Gönlügür Uğur, Bakici Mustafa Zahir, Gönlügür Tanseli E, Hasbek Mürşit
Cumhuriyet Universitesi Tip Fakültesi, Göğüs Hastaliklan Anabilim Dali, Sivas.
Mikrobiyol Bul. 2007 Jul;41(3):459-63.
Infections caused by drug-resistant Mycobacterium tuberculosis strains represent a serious public health problem in recent years. The aim of this retrospective study was to investigate the resistance rates of M. tuberculosis complex strains isolated from clinical specimens in the laboratories of Cumhuriyet University and Numune State Hospitals in Sivas province (located in the middle Anatolia), between May 2004-May 2006 period, to the major antituberculous drugs. A total of 158 M. tuberculosis complex strains which were isolated from sputum, bronchial lavage fluid, stomach fluid, urine, pus, peritoneal fluid and cerebrospinal fluid samples, each of which from different patients were included to the study. The identification of the isolates and antituberculosis drug susceptibility testing were performed by MGIT (Mycobacteria Growth Indicator Tube) 960 system in both of the laboratories. Of 158 isolates 42 (26.6%) were found resistant to at least one of the drugs, while 116 (73.4%) were susceptible to all of the tested antimycobacterials. The overall resistance rates were found as 17.7% (28/153) for isoniazid, 11.4% (18/153) for streptomycin, 4.4% (7/153) for rifampicin, and 5.1% (8/153) for ethambutol. The rate of multidrug resistant isolates characterized with resistance to isoniazid+rifampicin were 3.8% (6/158). As a result, the most common resistance patterns observed in our region were found as single isoniazid resistance (13/158; 8.2%), single streptomycin resistance (8/158; 5.1%) and combined isoniazid+streptomycin resistance (8/158; 5.1%), respectively, with lower resistance rate to rifampicin (4.4%) in comparison to the previous results reported from Turkey.
近年来,耐多药结核分枝杆菌菌株引起的感染已成为一个严重的公共卫生问题。本回顾性研究的目的是调查2004年5月至2006年5月期间,从锡瓦斯省(位于安纳托利亚中部)居米什耶特大学和努穆内国家医院实验室的临床标本中分离出的结核分枝杆菌复合群菌株对主要抗结核药物的耐药率。本研究共纳入了158株结核分枝杆菌复合群菌株,这些菌株分别从痰液、支气管灌洗液、胃液、尿液、脓液、腹腔液和脑脊液样本中分离得到,且每个样本均来自不同患者。两个实验室均采用MGIT(分枝杆菌生长指示管)960系统对分离菌株进行鉴定和抗结核药物敏感性试验。158株分离菌株中,42株(26.6%)对至少一种药物耐药,116株(73.4%)对所有测试的抗分枝杆菌药物敏感。异烟肼的总体耐药率为17.7%(28/153),链霉素为11.4%(18/153),利福平为4.4%(7/153),乙胺丁醇为5.1%(8/153)。对异烟肼和利福平耐药的多重耐药分离菌株率为3.8%(6/158)。结果显示,在我们地区观察到的最常见耐药模式分别为单一异烟肼耐药(13/158;8.2%)、单一链霉素耐药(8/158;5.1%)和异烟肼+链霉素联合耐药(8/158;5.1%),与土耳其此前报道的结果相比,利福平耐药率较低(4.4%)。