Six-Year Results of Clinical Samples of Patients with Tuberculosis Pre-Diagnosed in Eastern Anatolia Region and Resistance Rates to Antimycobacterial Drugs

Yalçın Dicle; Elif Aydın; Duygu Kübra Tuna

Article Details

Six-Year Results of Clinical Samples of Patients with Tuberculosis Pre-Diagnosed in Eastern Anatolia Region and Resistance Rates to Antimycobacterial Drugs

Authors:

Yalçın Dicle | Elif Aydın | Duygu Kübra Tuna

Publisher:

Van Yuzuncu Yıl University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Van Sağlık Bilimleri Dergisi Vol.16 Issue 1, pp.75-83

Document Type:

Article

Publication Date:

4/2023

Document Language:

Turkish

Document ID (Org No.):

2001289097

pISSN:

2667-5072

Keywords:

Abstract:

 Objective: In this study, it was aimed to compare the direct microscopy and culture results of the samples sent to our laboratory with a preliminary diagnosis of tuberculosis, as well as to investigate the susceptibility of Mycobacterium tuberculosis complex isolates to antituberculosis drugs and to determine the resistance rates. Material and Method: Direct microscopy and culture results of 9244 clinical samples sent to our laboratory between 2013 and 2018 were evaluated. Tuberculosis automated culture tests and first-line antituberculosis drug susceptibility tests were performed with the BACTEC MGIT 960 system in line with the methods recommended by the manufacturer. Results: A total of the 9244 samples included in the study, 507 5.5 were identified as Mycobacterium tuberculosis complex. Antibiotic susceptibility test was applied to 120 23.7 samples, one isolate for each patient from these positive samples. According to years, Mycobacterium tuberculosis complex positivity between 2013 and 2018, respectively; 3, 5.8, 7.3, 5.9, 4.6 and 6.8. The rates of resistance to a single antibiotic were found to be isoniazid 6.7 8, rifampicin 1.7 2, ethambutol 0.8 1, streptomycin 3.3 4 and pyrazinamide 0.8 1, respectively. Resistance to at least one of the anti-tuberculosis drugs was detected in 23 19.6 of the Mycobacterium tuberculosis complex samples whose drug resistance was examined. Multi-drug resistance was detected in 4 3.3 of these samples, and only rifampicin resistance was detected in 2 1.7 samples Conclusion: These positivity rates obtained from Van city and surrounding cities were found to be lower than many other regions of our country. The reasons are; It can be listed as the low sample rate at the time of diagnosis, the study of patient samples whose bacillus load decreases after antibiotics are started, the negative repetitive samples taken during the treatment follow-up process of smearculture positive pulmonary tuberculosis patients, and the patients diagnosed outside the province. With surveillance studies, resistance patterns should be revealed and it is important to follow the development of resistance by taking necessary precautions.

 Objective: In this study, it was aimed to compare the direct microscopy and culture results of the samples sent to our laboratory with a preliminary diagnosis of tuberculosis, as well as to investigate the susceptibility of Mycobacterium tuberculosis complex isolates to antituberculosis drugs and to determine the resistance rates. Material and Method: Direct microscopy and culture results of 9244 clinical samples sent to our laboratory between 2013 and 2018 were evaluated. Tuberculosis automated culture tests and first-line antituberculosis drug susceptibility tests were performed with the BACTEC MGIT 960 system in line with the methods recommended by the manufacturer. Results: A total of the 9244 samples included in the study, 507 5.5 were identified as Mycobacterium tuberculosis complex. Antibiotic susceptibility test was applied to 120 23.7 samples, one isolate for each patient from these positive samples. According to years, Mycobacterium tuberculosis complex positivity between 2013 and 2018, respectively; 3, 5.8, 7.3, 5.9, 4.6 and 6.8. The rates of resistance to a single antibiotic were found to be isoniazid 6.7 8, rifampicin 1.7 2, ethambutol 0.8 1, streptomycin 3.3 4 and pyrazinamide 0.8 1, respectively. Resistance to at least one of the anti-tuberculosis drugs was detected in 23 19.6 of the Mycobacterium tuberculosis complex samples whose drug resistance was examined. Multi-drug resistance was detected in 4 3.3 of these samples, and only rifampicin resistance was detected in 2 1.7 samples Conclusion: These positivity rates obtained from Van city and surrounding cities were found to be lower than many other regions of our country. The reasons are; It can be listed as the low sample rate at the time of diagnosis, the study of patient samples whose bacillus load decreases after antibiotics are started, the negative repetitive samples taken during the treatment follow-up process of smearculture positive pulmonary tuberculosis patients, and the patients diagnosed outside the province. With surveillance studies, resistance patterns should be revealed and it is important to follow the development of resistance by taking necessary precautions.

 Objective: In this study, it was aimed to compare the direct microscopy and culture results of the samples sent to our laboratory with a preliminary diagnosis of tuberculosis, as well as to investigate the susceptibility of Mycobacterium tuberculosis complex isolates to antituberculosis drugs and to determine the resistance rates. Material and Method: Direct microscopy and culture results of 9244 clinical samples sent to our laboratory between 2013 and 2018 were evaluated. Tuberculosis automated culture tests and first-line antituberculosis drug susceptibility tests were performed with the BACTEC MGIT 960 system in line with the methods recommended by the manufacturer. Results: A total of the 9244 samples included in the study, 507 5.5 were identified as Mycobacterium tuberculosis complex. Antibiotic susceptibility test was applied to 120 23.7 samples, one isolate for each patient from these positive samples. According to years, Mycobacterium tuberculosis complex positivity between 2013 and 2018, respectively; 3, 5.8, 7.3, 5.9, 4.6 and 6.8. The rates of resistance to a single antibiotic were found to be isoniazid 6.7 8, rifampicin 1.7 2, ethambutol 0.8 1, streptomycin 3.3 4 and pyrazinamide 0.8 1, respectively. Resistance to at least one of the anti-tuberculosis drugs was detected in 23 19.6 of the Mycobacterium tuberculosis complex samples whose drug resistance was examined. Multi-drug resistance was detected in 4 3.3 of these samples, and only rifampicin resistance was detected in 2 1.7 samples Conclusion: These positivity rates obtained from Van city and surrounding cities were found to be lower than many other regions of our country. The reasons are; It can be listed as the low sample rate at the time of diagnosis, the study of patient samples whose bacillus load decreases after antibiotics are started, the negative repetitive samples taken during the treatment follow-up process of smearculture positive pulmonary tuberculosis patients, and the patients diagnosed outside the province. With surveillance studies, resistance patterns should be revealed and it is important to follow the development of resistance by taking necessary precautions.

 Amaç: Çalışmada, tüberküloz ön tanısıyla laboratuvarımıza gönderilen numunelerin doğrudan mikroskopi ve kültür sonuçlarının karşılaştırılması aynı zamanda Mycobacterium tuberculosis kompleks izolatlatlarının antitüberküloz ilaçlara duyarlılıklarının araştırılması ve direnç oranlarının belirlenmesi amaçlanmıştır. Materyal ve Metot: 2013 ile 2018 tarihleri arasında laboratuvarımıza gönderilen 9244 klinik numune doğrudan mikroskopi ve kültür sonuçları değerlendirmeye alınmıştır. Tüberküloz otomatize kültür testleri ve birinci seçenek antitüberküloz ilaç duyarlılık testleri üretici firmanın tavsiye ettiği yöntemler doğrultusunda BACTEC MGIT 960 sistemi ile çalışılmıştır. Bulgular: Çalışmaya alınan 9244 örnekten 507 5,5si Mycobacterium tuberculosis kompleks olarak tanımlanmıştır. Bu pozitif örneklerden her hastaya bir izolat olacak şekilde 120 23,7 örneğe antibiyotik duyarlılık testi uygulanmıştır. Yıllara göre Mycobacterium tuberculosis kompleks pozitifliği 2013-2018 yılları arasında sırasıyla; 3, 5,8, 7,3, 5,9, 4,6, 6,8 olarak saptanmıştır. Tek antibiyotik dirençleri sırasıyla izoniazid 8 6,7, rifampisin 2 1,7, etambutol 1 0,8, streptomisin 4 3,3 ve pirazinamid 1 0,8 olarak bulunmuştur. İlaç direnci bakılan Mycobacterium tuberculosis kompleks örneklerinin 23 19,2ünde antitüberküloz ilaçlardan en az bir tanesinde direnç tespit edilmiş olup, bu örneklerin 4 3,3ünde çok ilaca direnç ve 2 1,7 örnekte de yalnızca rifampisin direnci tespit edilmiştir. Sonuç: İlimiz ve çevre illerden elde edilen bu pozitiflik oranları ülkemizin diğer pek çok yöresine göre daha düşük bulunmuştur. Sebepleri ise; tanı anında çalışılan numune oranının düşük olması, antibiyotik başlanıp basil yükü düşen hasta numunelerinin çalışılması, yaymakültür pozitif akciğer tüberküloz hastalarının tedavi takip sürecinde alınan mükerrer numunelerinin negatif olması ve hastaların il dışı tanılı olması şeklinde sıralanabilir. Sürveyans çalışmaları ile direnç paternleri ortaya koyulmalı ve gerekli önlemler alınarak direnç gelişiminin takibi önem arz etmektedir.

Article Details

Six-Year Results of Clinical Samples of Patients with Tuberculosis Pre-Diagnosed in Eastern Anatolia Region and Resistance Rates to Antimycobacterial Drugs

Authors:

Yalçın Dicle | Elif Aydın | Duygu Kübra Tuna

Publisher:

Van Yuzuncu Yıl University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Van Sağlık Bilimleri Dergisi Vol.16 Issue 1, pp.75-83

Document Type:

Article

Publication Date:

4/2023

Document Language:

Turkish

Document ID (Org No.):

2001289097

pISSN:

2667-5072

Tuberculosis

Mycobacterium tuberculosis complex

antitubercular

multidrug resistance tuberculosis

extensively drug resistant tuberculosisTüberküloz

Mycobacterium tuberculosis kompleks

antitüberküloz

çok ilaç dirençli tüberküloz

yaygın ilaç dirençli tüberküloz

Issues

Article Details

Authors: Yalçın Dicle | Elif Aydın | Duygu Kübra Tuna

Publisher: Van Yuzuncu Yıl University

Main Topics: Klinik Tıp Bilimleri

Journal: Van Sağlık Bilimleri Dergisi Vol.16 Issue 1, pp.75-83

Document Type: Article

Publication Date: 4/2023

Document Language: Turkish

Document ID (Org No.): 2001289097

pISSN: 2667-5072

Issues

Authors:

Yalçın Dicle | Elif Aydın | Duygu Kübra Tuna

Publisher:

Van Yuzuncu Yıl University

Main Topics:

Klinik Tıp Bilimleri

Journal:

Van Sağlık Bilimleri Dergisi Vol.16 Issue 1, pp.75-83

Document Type:

Article

Publication Date:

4/2023

Document Language:

Turkish

Document ID (Org No.):

2001289097

pISSN:

2667-5072