Düzce Bölgesinde Mikobakteri Varlığı ve Antitüberküloz İlaç Direnci Profili: 18 Yıllık Deneyim

Abstract

Amaç: Bu çalışmanın amacı, tüberküloz şüphesi olan hastalardan 18 yıl boyunca toplanan mikobakteri izolatlarında Mycobacterium tuberculosis kompleks (MTBK) ve tüberküloz dışı mikobakteri (TDM) üreme sıklığını belirlemek ve MTBK olarak izole edilen suşların birinci basamak anti-tüberküloz ilaçlara direnç oranlarını değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada, Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezi Tıbbi Mikrobiyoloji Anabilim Dalı Mikobakteriyoloji Laboratuvarı'na 2004 ve 2021 yılları arasında tüberküloz şüphesi ile gönderilen toplam 17.199 klinik örnek geriye dönük olarak analiz edildi. MTBK'yi TDM'den ayırt etmek için, MTBK'nin MPT64 antijenini tespit etmek amacıyla TBC Tanımlama Testi yapıldı. Asit-dirençli basillerin (ARB) varlığını tespit etmek amacıyla Ehrlich-Ziehl-Neelsen (EZN) boyama yöntemi kullanıldı. Bulgular: Tüberküloz şüphesi ile gönderilen örneklerden 896 (%5,2) vakada mikobakteri üremesi tespit edildi. Bunlardan 824'ü (%91,9) MTBK olarak tanımlanırken 72'si (%8,1) TDM olarak sınıflandırıldı. EZN boyama sonucunda 896 izolatın 404'ünde (%45,1) ARB pozitifliği saptandı. 824 MTBK izolatında birinci basamak anti-tüberküloz ilaç duyarlılığının analizi, 194'ünün en az bir birinci basamak anti-tüberküloz ilaca dirençli olduğunu ortaya koydu. Bunlardan 135 izolat tek bir ilaca direnç gösterirken, 59'u birden fazla ilaca direnç göstermekteydi. Sonuç: Tüberküloz, hem küresel olarak hem de Türkiye'de önemli bir halk sağlığı sorunu olmaya devam etmektedir. Tüberkülozun ortadan kaldırılması ve yok edilmesi hedeflerine ulaşmak için yerel ve bölgesel üreme kalıplarının ve direnç profillerinin düzenli olarak araştırılması hayati önem taşımaktadır.

Keywords

• Tüberküloz
• atipik mikobakteri
• anti-tüberküloz ilaç direnci

Mycobacteria Presence and Anti-Tuberculosis Drug Resistance Profile in Düzce Region: 18 Years of Experience

Abstract

Aim: The aim of this study was to determine the frequency of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM) growth among mycobacterial isolates collected over 18 years from patients suspected of having tuberculosis, and to evaluate the resistance rates of MTBC strains to first-line anti-tuberculosis drugs. Material and Methods: A total of 17,199 clinical specimens, sent to the Mycobacteriology Laboratory, Department of Medical Microbiology, at Düzce University Health Application and Research Centre between 2004 and 2021 for suspected tuberculosis, were retrospectively analyzed in this study. To differentiate MTBC from NTM, the TBC Identification Test was performed to detect the MPT64 antigen of the MTBC. Ehrlich-Ziehl-Neelsen (EZN) staining method was used to detect the presence of acid-fast bacilli (AFB). Results: Out of the samples with suspected tuberculosis, mycobacterial growth was detected in 896 (5.2%) cases. Among these, 824 (91.9%) were identified as MTBC, while 72 (8.1%) were classified as NTM. EZN staining revealed that 404 (45.1%) out of the 896 isolates were found AFB positive. Analysis of first-line anti-tuberculosis drug susceptibility in the 824 MTBC isolates revealed that 194 were resistant to at least one first-line anti-tuberculosis drug. Of these, 135 isolates showed resistance to a single drug, while 59 exhibited resistance to more than one drug. Conclusion: Tuberculosis remains a significant public health problem both globally and in Türkiye. Regular investigation of local and regional growth patterns and resistance profiles is crucial for achieving the goals of tuberculosis elimination and eradication.

Keywords

• Tuberculosis
• non-tuberculous mycobacteria
• anti-tuberculosis drug resistance

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