Kehinde Aderemi Oludiran, Obaseki Felix Ariebuwa, Ishola Oluponle Christiana, Ibrahim Kolo Doko
Department of Medical Microbiology, University College Hospital, Ibadan, Nigeria.
J Natl Med Assoc. 2007 Oct;99(10):1185-9.
The magnitude of drug-resistant Mycobacterium tuberculosis infection (MDR-TB) in Nigeria, the most populous country in sub-Saharan Africa, is largely unknown. This information would assist policymakers to develop intervention strategies against tuberculosis (TB) in the country.
This is a one-year laboratory-based study. Specimens from suspected new TB patients sent to the TB laboratory of the Department of Medical Microbiology, University College Hospital Ibadan, Nigeria from May 1, 2005 to April 27, 2006 were processed and analyzed. The specimens were stained with Ziehl-Neelsen (Z-N) reagents and cultured on Lowenstein-Jensen medium, incubated at 37 degrees C for 6-8 weeks. Isolates were confirmed as MDR-TB by Z-N reactions and biochemical methods. Drug susceptibility to streptomycin, ethambutol, rifampicin and isoniazid was done using Bactec 460 TB radiometric method.
Of the 1,120 specimens processed, 80 (7.1%) were smear positive, while 56 (5.0%) were culture positive, even though the association was not statistically significant (p > 0.05). Culture contamination rate was 8.8%. Thirty (53.6%) of the culture positive isolates were resistant to both isoniazid and rifampicin, while 26 (46.4%) were susceptible. About half--53.3%--of the resistant isolates were from the antiretroviral clinic, while 10 (33.4%) were from peripheral centers.
This study shows that MDR-TB is emerging in Nigeria. Further studies on MDR-TB are urgently needed in the country to ascertain the magnitude of the problem and to proffer solutions to it.
在撒哈拉以南非洲人口最多的国家尼日利亚，耐多药结核分枝杆菌感染（MDR-TB）的规模很大程度上未知。这些信息将有助于政策制定者制定该国针对结核病（TB）的干预策略。
这是一项为期一年的基于实验室的研究。对2005年5月1日至2006年4月27日期间送往尼日利亚伊巴丹大学学院医院医学微生物学系结核病实验室的疑似新结核病患者的标本进行处理和分析。标本用萋-尼（Z-N）试剂染色，并在罗-琴培养基上培养，于37℃孵育6-8周。通过Z-N反应和生化方法将分离株确认为耐多药结核病。使用Bactec 460 TB放射性测定法对链霉素、乙胺丁醇、利福平和异烟肼进行药敏试验。
在处理的1120份标本中，80份（7.1%）涂片阳性，而56份（5.0%）培养阳性，尽管这种关联无统计学意义（p>0.05）。培养污染率为8.8%。30份（53.6%）培养阳性分离株对异烟肼和利福平均耐药，而26份（46.4%）敏感。约一半（53.3%）的耐药分离株来自抗逆转录病毒诊所，而10份（33.4%）来自周边中心。
本研究表明耐多药结核病在尼日利亚正在出现。该国迫切需要对耐多药结核病进行进一步研究，以确定问题的严重程度并提出解决方案。
