Nagu Tumaini J, Aboud Said, Mwiru Ramadhani, Matee Mecky, Fawzi Wafaie, Mugusi Ferdinand
Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLoS One. 2015 Apr 7;10(4):e0118601. doi: 10.1371/journal.pone.0118601. eCollection 2015.
Surveillance and effective management of drug resistance is important to sustaining tuberculosis (TB) control efforts. We aimed to determine resistance rates to first line anti tuberculosis drugs and to describe factors associated with the resistance to any of the first line anti tuberculosis drugs in Dar es Salaam Tanzania.
Newly diagnosed, TB patients with neither history of tuberculosis treatment nor isoniazid prophylaxis were included into the study. Sputum specimens were cultured on either mycobacteria growth indicator tube 960 (MGIT 960) or Lowenstein Jenstein (LJ) medium supplemented with either glycerol (GLJ) or pyruvate (PLJ). Drug susceptibility for isoniazid, rifampicin, streptomycin and ethambutol was determined by either Lowenstein-Jensen (LJ) medium or mycobacteria growth indicator tube 960 (MGIT 960).
A total of 933 newly diagnosed TB patients, were included into the study. Multi drug resistance (MDR) tuberculosis was detected among 2 (0.2%) patients. Resistance to any of the four tested drugs was detected among 54 (5.8%) patients. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol were 21(2.3%), 3 (0.3%), 13 (1.4%), 9 (1.0%) respectively.
Primary resistance to first line anti tuberculosis drugs is still low in this setting. Continued vigilance including periodic national surveillance of anti-tuberculosis resistance is recommended.
耐药监测与有效管理对于维持结核病控制工作至关重要。我们旨在确定坦桑尼亚达累斯萨拉姆对一线抗结核药物的耐药率，并描述与对任何一线抗结核药物耐药相关的因素。
本研究纳入了新诊断的、既无结核病治疗史也无异烟肼预防史的结核病患者。痰标本在添加甘油（GLJ）或丙酮酸盐（PLJ）的分枝杆菌生长指示管960（MGIT 960）或罗氏培养基（LJ）上培养。异烟肼、利福平、链霉素和乙胺丁醇的药敏试验通过罗氏培养基（LJ）或分枝杆菌生长指示管960（MGIT 960）进行。
本研究共纳入933例新诊断的结核病患者。2例（0.2%）患者检测到耐多药（MDR）结核病。54例（5.8%）患者检测到对四种受试药物中的任何一种耐药。对异烟肼、利福平、链霉素和乙胺丁醇的单耐药分别为21例（2.3%）、3例（0.3%）、13例（1.4%）、9例（1.0%）。
在本研究环境中，对一线抗结核药物的原发耐药性仍然较低。建议持续保持警惕，包括定期进行全国性的抗结核耐药监测。
