An outbreak of tuberculosis that has proved to be resistant to treatment with several drugs is complicating health officials' efforts to combat the disease in Texas, California and Pennsylvania.

The incident, reported earlier this month in the Morbidity and Mortality Weekly Report published by the Centers for Disease Control, involved nine patients who were relatives or friends of a 41-year-old man who died of TB in 1987. A contagious disease caused by a bacteria that infects the lungs, TB is transmitted in airborne droplets, typically by coughing or sneezing. It usually strikes relatives of an infected person or others who have had prolonged contact in a closed environment.

When the man was first diagnosed in 1971, he was treated successfully in a Texas hospital. During the next decade, he was hospitalized six times with recurrent tuberculosis. By the time he died from the disease, he was resistant to five drugs prescribed to treat him.

Part of the problem, researchers said, was that the man did not comply with the prescribed therapies. According to Bess Miller, deputy chief of CDC's division of tuberculosis control, multidrug-resistant tuberculosis is difficult to treat, especially when patients don't take prescribed medications.

The cost of hospitalizing the 10 patients has been estimated at nearly $1 million. "It takes a tremendous amount of time and money to treat patients with multi-drug resistance," Miller said. Most cases of tuberculosis are curable within six months.

Antibiotics, such as streptomycin, that are effective against TB were first developed in the 1940s. But in recent years, drug-resistant strains of the disease have proved to be a particular problem.

Since 1985, the number of new cases has increased alarmingly, according to federal health officials, who attribute the jump to the spread of AIDS. Last year, about 1,700 people died of TB, Miller said.