Mycobacterium tuberculosis Kompleks İzolatlarının Birinci Basamak Anti-tüberküloz İlaçlara Direnç Oranları: 5 Yıllık Retrospektif Araştırma

Year 2024, Volume: 34 Issue: 2, 190 - 194, 30.04.2024

Sondos A. A. Ibnouf , Fatma Esenkaya Taşbent

https://doi.org/10.54005/geneltip.1333907

Abstract

Giriş/Amaç: Tüberküloz, yüksek morbidite ve mortalite oranı ile önemli bir küresel sağlık sorunu olmaya devam etmektedir ve nüfusun yaklaşık dörtte biri tüberküloz ile enfektedir. İlaç duyarlılık testleri, ilaca dirençli tüberkülozu tanımlamak ve yönetmek için önemlidir. Bu çalışmada, bir üniversite hastanesinden izole edilen Mycobacterium tuberculosis compleks suşlarının ilaca duyarlılık paterninin değerlendirilmesi amaçlanmıştır.
Yöntemler: Ocak 2018-Ocak 2022 tarihleri arasında tüberküloz şüphesi ile mikrobiyoloji laboratuvarına gönderilen toplam 10900 örnek retrospektif olarak incelenmiştir. Örneklerin kültürü ve duyarlılık testleri için BACTEC MGIT 960 (Becton Dickinson, ABD) otomatize sistem kullanılmıştır. Elde edilen veriler Statistical Package for Social Sciences (SPSS version 20) ile istatistiksel olarak analiz edilmiştir.
Bulgular: Pozitif olarak bulunan 154 hastada erkek ve kadın oranı eşit olarak bulunmuştur. Tüberküloz olgularının çoğunluğu 56-75 yaş grubunda (%42,2) olup, hastaların %90,3'ünde akciğer tüberkülozu saptanırken, %9,7 oranında akciğer dışı tüberküloz tespit edilmiştir. Pozitif örnkelerde yapılan duyarlılık çalışmaları sonucunda izoniazid direnci %5,2; streptomisin direnci %1,3; etambutol direnci %0,6 oranında tespit edilirken, rifampisin dirençli örnek bulunmamıştır. Örneklerin %1,3’ünde hem streptomisin hem de izoniazid direnci birlikte görülmüştür.
Sonuç: Türkiye'de farklı illerde yapılan diğer çalışmalarda birinci basamak antitüberküloz ilaçlarda benzer direnç paterni gözlenmiştir. Çalışmamızda çok ilaca dirençli tüberküloz ve yaygın ilaca dirençli tüberküloz suşlarının bulunmaması, bölgemizde uygulanan tüberküloz sürveyans programınının başarılı olduğunu göstermektedir.

Keywords

Mycobacterium tuberculosis complex, tuberculosis, anti-tuberculosis drug, drug susceptibility testing.

Resistance Rates of Mycobacterium tuberculosis Complex Isolates to Primary Anti-tuberculosis Drugs: A 5-Year Retrospective Study

Abstract

Background/Aim: Tuberculosis remains a major global health problem with a high morbidity and mortality rate, approximately a quarter of the population is infected with tuberculosis. Drug susceptibility testing is an essential tool for identifying and managing drug-resistant tuberculosis. This study was conducted to evaluate the drug susceptibility pattern of Mycobacterium tuberculosis complex strains isolated from a university hospital.
Methods: A total of 10900 samples sent to the microbiology laboratory with the suspicion of tuberculosis clinically between January 2018 and January 2022 were analyzed retrospectively. The automated BACTEC MGIT 960 (Becton Dickinson, USA) was used for sample culture and susceptibility testing. The obtained data were statistically analyzed with the Statistical Package for Social Sciences (SPSS version 20).
Results: Out of the 154 isolated positive samples, males and females constituted equal parts of the study population (50%). The majority of tuberculosis cases were in the age group 56–75 years (42.2%), Pulmonary TB was detected in (90.3%) of the patients, while extrapulmonary TB cases were observed in (9.7%). As a result of susceptibility studies on positive samples, isoniazid resistance was 5.2%; streptomycin resistance 1.3%; ethambutol resistance was detected at a rate of 0.6%, while no rifampicin resistant sample was found. Both streptomycin and isoniazid resistance were seen together in 1.3% of the samples.
Conclusion: A similar resistance pattern of the first-line antituberculosis drugs was observed in other studies conducted in different provinces of Turkey. The absence of multi-drug resistant and extensively drug-resistant tuberculosis in our study indicates that the tuberculosis surveillance program implemented in our region was successful.

Keywords

Mycobacterium tuberculosis complex, tuberculosis, anti-tuberculosis drug, drug susceptibility testing.

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