AI Summary & Key Takeaways
AI InsightThe results emphasize that the high ratio of secondary resistance in public may be related to insufficient-therapy and this may cause a serious raise of primary tuberculosis.
📌 3 Key Takeaways
Abstract
In a three year period from 2001 to 2003, it is aimed to detect the resistance patterns of 166 Mycobacterium tuberculosis strains isolated by BACTEC MGIT (Mycobacteria Growth Indicator Tubes, Becton-Dickenson) 960 System and reference method Lowenstein-Jensen (L-J) from clinical samples of patients with suspect pulmonary and extrapulmonary tuberculosis, against four major antimicrobial drugs and to investigate the presence of primary or secondary resistance pattern in the cases. Antimicrobial susceptibility tests were performed with BACTEC MGIT 960 SIRE kit and L-J. The test procedure in the MGIT kit was followed and proportion method in L-J was used to detect susceptibility to streptomycin (S), isoniazid (I), rifampin ©and ethambutole (E). In 166 cases consisting of 141 newly and 25 previously diagnosed patients; the primary resistance was seen in 7.09% (10/141) and secondary in 52% (13/25). In one drug resistance, both primary and secondary type of resistance were detected, 2 drug resistance was seen only in primary resistance (one case), 4 drug resistance was only in secondary resistance (four cases) and 3 drug resistance was only in secondary resistance (one case). The highest cumulative drug resistance was found against S in primary and against R in secondary resistance. The results emphasize that the high ratio of secondary resistance in public may be related to insufficient-therapy and this may cause a serious raise of primary tuberculosis.
Özet
Çalışmada, 2001 ve 2003 yıllarını kapsayan üç yıllık bir dönemde, akciğer tüberkülozu ve akciğer dışı tüberküloz kuşkulu klinik örneklerde BACTEC MGIT (Mycobacteria Growth Indicator Tubes, Becton-Dickenson) 960 SİSTEMİ ve Lowenstein-Jensen (L-J) referans yöntemi ile izole edilen 166 Mycobacterium tuberculosis susunun dört majör antitüberküloz ilaca karşı dirençlerinin belirlenerek, olguların primer ve sekonder dirençlerinin değerlendirilmesi amaçlandı. Antibiyotik duyarlılık testleri, BACTEC MGIT 960 SIRE kit ve Lowenstein-Jensen besiyerinde proporsiyon yöntemleriyle yapıldı. Yüzkırkbiri yeni, 25'i de eski olan hastalardan izole edilen M. tuberculosis suşlarının %7.09'unda (10/141) primer, %52'ünde (13/25) ise sekonder direnç saptandı. Tek ilaca karşı olan direnç hem primer hem de sekonder tipte görülürken, iki ilaç direncine [S (Streptomisin) + R (Rifampin)] primer dirençli bir olguda, üç ilaç direncine [i (izoniyazit)+ R+E (Etambutol)] sadece sekonder direnç görülen bir olguda, dört 4 ilaç direncine ise [İ+R+S+E] sadece sekonder dirençli dört olguda rastlandı. Kümülatif en yüksek ilaç direnci primer olarak S'ye karşı, sekonder olarak R'ye karşı belirlendi. Sekonder dirençle İlgili olarak saptanan yüksek oran toplumda, tüberküloz tedavisindeki uyumsuzluk ve yetersizliği düşündürmekte, böylece yeni bulaşmalarla primer tüberküloz oranını ciddi olarak artırabileceğini akla getirmektedir.