Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Department of Medical Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2021 Jan 28;16(1):e0245687. doi: 10.1371/journal.pone.0245687. eCollection 2021.
Drug-resistance in Mycobacterium tuberculosis complex remains a major health burden in human history and still is a major leading cause of death in developing countries including Ethiopia. Early detection of all forms of drug-resistant Tuberculosis(TB) is a key factor to reduce and contain the spread of these resistant strains.
A health facility-based cross-sectional study was employed, based on demographic, clinical, and laboratory data collected from 204 patients with bacteriological confirmed TB. Sputum samples were analyzed using conventional TB culture and identification test followed by molecular species identification, and then phenotypic drug susceptibility tests. Data were entered using an excel spreadsheet and exported to SPSS version 20 for analysis. Descriptive analysis; frequencies, and proportions were computed.
Among the 204 sputum samples inoculated in culture media, Mycobacterium species were recovered from 165 specimens, with 160 Mycobacterium tuberculosis complex and five Non- Tuberculosis Mycobacterium(NTM) species. All Mycobacterium tuberculosis complex was found to be M. tuberculosis. Of the five NTM species, 2 M.fortuitum, 2 M.intracellulare, and 1 M.gordonae were identified. Among 160 species of M. tuberculosis isolates, 110(68.8%) were resistant to any of the anti-TB drugs. The resistance pattern was; INH (109, 68.1%), RIF (99, 61.9%), STM (73,45.6%), and EMB (32,20.0%). Mono-resistance was found for INH (7,4.3%) and STM (1,0.6%). Ninety-nine (61.9%) isolates become MDR, while resistance to any of the second-line anti-TB drugs was detected in 9 (5.6%) strains, with 8(5%) Pre-XDR and one (0.6%) XDR cases.
Our findings highlight high frequencies of drug resistance to first and second-line anti-TB drugs.Determining the drug-resistance pattern of MTB is important for programmatic management of drug-resistant TB in Ethiopia. The circulating Pre-XDR and XDR case identified in the current study is alarming to the tuberculosis control program in the country.
结核分枝杆菌耐药性仍然是人类历史上的主要健康负担，也是包括埃塞俄比亚在内的发展中国家主要的死亡原因之一。早期发现所有形式的耐药结核病（TB）是减少和控制这些耐药菌株传播的关键因素。
采用基于卫生机构的横断面研究，收集了 204 例经细菌学证实的结核患者的人口统计学、临床和实验室数据。对痰液样本进行常规结核培养和鉴定试验，然后进行分子种鉴定，再进行表型药敏试验。数据使用 Excel 电子表格输入，并导出到 SPSS 20 进行分析。采用描述性分析；计算频率和比例。
在接种于培养介质的 204 份痰液样本中，从 165 份标本中回收了分枝杆菌属，其中 160 株为结核分枝杆菌复合体，5 株为非结核分枝杆菌（NTM）。所有结核分枝杆菌复合体均为结核分枝杆菌。在 5 株 NTM 中，鉴定出 2 株脓肿分枝杆菌、2 株胞内分枝杆菌和 1 株戈登分枝杆菌。在 160 株结核分枝杆菌分离株中，有 110 株（68.8%）对任何一种抗结核药物均耐药。耐药模式为：异烟肼（INH）（109 株，68.1%）、利福平（RIF）（99 株，61.9%）、链霉素（STM）（73 株，45.6%）和乙胺丁醇（EMB）（32 株，20.0%）。异烟肼（7 株，4.3%）和链霉素（1 株，0.6%）分别出现单耐药。99 株（61.9%）为耐多药，9 株（5.6%）对任何一种二线抗结核药物耐药，其中 8 株（5%）为预泛耐药，1 株（0.6%）为广泛耐药。
我们的研究结果突出了抗结核药物的一线和二线药物的耐药率很高。确定结核分枝杆菌的耐药模式对于在埃塞俄比亚进行抗结核药物耐药性管理计划非常重要。在当前研究中发现的流行的预泛耐药和广泛耐药病例令人对该国的结核病控制计划感到震惊。
