Comment on “Mycobacteria Presence and Anti-Tuberculosis Drug Resistance Profile in Düzce Region: 18 Years of Experience”: An Interpretation of Regional Resistance Patterns and Temporal Fluctuations in Light of National Trends

Abstract

This letter to the editor analyzes the study by Akbaş et al. on tuberculosis drug resistance in the Düzce region by comparing its findings with Turkey's national data. The analysis reveals that while the overall resistance rate in Düzce (23.5%) is significantly higher than the national average (~16.5%), the resistance dynamics show unique regional characteristics. Notably, the rates of mono-resistance to Isoniazid (8.9%) and Ethambutol (2.9%) in Düzce are substantially higher than the national averages (~5.3% and ~0.6%, respectively). Furthermore, temporal analysis highlights dramatic fluctuations and peaks in resistance in Düzce (e.g., 35.8% H-resistance in 2016), which are not reflected in the stable national trends. This comparison underscores the critical importance of local surveillance in identifying regional resistance hotspots and proves that national averages alone may mask significant local public health threats.

Keywords

• Tuberculosis
• drug resistance
• microbial
• epidemiologic surveillance
• Türkiye

References

1. Akbaş E, Keskin BH, Çalışkan E, Öksüz Ş, Şahin İ, Öztürk CE. Mycobacteria presence and anti-tuberculosis drug resistance profile in Düzce region: 18 years of experience. Duzce Med J. 2025;27(1):29-34. doi:10.18678/dtfd.1564849.
2. Republic of Türkiye Ministry of Health, General Directorate of Public Health. Tuberculosis control in Türkiye 2021 Report [Internet]. Ankara: Publication No: 1274; 2023 [cited 2026 Jan 23]. 163 p. Available from: https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz-db/Dokumanlar/Raporlar/Turkiyede_Verem_Savasi_2021_Raporu.pdf. Turkish.