Decreasing prevalence of multi-drugs resistant Mycobacterium tuberculosis in Nashik City, India

Abstract

Objective: In India, increasing prevalence of multi-drug resistant tuberculosis (MDR) has aggravated the control of tuberculosis problem. In many urban and semi-urban regions of India, no surveillance data of multidrug resistance in Mycobacterium tuberculosisis available. Methods: A surveillance study on multidrug resistance was carried out in semi-urban and rural regions in and around Nashik City of Maharashtra, India. The surveillance study was conducted in this region found that the prevalence of combined resistance to first and second-line anti-tuberculosis drugs is remarkably high. The isolates of M. tuberculosis was identified and subjected to drug susceptibility testing. The patterns of drug susceptibility of isolates of M. tuberculosis during the periods 2000 and 2004 were compared with drug susceptibility patterns of the organisms during the period 2008 to 2011. Results: The 260 isolates identified as M. tuberculosis show mean drug resistance prevalence of 45.6% for more than any two drugs and the MDR rate as 37% in the years 2000 to 2004 whereas 305 isolates of the organism show mean drug resistance prevalence of 30.2% and the MDR rate as 25% in the years 2008 to 2011. Conclusion: The researcher found that, though the prevalence of multidrug resistance to the drugs tested is remarkably high, it has come down noticeably during the past seven years due to efforts of State Government and strict implementation of treatment guidelines of WHO by the physicians.

Keywords

• MDR-TB, XDR-TB, DOTS, drug-resistance prevalence rate

Decreasing prevalence of multi-drugs resistant Mycobacterium tuberculosis in Nashik City, India

Öz

Amaç: Hindistan’da, çok ilaca dirençli tüberküloz (ÇİD) prevalansının artışı tüberküloz sorununun kontrolünü güçleştirdi. Hindistan’ın birçok kentsel ve yarı kentsel bölgelerinde, Mycobacterium tuberculosis suşlarında çoklu ilaç direnci gösteren sürveyans verisi mevcuttur.Yöntemler: Çoklu ilaç direnci üzerine olan bu sürveyans çalışması Maharashtra, Hindistan Nashik şehri ve çevresindeki yarı kentsel ve kırsal bölgelerde yürütüldü. Sürveyans çalışması, ilk ve ikinci seçenek anti-tüberküloz ilaçlara karşı kombine direnç sıklığı önemli ölçüde yüksek bulunan bu bölgede yürütüldü. M. tuberculosis izolatları tanımlandı ve ilaç duyarlılık testine tabi tutuldu. M. tuberculosis izolatlarının 2000 ve 2004 dönemi ile 2008-2011 dönemindeki ilaç duyarlılık paternleri karşılaştırıldı.Bulgular: 260 izolat M. tuberculosis olarak tanımlandı, 2000-2004 yıllarında herhangi iki ilaçtan fazla ilaca direnç gösterme oranı ortalama % 45,6 ve ÇİD oranı % 37 iken 2008-2011 yıllarında 305 izolatda ortalama direnç oranı % 30,2 ve ÇİD oranı % 25 idi.Sonuç: Çoklu ilaç direncinin prevalansı oldukça yüksek bulunmasına rağmen, bu oran devletin çabaları ve tedavi kılavuzlarının hekimler tarafından sıkı bir şekilde uygulanması ile son yedi yıl içinde belirgin bir düşüş gösterdi

Anahtar Kelimeler

• MDR-TB, XDR-TB DOTS, ilaç direnci sıklığı

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