As the number of drug resistant pulmonary TB is increasing around the world, the number of drug resistant TB with extrapulmonary manifestations are also on rise. However, there is surprisingly scant information in medical literatures on prevalence and impact of extrapulmonary drug-resistant TB Aim:This study aimed to detect and isolate Mycobacterium Tuberculosis Complex (MTC or MTBC) strains from extrapulmonary samples then determine the drug resistance pattern of these strains to antituberculus drugs. Materials and Methods: A total of 100 clinical specimens were collected during the study period from September 2016 to January 2018 at Medial Microbiology & Immunology Department, Sohag Faculty of Medicine from patients suspected to have EPTB. All samples subjected to ZN staining &cultures on LJ media then all positive culture were subjected for identification of the type of mycobacteria by two methods, phenotypically by biochemical tests and genotypically by conventional PCR fordetection of MTC.Antimicrobial susceptibility pattern was done for MTC strains. Results:Out of100 collected extrapulmonary samples, 66 samples were positive for mycobacterial culture. By using biochemical tests and PCR for identification of species, 53 isolates were identified as MTC and 13 isolates were identified as NTM. Antimicrobial susceptibility pattern was done for MTCstrains and detected 5 strains were MDR and one strain was XDR. Conclusion:Extrapulmonary TB infection rate in Sohag governorate is high and the problem of drug resistance in extrapulmonary tuberculosis (EPTB) cannot be overlooked.
Tuberculosis is a major global health problem. ExtrapulmonaryTB(EPTB) refers to TB involving organs other than the lungs. It shoulddrag more attention after increasing numbers of immunocompromised individualswith higher risk of developing EPTB. Aim: This study aimed to detectEPTB in clinically suspected cases and identificationof mycobacteria species by phenotypic and genotypicmethods. Materials and Methods: A total of 100 clinical specimens were collected during the study period from September 2016 to January 2018 at Sohag University from patients suspected to have EPTB. All samples subjected to ZN staining & culture on LJ media then all positive culture were subjected for identification of mycobacteria speciesby two methods, phenotypically by biochemical tests and genotypically by conventional PCR for detection of mycobacterium Tuberculosis Complex (MTC).Immunochromatographic tests were done for all strains with negative PCR in addition to some strains with positive PCR for confirmation and for comparison between immunochromatographic test and both biochemical test and PCR in identification of MTC. Results: Mycobacteria were isolated from 66 samples of which the highest number of isolates were obtained from urine samples followed by stool samples then other extrapulmonary samples. By using different methods of identification, 53 isolates were identified as MTC and 13 isolates were identified as nontuberculus mycobacteria (NTM). Conclusion: Our results suggest that due attention should be given for EPTB and rapid differentiation between MTC and NTM is very important for the proper management of patients with mycobacterial infections.
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