Anti tuberculosis drug resistance in west of Iran

Abstract

Background and Objective:Mycobacterium tuberculosis has developed resistance to antituberculosis drugs and becoming a major and alarming public health problem in worldwide. This study was aimed to determine antituberculosis drug resistance rate and to identify multidrug resistant tuberculosis (MDR-TB) in West of Iran.Materials and Methods:Of 130 samples were included between December 2011 and July 2012 in the study from that 112 cases were M. tuberculosis. The proportional method was carried out according to the Clinical and Laboratory Standards Institute on Lowenstein-Jensen against isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide, para aminosalicylic acid, ethionamide, cycloserine (CYC). The microdilution method was carried out using 7H9 broth with 96 well-plates.Results:From 112 isolates, resistance was observed to isoniazid 18 (16.07%), rifampicin 16 (14.28%), streptomycin 25 (22.32%), ethambutol 15 (13.39%), pyrazinamide 27 (24.10%), para aminosalicylic acid 19 (16.96%), CYC 4 (3.57%), and ethionamide 14 (12.5%) cases. 16 isolates were MDR.Conclusion:The high prevalence of MDR-TB in our study is assumed to be due to recent transmission of drug-resistant strains. Overall, the rate of drug resistance in our study was high, which is in line with findings of some high-burden countries. Hence that early case detection, rapid drug susceptibility testing, and effective anti-TB treatment is necessary.

Evaluation of GeneXpert MTB/RIF for determination of rifampicin resistance among new tuberculosis cases in west and northwest Iran

“…Drug susceptibility testing against rifampicin (40 mg/L) and isoniazid (0.2 mg/L) in new smear-positive TB was performed by the proportional method on Lowenstein–Jensen medium. Drug resistance to rifampicin in TB was >1% in the rifampicin-containing media compared with the rifampicin-free media [15] .…”

“…Sputum samples were gathered from ten provinces of west and northwest Iran (East Azerbaijan, West Azerbaijan, Ardabil, Hamadan, Kurdistan, Zanjan, Ilam, Qazvin, Lorestan and Kermanshah) from March 2014 to November 2014, and moved to the TB reference laboratory of Kermanshah City, Iran. Sputum samples were screened for M. tuberculosis using Ziehl–Neelsen smear and mycobacterial culture [15] . New smear-positive TB cases were cultured on Lowenstein–Jensen medium and M. tuberculosis complex strains were identified on the basis of biochemical tests such as pigment production, niacin, nitrate reduction and the 68°C catalase test [16] .…”

Cyclic di-GMP regulates Mycobacterium tuberculosis resistance to ethionamide

“…In clinic, we already found ETH-resistance strains, with as many as 50–75% of MDR-TB isolates show ETH resistance in some population 19 . As we know, ETH resistance is associated with mutations in the etha genes, msha genes, nadh genes, inha genes, or in the Ethr overexpression strain 19 , 48 , 49 . Mutations in msha and ndh genes are less frequently appear, and msha encodes a glycosyltransferase involved in mycothiol biosynthesis to promote ETH activation 49 .…”

Patients’ Experience of Tuberculosis Treatment Using Directly Observed Treatment, Short-Course (DOTS): A Qualitative Study

“…The TB is an important health problem in Iran and the issue has become even more and therefore, as a result of increasing drug-resistant strains, drug resistance complicates efforts to control TB. Moreover, the problem of extensively drug-resistant strains has recently been introduced ( 14 , 15 ). Despite effective drugs and diagnostic methods, TB is one of the main killers of humanity throughout history and is still growing ( 16 , 17 ).…”