Yıldırım Dilara, Aldemir Özlem, Yanık-Yalçın Tuğba, Parlak Mesut
Department of Medical Microbiology, Sivas Numune Hospital, Sivas, Türkiye.
Department of Infectious Diseases and Clinical Microbiology, Sivas Numune Hospital, Sivas, Türkiye.
Infect Dis Clin Microbiol. 2024 Dec 19;6(4):320-327. doi: 10.36519/idcm.2024.435. eCollection 2024 Dec.
Tuberculosis (TB) is a public health problem. This study aimed to determine the growth rates and drug susceptibility levels of patients with complex (MTC) growth in cultures obtained and to compare the results with the growth rates and drug susceptibility levels found in our country and other countries. It also aimed to evaluate the results of supplementing classical methods such as Lowenstein-Jensen (LJ) with liquid TK MEDIUM and to determine the relationship between the growth rates obtained with both methods.
The study included patients who were Erlich Ziehl Neelsen (EZN) positive or negative and whose samples showed MTC growth in culture and susceptibility to the main drugs used in the treatment of TB, including streptomycin (SM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB). Patient samples were inoculated simultaneously into liquid TK MEDIUM based on color change and LJ solid medium. TB identification and antimicrobial susceptibility testing were performed using the TK ANTI TB and PNB KIT for the Mycolor TK automated mycobacterial culture system.
The study found resistance to dual drugs at 5.4%, INH+RIF at 1.35%, INH at 6.8%, RIF at 14.8%, EMB at 17.6%, and SM at 1.35%. Out of 69 samples cultured in LJ medium, three failed to grow in liquid TK MEDIUM, and two of 71 samples cultured in liquid TK MEDIUM gave negative results in solid LJ medium.
We found that the drug resistance rates we obtained in our study were similar to the results of the Republic of Türkiye Ministry of Health and other studies conducted in our country. In a joint study conducted with liquid and solid media, no difference was found in the detection of TB bacilli. Mycolor TK automated system can enable rapid mycobacterial culture in laboratories with limited resources.
结核病是一个公共卫生问题。本研究旨在确定所获得培养物中复合（MTC）生长患者的生长速率和药物敏感性水平，并将结果与我国及其他国家的生长速率和药物敏感性水平进行比较。它还旨在评估用液体TK培养基补充传统方法（如罗-琴（LJ）培养基）的结果，并确定两种方法获得的生长速率之间的关系。
该研究纳入了萋-尼（EZN）染色阳性或阴性、样本在培养中显示MTC生长且对结核病治疗中使用的主要药物（包括链霉素（SM）、异烟肼（INH）、利福平（RIF）和乙胺丁醇（EMB））敏感的患者。根据颜色变化将患者样本同时接种到基于液体TK培养基和LJ固体培养基中。使用用于Mycolor TK自动分枝杆菌培养系统的TK抗结核和PNB试剂盒进行结核分枝杆菌鉴定和抗菌药物敏感性试验。
该研究发现对两种药物的耐药率为5.4%，对INH+RIF为1.35%，对INH为6.8%，对RIF为14.8%，对EMB为17.6%，对SM为1.35%。在LJ培养基中培养的69个样本中，有3个在液体TK培养基中未生长，在液体TK培养基中培养的71个样本中有2个在固体LJ培养基中结果为阴性。
我们发现本研究中获得的耐药率与土耳其共和国卫生部的结果以及在我国进行的其他研究结果相似。在液体和固体培养基联合进行的研究中，结核杆菌的检测没有差异。Mycolor TK自动系统可以在资源有限的实验室中实现快速分枝杆菌培养。
