Department of Medical Laboratory Technology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Tuberc Lung Dis. 2012 Jun;16(6):805-11. doi: 10.5588/ijtld.11.0522. Epub 2012 Feb 29.
Gondar Hospital, Gondar Health Centre, Metemma Hospital, Bahir Dar Hospital and Debre Markos Hospital in Northwest Ethiopia.
To assess the level of and risk factors for first- and second-line drug resistance among tuberculosis (TB) patients.
Drug susceptibility testing (DST) against first-line drugs, including isoniazid (INH), rifampicin (RMP), streptomycin (SM), ethambutol (EMB) and pyrazinamide (PZA), was performed using the BacT/ALERT 3D system. DST against second-line drugs, including fluoroquinolones and aminoglycocides/cyclic peptides, was performed using GenoType MTBDRsl.
Of 260 Mycobacterium tuberculosis isolates, 41 (15.8%) were resistant to at least one first-line drug, 13 (5.0%) were multidrug-resistant (MDR) and 9 (3.5%) were resistant to all first-line drugs. Any resistance to INH, RMP, SM, EMB and PZA was respectively 36 (13.8%), 15 (5.8%), 26 (10.0%), 19 (7.3%) and 12 (4.6%). Of 214 new and 46 previously treated cases, respectively 8 (3.7%) and 5 (10.9%) were MDR. All isolates were susceptible to all second-line drugs.
A substantial number of new and previously treated cases harbour MDR-TB. We recommend DST at least for previously treated cases, patients who remain smear-positive at the end of the second month of treatment and patients in close contact with MDR-TB cases. Improved infection control measures need to be implemented in Ethiopia.
埃塞俄比亚西北部的贡德尔医院、贡德尔保健中心、默特马医院、巴哈达尔医院和德布雷马克罗斯医院。
评估结核病（TB）患者一线和二线药物耐药的水平和危险因素。
使用 BacT/ALERT 3D 系统对包括异烟肼（INH）、利福平（RMP）、链霉素（SM）、乙胺丁醇（EMB）和吡嗪酰胺（PZA）在内的一线药物进行药物敏感性试验（DST）。使用 GenoType MTBDRsl 对包括氟喹诺酮类和氨基糖苷类/环肽在内的二线药物进行 DST。
在 260 株结核分枝杆菌分离株中，有 41 株（15.8%）至少对一种一线药物耐药，13 株（5.0%）为耐多药（MDR），9 株（3.5%）对所有一线药物均耐药。INH、RMP、SM、EMB 和 PZA 的任何耐药率分别为 36（13.8%）、15（5.8%）、26（10.0%）、19（7.3%）和 12（4.6%）。在 214 例新发病例和 46 例既往治疗病例中，MDR 分别为 8（3.7%）和 5（10.9%）。所有分离株均对所有二线药物敏感。
相当数量的新发病例和既往治疗病例携带耐多药结核分枝杆菌。我们建议至少对既往治疗病例、治疗两个月末仍痰涂片阳性的患者和与耐多药结核分枝杆菌病例密切接触的患者进行 DST。埃塞俄比亚需要实施改进的感染控制措施。
