Wondale Biniam, Medhin Girmay, Abebe Gemeda, Tolosa Samuel, Mohammed Temesgen, Teklu Takele, Pieper Rembert, Ameni Gobena
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia,
Department of Biology, Arba Minch University, Arba Minch, Ethiopia,
Infect Drug Resist. 2018 Sep 25;11:1581-1589. doi: 10.2147/IDR.S165088. eCollection 2018.
Knowledge of drug-sensitivity patterns of complex (MTBC) strains isolated from patients is an important aspect of TB control strategy. This study was conducted to evaluate the drug sensitivity of MTBC isolates in South Omo, southern Ethiopia.
A total of 161 MTBC isolates (153 from new cases and eight re-treatment TB cases) were isolated using Lowenstein Jensen medium of which 126 isolates were able to be tested for drug sensitivity by BACTEC™MGIT™ 960 system, while all the 161 isolates were tested by GenoType MTBDR VER 2.0. Descriptive statistics and logistic regression were used to express and present results.
On the basis of MGIT 960 system, the prevalence of mono-resistance was 9.2% (11/119) in the new cases, although neither poly-resistance nor multidrug resistance (MDR) was recorded in these cases. On the basis of GenoType MTBDR assay, two of the 153 isolates (1.3%) of the new cases were mono-resistant for rifampicin (RIF) and one of these isolates had known gene mutation (H526D). One of the eight (12.5%) isolates obtained from the re-treatment cases was MDR with gene mutation (D516V) and gene mutation (S315T2). Taking MGIT 960 system as a gold standard, the sensitivities of the MTBDR assay were 33.3%, 100% and 100% for detection of resistance to isoniazid, RIF and MDR, respectively. On the other hand, its specificities were 99.2%, 100% and 100% for detection of resistance to RIF, isoniazid and MDR, respectively.
The magnitude of drug resistance was relatively low in the new TB cases of South Omo as compared to the reports from the other regions of the country. This is encouraging and hence the TB Control Program in the Zone should strengthen its program so that the emergence of drug resistance is inhibited.
了解从患者中分离出的复杂结核分枝杆菌（MTBC）菌株的药敏模式是结核病控制策略的一个重要方面。本研究旨在评估埃塞俄比亚南部奥莫地区MTBC分离株的药敏情况。
使用罗-琴培养基共分离出161株MTBC分离株（153株来自新发病例，8株来自复治结核病例），其中126株分离株能够通过BACTEC™MGIT™ 960系统进行药敏试验，而所有161株分离株均通过GenoType MTBDR VER 2.0进行检测。采用描述性统计和逻辑回归来表述和呈现结果。
基于MGIT 960系统，新发病例中的单耐药患病率为9.2%（11/119），不过这些病例中未记录到多耐药或耐多药（MDR）情况。基于GenoType MTBDR检测，153例新发病例中的2株（1.3%）对利福平（RIF）单耐药，其中1株分离株存在已知基因突变（H526D）。从复治病例中获得的8株分离株中有1株（12.5%）为耐多药，存在基因突变（D516V）和基因突变（S315T2）。以MGIT 960系统作为金标准，MTBDR检测对异烟肼、利福平和耐多药的耐药检测敏感性分别为33.3%、100%和100%。另一方面，其对利福平、异烟肼和耐多药的耐药检测特异性分别为99.2%、100%和100%。
与该国其他地区的报告相比，奥莫南部新结核病例中的耐药程度相对较低。这令人鼓舞，因此该地区的结核病控制项目应加强其计划，以抑制耐药性的出现。
