Tavanaee Sani Ashraf, Shakiba Abolfazl, Salehi Maryam, Bahrami Taghanaki Hamid Reza, Ayati Fard Seiedeh Fatemeh, Ghazvini Kiarash
Department of Infectious Diseases, Mashhad University of Medical Sciences, Mashhad, Iran.
Departments of Community Medicine, School of Medicine and Research Center for Patient Safety, Mashhad University of Medical Sciences, Mashhad, Iran.
Biomed Res Int. 2015;2015:747085. doi: 10.1155/2015/747085. Epub 2015 May 3.
Tuberculosis is still one of the most important health problems in developing countries and increasing drug resistance is the main concern for its treatment. This study was designed to characterize the drug resistant Mycobacterium tuberculosis isolated from patients suffering from pulmonary tuberculosis in northeast of Iran.
In this cross-sectional study during 2012-2013, drug susceptibility testing was performed on Mycobacterium tuberculosis isolated in northeast of Iran using proportional method. Epidemiological data concerning these strains were also analyzed.
Among 125 studied isolates, 25 mycobacteria (20%) were diagnosed as nontuberculosis mycobacteria. Among the remaining 100 Mycobacterium tuberculosis isolates, the resistance rates were 7%, 7%, 3%, and 9% against isoniazid, rifampin, ethambutol, and streptomycin, respectively. Four isolates were resistant against both isoniazid and rifampin (MDR tuberculosis). The highest resistance rate was observed among 15-45-year-old patients. The MDR tuberculosis was much more prevalent among those who had previous history of treatment.
Considering these findings, DOTS strategy should be emphasized and promptly used in order to prevent further resistance. Regarding the high rate of nontuberculosis mycobacteria, it is recommended that confirmatory tests were performed before any therapeutic decision.
结核病仍是发展中国家最重要的健康问题之一，耐药性不断增加是其治疗的主要担忧。本研究旨在对从伊朗东北部肺结核患者中分离出的耐药结核分枝杆菌进行特征分析。
在这项2012 - 2013年的横断面研究中，采用比例法对从伊朗东北部分离出的结核分枝杆菌进行药敏试验。还对这些菌株的流行病学数据进行了分析。
在125株研究分离株中，25株分枝杆菌（20%）被诊断为非结核分枝杆菌。在其余100株结核分枝杆菌分离株中，对异烟肼、利福平、乙胺丁醇和链霉素的耐药率分别为7%、7%、3%和9%。4株分离株对异烟肼和利福平均耐药（耐多药结核病）。在15 - 45岁患者中观察到最高耐药率。耐多药结核病在有既往治疗史的患者中更为普遍。
考虑到这些发现，应强调并及时采用直接观察短程治疗（DOTS）策略以防止进一步耐药。鉴于非结核分枝杆菌的高检出率，建议在做出任何治疗决定之前进行确诊试验。
