA 6 100.0 4 100.0 14 100.0 13 100.0 10 100.0 5 100.0 8 100.0 6 100.0 3 100.0 2 100.0 4 100.0
Isolates susceptible to all first-line TB drugs 6 100.0 3 75.0 14 100.0 13 100.0 9 90.0 4 80.0 8 100.0 6 100.0 3 100.0 2 100.0 4 100.0
Monoresistant TB
INH 0 0.0 1 25.0 0 0.0 0 0.0 0 0.0 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
RMP 0 0.0 0 0.0 0 0.0 0 0.0 1 10.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Monoresistant TB 0 0.0 1 25.0 0 0.0 0 0.0 1 10.0 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 0 0.0 1 25.0 0 0.0 0 0.0 1 10.0 1 20.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TABLE 11: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Nova Scotia, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 11 - Footnote * 7 100.0 8 100.0 5 100.0 3 100.0 7 100.0 8 100.0 7 100.0 9 100.0 9 100.0 8 100.0 7 100.0
Isolates susceptible to all first-line TB drugs 6 85.7 8 100.0 5 100.0 3 100.0 7 100.0 5 62.5 7 100.0 9 100.0 8 88.9 5 62.5 7 100.0
Monoresistant TB
INH 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 0 0.0 1 11.1 3 37.5 0 0.0
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 1 14.3 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Monoresistant TB 1 14.3 0 0.0 0 0.0 0 0.0 0 0.0 2 25.0 0 0.0 0 0.0 1 11.1 3 37.5 0 0.0
Polyresistant
INH & PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 12.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 1 14.3 0 0.0 0 0.0 0 0.0 0 0.0 3 37.5 0 0.0 0 0.0 1 11.1 3 37.5 0 0.0
TABLE 12: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Nunavut, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZA 28 100.0 37 100.0 25 100.0 51 100.0 50 100.0 71 100.0 64 100.0 65 100.0 42 100.0 66 100.0 35 100.0
Isolates susceptible to all first-line TB drugs 28 100.0 37 100.0 24 96.0 51 100.0 49 98.0 70 98.6 62 96.9 65 100.0 42 100.0 66 100.0 33 94.3
Monoresistant TB
INH 0 0.0 0 0.0 1 4.0 0 0.0 1 2.0 1 1.4 1 1.6 0 0.0 0 0.0 0 0.0 2 5.7
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.6 0 0.0 0 0.0 0 0.0 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Monoresistant TB 0 0.0 0 0.0 1 4.0 0 0.0 1 2.0 1 1.4 2 3.1 0 0.0 0 0.0 0 0.0 2 5.7
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 0 0.0 0 0.0 1 4.0 0 0.0 1 2.0 1 1.4 2 3.1 0 0.0 0 0.0 0 0.0 2 5.7
TABLE 13: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Ontario, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  AK=amikacin; CM=capreomycin; EMB=ethambutol; ETH=ethionamide; INH=isoniazid; KM=kanamycin;  MOX=moxifloxacin; OFL=ofloxacin; PAS=para-aminosalicylic acid; PZA=pyrazinamide; RBT=rifabutin; RMP=rifampin; SM=streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 13 - Footnote * 553 100.0 567 100.0 538 100.0 479 100.0 488 100.0 496 100.0 507 100.0 493 100.0 511 100.0 457 100.0 480 100.0
Isolates susceptible to all first-line TB drugs 487 88.1 504 88.9 466 86.6 427 89.1 428 87.7 456 91.9 454 89.6 429 87.0 458 89.6 407 89.1 421 87.7
Monoresistant TB
INH 44 8.0 39 6.9 50 9.3 33 6.9 39 8.0 27 5.4 39 7.7 45 9.1 27 5.3 30 6.6 30 6.3
RMP 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 2 0.4 1 0.2 0 0.0
EMB 0 0.0 0 0.0 1 0.2 1 0.2 1 0.2 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0
PZA 7 1.3 9 1.6 9 1.7 6 1.3 4 0.8 2 0.4 6 1.2 10 2.0 8 1.6 11 2.4 15 3.1
Subtotal - Monoresistant TB 51 9.2 49 8.6 61 11.3 40 8.4 44 9.0 29 5.8 45 8.9 57 11.6 37 7.2 42 9.2 45 9.4
Polyresistant
EMB & PZA 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & EMB 2 0.4 3 0.7 1 0.2 2 0.4 3 0.6 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0
INH & EMB & PZA 0 0.0 0 0.0 0 0.0 2 0.4 2 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & PZA 0 0.0 0 0.0 2 0.4 0 0.0 0 0.0 1 0.2 0 0.0 1 0.2 2 0.4 1 0.2 0 0.0
Subtotal - Polyresistant TB 2 0.4 3 0.5 4 0.7 4 0.8 5 1.0 1 0.2 0 0.0 1 0.2 3 0.6 1 0.2 0 0.0
Multidrug-resistant TBTable 13 - Footnote
INH & RMP 0 0.0 2 0.4 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & AK & CM & RBT 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & CM & RBT 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0
INH & RMP & EMB & PZA & AK & CM & ETH & RBT 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & CM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & ETH & RBT 0 0.0 0 0.0 2 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & RBT 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2
INH & RMP & EMB & PZA & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & AK & KM & CM & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2
INH & RMP & EMB & PZA & SM & ETH & RBT 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 1 0.2 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & OFL & MOX & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & OFL & RBT 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & RBT 0 0.0 0 0.0 1 0.2 1 0.2 1 0.2 0 0.0 1 0.2 0 0.0 1 0.2 0 0.0 3 0.6
INH & RMP & EMB & RBT 0 0.0 2 0.4 1 0.2 1 0.2 2 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & AK & CM 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & ETH & RBT 1 0.2 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0
INH & RMP & EMB & SM & KM & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & OFL & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & OFL & MOX & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & OFL & RBT 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & RBT 2 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0
INH & RMP & ETH & RBT 0 0.0 1 0.4 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 1 0.2
INH & RMP & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & OFL & ETH & RBT & PAS 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & ETH & RBT 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & AK & KM & CM & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2
INH & RMP & PZA & SM & ETH & RBT 0 0.0 0 0.0 1 0.2 1 0.2 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2
INH & RMP & PZA & SM & OFL & MOX & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 1 0.2 1 0.2 0 0.0
INH & RMP & RBT 3 0.5 1 0.2 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 2 0.4 0 0.0 0 0.0
INH & RMP & SM 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0
INH & RMP & SM & CM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0
INH & RMP & SM & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2
INH & RMP & SM & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0
INH & RMP & SM & KM & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0
INH & RMP & SM & OFL & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM & RBT 2 0.4 0 0.0 0 0.0 3 0.6 1 0.2 1 0.2 1 0.2 1 0.2 2 0.4 1 0.2 5 1.0
Subtotal - Multidrug-resistant TB 13 2.4 10 1.8 7 1.3 7 1.5 11 2.3 10 2.0 7 1.4 5 1.0 13 2.5 6 1.3 14 2.9
Extensively drug-resistant TBTable 13 - Footnote
INH & RMP & AK & CM & OFL & ETH & RBT 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & CM & OFL & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & KM & OFL & MOX & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & KM & OFL & MOX & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & KM & OFL & MOX & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.2 0 0.0
Subtotal - Extensively drug-resistant TB 0 0.0 1 0.2 0 0.0 1 0.2 0 0.0 0 0.0 1 0.2 1 0.2 0 0.0 1 0.2 0 0.0
Total number of isolates resistant to one or more first line drugs 66 11.9 63 11.1 72 13.4 52 10.9 60 12.3 40 8.1 53 10.5 64 13.0 53 10.4 50 10.9 59 12.3
TABLE 14: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Prince Edward Island, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZA 1 100.0 0 - 0 - 0 - 1 100.0 1 100.0 3 100.0 0 - 0 - 2 100.0 2 100.0
Isolates susceptible to all first-line TB drugs 1 100.0 0 - 0 - 0 - 1 100.0 1 100.0 2 66.7 0 - 0 - 2 100.0 2 100.0
Monoresistant TB
INH 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
RMP 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
EMB 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
PZA 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 1 33.3 0 - 0 - 0 0.0 0 0.0
Subtotal - Monoresistant TB 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 1 33.3 0 - 0 - 0 0.0 0 0.0
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 0 0.0 0 - 0 - 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 0 0.0 0 - 0 - 0 - 0 0.0 0 0.0 1 33.3 0 - 0 - 0 0.0 0 0.0
TABLE 15: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Quebec, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  AK= amikacin; CM= capreomycin;  ETH= ethionamide;  KM= kanamycin;  MOX=moxifloxacin; OFL= ofloxacin; PAS= para-aminosalicylic acid; RBT= rifabutin; RMP= rifampin; SM= streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 15 - Footnote * 226 100.0 201 100.0 200 100.0 210 100.0 171 100.0 197 100.0 205 100.0 209 100.0 205 100.0 186 100.0 185 100.0
Isolates susceptible to all first-line TB drugs 207 91.6 173 86.1 177 88.5 188 89.5 156 91.2 179 90.9 180 87.8 187 89.5 187 91.2 167 89.8 167 90.3
Monoresistant TB
INH 14 6.2 21 10.4 12 6.0 15 7.1 7 4.1 11 5.6 18 8.8 13 6.2 12 5.9 10 5.4 8 4.3
RMP 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 4 1.8 4 2.0 4 2.0 4 1.9 2 1.2 5 2.5 6 2.9 9 4.3 4 2.0 7 3.8 6 3.2
Subtotal - Monoresistant TB 18 8.0 26 12.9 17 8.5 19 9.0 9 5.3 16 8.1 24 11.7 22 10.5 16 7.8 17 9.1 15 8.1
Polyresistant
INH & EMB 0 0.0 0 0.0 3 1.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
INH & PZA 0 0.0 0 0.0 1 0.5 1 0.5 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Polyresistant TB 0 0.0 0 0.0 4 2.0 1 0.5 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
Multidrug-resistant TBTable 15 - Footnote
INH & RMP & EMB & ETH & RBT 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
INH & RMP & EMB & PZA & RBT 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & ETH 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & KM & ETH & RBT & PAS 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0
INH & RMP & EMB & PZA & SM & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & RBT 0 0.0 0 0.0 1 0.5 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & EMB & SM & RBT 0 0.0 1 0.5 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5
INH & RMP & PZA & ETH & RBT 1 0.4 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0
INH & RMP & PZA & SM & AK & KM & CM 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & PZA & SM & KM & CM & ETH 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & RBT 0 0.0 0 0.0 0 0.0 0 0.0 1 0.6 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM & RBT 0 0.0 0 0.0 0 0.0 1 0.5 2 1.2 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0
Subtotal - Multidrug-resistant TB 1 0.4 2 1.0 2 1.0 2 1.0 6 3.5 1 0.5 1 0.5 0 0.0 1 0.5 2 1.1 2 1.1
Extensively drug-resistant TBTable 15 - Footnote
INH & RMP & EMB & PZA & SM & AK & KM & CM & OFL & MOX & ETH & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 0.5 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 19 8.4 28 13.9 23 11.5 22 10.5 15 8.8 18 9.1 25 12.2 22 10.5 18 8.8 19 10.2 18 9.7
TABLE 16: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Saskatchewan, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide; RBT = rifabutin; RMP=rifampin; SM=streptomycin.
Isolates tested for resistance to INH, RMP, EMB & PZA 74 100.0 58 100.0 60 100.0 81 100.0 77 100.0 54 100.0 66 100.0 72 100.0 71 100.0 63 100.0 50 100.0
Isolates susceptible to all first-line TB drugs 72 97.3 57 98.3 59 98.3 79 97.5 72 93.5 51 94.4 62 93.9 68 94.4 69 97.2 60 95.2 49 98.0
Monoresistant TB
INH 2 2.7 1 1.7 1 1.7 2 2.5 3 3.9 2 3.7 4 6.1 1 1.4 1 1.4 0 0.0 0 0.0
RMP 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.6 0 0.0
EMB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 3 4.2 1 1.4 1 1.6 1 2.0
Subtotal - Monoresistant TB 2 2.7 1 1.7 1 1.7 2 2.5 3 3.9 2 3.7 4 6.1 4 5.6 2 2.8 2 3.2 1 2.0
Polyresistant
INH & EMB 0 0.0 0 0.0 0 0.0 0 0.0 1 1.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & PZA 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.6 0 0.0
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 1 1.3 0 0.0 0 0.0 0 0.0 0 0.0 1 1.6 0 0.0
Multidrug-resistant TBTable 16 - Footnote *
INH & RMP & RBT 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 1 1.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
INH & RMP & SM 0 0.0 0 0.0 0 0.0 0 0.0 1 1.3 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 1 1.3 1 1.9 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 2 2.7 1 1.7 1 1.7 2 2.5 5 6.5 3 5.6 4 6.1 4 5.6 2 2.8 3 4.8 1 2.0
TABLE 17: Results for routine drug susceptibility testing of Mycobacterium tuberculosis complex isolates to anti-tuberculosis drugs for Yukon, 2005 to 2015
  REPORTING YEAR
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
n % n % n % n % n % n % n % n % n % n % n %
Abbreviations:  EMB=ethambutol; INH=isoniazid;  PZA=pyrazinamide;  RMP=rifampin.
Isolates tested for resistance to INH, RMP, EMB & PZATable 17 - Footnote * 2 100.0 2 100.0 2 100.0 7 100.0 3 100.0 5 100.0 2 100.0 1 100.0 1 100.0 4 100.0 3 100.0
Isolates susceptible to all first-line TB drugs 2 100.0 2 100.0 2 100.0 7 100.0 3 100.0 5 100.0 2 100.0 1 100.0 1 100.0 4 100.0 3 100.0
Monoresistant TB
Subtotal - Monoresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Polyresistant
Subtotal - Polyresistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Multidrug-resistant TB
Subtotal - Multidrug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Extensively drug-resistant TB
Subtotal - Extensively drug-resistant TB 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
Total number of isolates resistant to one or more first line drugs 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0
TABLE 18: Multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis isolates by province/territory of origin, 2015
  CANADA ORIGINATING PROVINCE/TERRITORY
N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. N.W.T Nvt.
Abbreviations:   Alta.= Alberta; B.C.= British Columbia; Man.= Manitoba;  N.B.= New Brunswick; N.L.= Newfoundland and Labrador; N.S.= Nova Scotia; Nvt.= Nunavut; N.W.T.= Northwest Territories; Ont.= Ontario; P.E.I.= Prince Edward Island; Que.= Quebec; Sask.= Saskatchewan; Y.T.= Yukon. 
INH and RMP 11 0 0 0 0 1 7 1 0 1 1 0 0 0
INH and RMP and PZA 3 0 0 0 1 0 2 0 0 0 0 0 0 0
INH and RMP and EMB 1 0 0 0 0 0 0 0 0 0 1 0 0 0
INH and RMP and EMB and PZA 7 0 0 0 0 1 5 0 0 1 0 0 0 0
Total number of Multidrug-resistant TBTable 18 - Footnote * 22 0 0 0 1 2 14 1 0 2 2 0 0 0
Extensively drug-resistant TBTable 18 - Footnote 0 0 0 0 0 0 0 0 0 0 0 0 0 0
TABLE 19: Provincial/territorial breakdown by any resistance, multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis in Canada, 2005 to 2015
ORIGINATING PROVINCE/TERRITORY TOTAL NUMBER OF REPORTED  MTBC ISOLATES RESISTANT TO ONE OR MORE FIRST-LINE DRUGS MULTIDRUG-RESISTANT TBTable 19 - Footnote * EXTENSIVELY DRUG-RESISTANT TBTable 19 - Footnote
NUMBER  PERCENT (%) NUMBER  PERCENT (%) NUMBER  PERCENT (%)
Abbreviations: Alta.= Alberta; B.C.= British Columbia; Man.= Manitoba; N.B.= New Brunswick; N.L.= Newfoundland and Labrador; N.S.= Nova Scotia; Nvt.= Nunavut; N.W.T.= Northwest Territories; Ont.= Ontario; P.E.I.= Prince Edward Island; Que.= Quebec; Sask.= Saskatchewan; Y.T.= Yukon.
Ont. 5,569 632 11.3 103 1.8 5 0.1
B.C. 2,579 261 10.1 23 0.9 0 0.0
Que. 2,195 227 10.3 20 0.9 1 0.0
Alta. 1,570 154 9.8 24 1.5 0 0.0
Man. 1,254 73 5.8 5 0.4 1 0.1
Sask. 726 28 3.9 2 0.3 0 0.0
Nvt. 534 7 1.3 0 0.0 0 0.0
N.L. 94 1 1.1 0 0.0 0 0.0
N.S. 78 8 10.3 0 0.0 0 0.0
N.W.T. 75 3 4.0 0 0.0 0 0.0
N.B. 60 7 11.7 1 1.7 0 0.0
Y.T. 32 0 0.0 0 0.0 0 0.0
P.E.I. 10 1 10.0 0 0.0 0 0.0
CANADA 14,776 1,402 9.5 178 1.2 7 0.0
TABLE 20: Tuberculosis drug resistance by sex and age group in Canada, 2015
AGE GROUP AND SEX ISOLATES REPORTED RESISTANT TO ONE OR MORE FIRST-LINE DRUGS MULTIDRUG RESISTANTTable 20 - Footnote * EXTENSIVELY DRUG RESISTANTTable 20 - Footnote
NUMBER PERCENT (%) NUMBER PERCENT (%) NUMBER PERCENT (%) NUMBER PERCENT (%)
< 1 Male 2 0.1 0 0.0 0 0.0 0 0.0
Female 1 0.1 0 0.0 0 0.0 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 3 0.2 0 0.0 0 0.0 0 0.0
1 to 4 Male 3 0.2 0 0.0 0 0.0 0 0.0
Female 2 0.1 0 0.0 0 0.0 0 0.0
Unknown 1 0.1 0 0.0 0 0.0 0 0.0
Total 6 0.4 0 0.0 0 0.0 0 0.0
5 to 14 Male 10 0.7 0 0.0 0 0.0 0 0.0
Female 10 0.7 0 0.0 0 0.0 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 20 1.5 0 0.0 0 0.0 0 0.0
15 to 24 Male 86 6.4 9 6.5 2 9.1 0 0.0
Female 82 6.1 12 8.6 1 4.5 0 0.0
Unknown 2 0.1 0 0.0 0 0.0 0 0.0
Total 170 12.7 21 15.1 3 13.6 0 0.0
25 to 34 Male 119 8.9 9 6.5 3 13.6 0 0.0
Female 122 9.1 17 12.2 5 22.7 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 241 18.0 26 18.7 8 36.4 0 0.0
35 to 44 Male 95 7.1 5 3.6 1 4.5 0 0.0
Female 99 7.4 12 8.6 1 4.5 0 0.0
Unknown 2 0.1 0 0.0 0 0.0 0 0.0
Total 196 14.6 17 12.2 2 9.1 0 0.0
45 to 54 Male 107 8.0 13 9.4 4 18.2 0 0.0
Female 69 5.2 7 5.0 2 9.1 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 176 13.1 20 14.4 6 27.3 0 0.0
55 to 64 Male 94 7.0 10 7.2 0 0.0 0 0.0
Female 62 4.6 4 2.9 1 4.5 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 156 11.7 14 10.1 1 4.5 0 0.0
65 to 74 Male 82 6.1 8 5.8 1 4.5 0 0.0
Female 64 4.8 10 7.2 0 0.0 0 0.0
Unknown 2 0.1 2 1.4 0 0.0 0 0.0
Total 148 11.1 20 14.4 1 4.5 0 0.0
75+ Male 135 10.1 9 6.5 1 4.5 0 0.0
Female 87 6.5 12 8.6 0 0.0 0 0.0
Unknown 1 0.1 0 0.0 0 0.0 0 0.0
Total 223 16.7 21 15.1 1 4.5 0 0.0
Unknown Male 0 0.0 0 0.0 0 0.0 0 0.0
Female 0 0.0 0 0.0 0 0.0 0 0.0
Unknown 0 0.0 0 0.0 0 0.0 0 0.0
Total 0 0.0 0 0.0 0 0.0 0 0.0
Total Male 733 54.7 63 45.3 12 54.5 0 0.0
Female 598 44.7 74 53.2 10 45.5 0 0.0
Unknown 8 0.6 2 1.4 0 0.0 0 0.0
TOTAL 1,339 100.0 139 100.0 22 100.0 0 0.0

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