Ozkütük Nuri, Ecemiş Talat, Sürücüoğlu Süheyla
Celal Bayar Universitesi Tip Fakültesi,Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Manisa.
Mikrobiyol Bul. 2008 Oct;42(4):585-90.
Pyrazinamide (PZA) is a primary antituberculous drug. BACTEC 460TB is the recommended reference method for the detection of PZA resistance in Mycobacterium tuberculosis. This method is more expensive than the conventional susceptibility methods and therefore, it is recommended that each laboratory should establish their own protocol for the inclusion of PZA in the panel of primary drugs tested. One of the most important factors that help this decision is the prevalence of PZA resistance, particularly PZA monoresistance in the related community. The aim of the present study was to determine the extent of PZA monoresistance in M. tuberculosis complex (MTBC) isolates in our region. In this study, PZA susceptibility testing of 109 MTBC strains (susceptible to isoniazid, rifampicin, ethambutol and streptomycin) isolated from Manisa province in the Aegean region of Turkey was performed by using the BACTEC 460TB radiometric system (Becton Dickinson, MD). Two (1.8%) of the 109 isolates which were susceptible to all primary drugs revealed monoresistance against PZA. One of the PZA-monoresistant isolates has been identified as M. bovis and the other as M. tuberculosis by molecular method (Genotype MTBC, Hain Lifescience, Germany). The results of our study indicated that since the rate of PZA monoresistance was low, susceptibility testing of a panel of primary drugs without PZA may be an economical alternative in our region.
吡嗪酰胺(PZA)是一种主要的抗结核药物。BACTEC 460TB是检测结核分枝杆菌对PZA耐药性的推荐参考方法。该方法比传统的药敏试验方法更昂贵,因此,建议每个实验室应制定自己的方案,以将PZA纳入主要检测药物组中。有助于做出这一决定的最重要因素之一是PZA耐药性的流行情况,尤其是相关社区中的PZA单耐药情况。本研究的目的是确定我们地区结核分枝杆菌复合群(MTBC)分离株中PZA单耐药的程度。在本研究中,使用BACTEC 460TB放射性测量系统(美国马里兰州贝塞斯达的BD公司)对从土耳其爱琴海地区马尼萨省分离出的109株MTBC菌株(对异烟肼、利福平、乙胺丁醇和链霉素敏感)进行了PZA药敏试验。在对所有主要药物敏感的109株分离株中,有2株(1.8%)显示对PZA单耐药。通过分子方法(德国海因生命科学公司的Genotype MTBC),其中一株PZA单耐药分离株被鉴定为牛分枝杆菌,另一株为结核分枝杆菌。我们的研究结果表明,由于PZA单耐药率较低,在我们地区,不进行PZA的一组主要药物的药敏试验可能是一种经济的选择。