Türkiyenin Doğusunda Çeşitli Klinik Örneklerden İzole Edilen Mycobacterium tuberculosis Suşlarinin Major Anti-Tüberküloz İlaçlara Duyarlılıklarının Araştırılması

Abstract

In the study, 419 Mycobacterium tuberculosis complex strains, which were isolated from samples sent to the Regional Tuberculosis Laboratory in our city between 2015 and 2019 with suspected tuberculosis from Erzurum and surrounding cities were investigated. Material and Method: Our research is a retrospective crosssectional study and clinical samples sent to the Regional Public Health Laboratory with suspicion of Tuberculosis within a five-year period from January 2015 to December 2019 were first evaluated by using Ehrlich-Ziehl-Neelsen staining technique. The samples were then simultaneously inoculated into the automated culture system (BACTEC MGIT 960) with Löwenstein-Jensen medium. Sensitivity research was conducted for isoniazide (INH), rifampicin (RIF), streptomycin (STM) and ethambutol (ETM) antibiotics with BACTEC MGIT 960 system to samples defined by M. tuberculosis complex strains identification test (TBc ID) from reproduction positive tubes. Results: In our study, 337 (80.4%) of the 419 M. tuberculosis complex strains investigated in our study were susceptible to all major anti-TB drugs, while 82 (19.6%) were found to be resistant to at least one major anti-TB drug. The distribution of resistance ratios was INH (11.9%), STM (11.7%), RIF (4.1%), ETM (3.6%). Multi-drug resistant (MDR)-TB ratio (IZN+ RIF) was found to be (3.6%). Conclusions: In our study, in the strains in which resistance to anti-TB drugs was investigated, the highest drug resistance was determined for IZN. The lowest drug resistance was determined for ETM.

Resistance Rates of Mycobacterium tuberculosis Complex Isolates to Primary Anti-tuberculosis Drugs: A 5-Year Retrospective Study

“…All procedures in the laboratory were carried out in Class II biosafety cabins using the required personal protective equipment. Sterile samples such as pleural fluid and cerebrospinal fluid which were obtained with aseptic techniques, were handled without being decontaminated; whereas other samples such as sputum, bronchoalveolar lavage (BAL), and abscess were examined after homogenization and decontamination with N-acetyl-L-cysteine and sodium hydroxide (10). The material obtained after the preliminary preparation was inoculated on BACTEC MGIT 960 TB automated system (Becton Dickinson, USA) and Löwenstein-Jensen (LJ) medium according to the recommendations of the manufacturer.…”

“…The Ehrlich-Ziehl-Neelsen (EZN) staining method was used for acid-fast bacilli (AFB) detection in direct smear preparations (12). Cultures were left for incubation for up to 42 days (10). Drug susceptibility testing was achieved by BACTEC MGIT 960 following the manufacturer's procedures (13).…”

“…Drug susceptibility testing was achieved by BACTEC MGIT 960 following the manufacturer's procedures (13). Reference strain H37RV (ATCC 27294) was used as a quality control of culture and drug susceptibility test, and the strain was sensitive to all standard anti-TB drugs (10).…”

“…In 2020 the nationwide incidence of multidrug-resistant/ rifampicin-resistant tuberculosis (MDR/RR-TB) was 3.3% in new cases and 18% in formerly treated cases (1). According to the instruction of the American Thoracic Society and the CDC, drug susceptibility testing must be done for at least the first-line anti-TB drugs in all older and new TB cases to guarantee the proper treatment for patients and to hinder the development of anti-TB drugs resistance (10). Drug susceptibility testing is critical for recognizing and managing drug-resistant TB (11).…”