Mersin bölgesinde izole edilen Mycobacterıum tuberculosıs suşlarında amikasin ve siprofloksasin duyarlılığı
Primer antitüberküloz ilaçların tümüne duyarlı (43) ve bir ya da daha fazlasına dirençli (48) Mycobacterium tuberculosis izolatlarının amikasine ve siprofloksasine in-vitro duyarlılıkları agar proporsiyon yöntemi ile belirlenmiştir. Suşların direnç oranları amikasin için % 2.2, siprofloksasin için % 1.1 olarak bulunmuştur. Çoğul ilaç direnci olan izolatların tümü amikasin ve siprofloksasine duyarlı olarak tespit edilmiştir. Çok ilaca dirençli tüberküloz suşlarının oluşturduğu infeksiyonların tedavisinde sekonder ilaç direncinin bilinmesi bu hastaların tedavi protokollerinin planlanması, DOTS-Plus stratejisi uygulaması ve tedavi başarısının artırılması için zorunlu olduğundan bu verilerin bölgemiz ve ülkemizdeki çok ilaca dirençli tüberküloz suşları ile infekte hastaların tedavisinin planlamasında faydalı olacağı düşünülmüştür.
The susceptibility of Mycobacterium tuberculosis strains isolated in Mersin region for amikacin and ciprofloxacin
In vitro susceptibility for amikacin and ciprofloxacin of 43 Mycobacterium tuberculosis isolates susceptible to all primary antituberculosis drugs and of 48 isolates resistant to one or more primary antituberculosis drugs was determined by agar proportion method. The resistance rates of the isolates were 2.2 % for amikacin and 1.1 % for ciprofloxacin. All of the multi-drug resistant isolates were found to be susceptible to amikacin and ciprofloxacin. As it is important to know the resistance rates to secondary drugs for the treatment of multi-drug resistant tuberculosis, for the practice of DOTSPlus strategies and increasing the therapeutic success, we consider that the results of such studies will aid the treatment of multi-drug resistant tuberculosis patients in our region and the country.
___
- 1. Akcali S, Surucuoglu S, Cicek C, Ozbakkaloglu B: In vitro activity of ciprofloxacin, ofloxacin and levofloxacin against Mycobacterium tuberculosis, Ann Saudi Med 2005;25(5):409-12.
- 2. Aslan G, Delialioğlu N, Emekdaş G et al: Mycobacterium tuberculosis suşlarının izoniazid, rifampisin, streptomisin ve etambutol duyarlılılarının BACTEC yöntemi ile belirlenmesi, ANKEM Derg 2005;19(1):43-7.
- 3. Avkan Oğuz V, Akbal H, Sarıbaş S, Karagöz T, Öztürk R: Edinsel çok ilaca dirençli Mycobacterium tuberculosis suşlarının major ve sekonder antitüberküloz ilaçlara duyarlığı, İnfeksiyon Derg 2000;14(3):383-6.
- 4. Balabanova Y, Ruddy M, Hubb J et al: Multidrug-resistant tuberculosis in Russia: clinical characteristics, analysis of second-line drug resistance and development of standardized therapy, Eur J Clin Microbiol Infect Dis 2005;24(2):136-9.
- 5. Bastian I, Rigouts L, Van Deun A, Portaels F: Directly observed treatment, short-course strategy and multidrug-resistant tuberculosis: are any modifications required? Bull World Health Organ 2000;78(2):238-51.
- 6. Bozeman L, Burman W, Metchock B, Welch L, Weiner M, Tuberculosis Trials Consortium: Fluoroquinolone susceptibility among Mycobacterium tuberculosis isolates from the United States and Canada, Clin Infect Dis 2005;40(3):386-91.
- 7. CDC: Initial therapy for tuberculosis era of multiagent resistance: recommendations of Advisory Council for the elimination of tuberculosis, MMWR 1993;42(R-7):001.
- 8. Çiçek Saydam C, Çavuşoğlu C, Burhanoğlu D, Bardak FZ, Bilgiç A: Susceptibility of Mycobacterium tuberculosis strains to first-line and second-line antituberculosis drugs in Ege University Hospital, Turk J Med Sci 2001;31(5):395-400.
- 9. Kruuner A, Jureen P, Levina K, Ghebremichael S, Hoffner S: Discordant resistance to kanamycin and amikacin in drug-resistant Mycobacterium tuberculosis, Antimicrob Agents Chemother 2003;47(9):2971-3.
- 10. Maus CE, Plikaytis BB, Shinnick TM: Molecular analysis of crossresistance to capreomycin, kanamycin, amikacin, and viomycin in Mycobacterium tuberculosis, Antimicrob Agents Chemother 2005;49 (8):3192-7.
- 11. Mirsaeidi SM, Tabarsi P, Khoshnood K et al: Treatment of multiple drug-resistant tuberculosis (MDR-TB) in Iran, Int J Infect Dis 2005;9 (6):317-22.
- 12. Muralidhar S, Srivastava L: Evaluation of three methods to determine the antimicrobial susceptibility of Mycobacterium tuberculosis, Indian J Med Res 2004;120(5):463-7.
- 13. Parsons LM, Somoskovi A, Urbanczik R, Salfinger M: Laboratory diagnostic aspects of drug resistant tuberculosis, Front Biosci 2004;1(9):2086-105.
- 14. Pfyffer GE, Bonato DA, Ebrahimzadeh A et al: Multicenter laboratory validation of susceptibility testing of Mycobacterium tuberculosis against classical second-line and newer antimicrobial drugs by using the radiometric BACTEC 460 technique and the proportion method with solid media, J Clin Microbiol 1999;37(10):3179-86.
- 15. Rusch-Gerdes S, Domehl C, Nardi G, Gismondo MR, Welscher HM, Pfyffer GE: Multicenter evaluation of the mycobacteria growth indicator tube for testing susceptibility of Mycobacterium tuberculosis to firstline drugs, J Clin Microbiol 1999;37(1):45-8.
- 16. Siddiqi SH: BACTEC 460 TB System Product and Procedure Manual, Becton Dickinson and Company, Sparks, Md. (1995).
- 17. Tahaoglu K, Torun T, Sevim T et al: The treatment of multidrug-resistant tuberculosis in Turkey, N Engl J Med 2001;345(3):170-4.
- 18. Tansel Ö, Yüksel P, Kuloğlu F, Akata F: Çok ilaca dirençli Mycobacterium tuberculosis suşlarının sekonder antitüberküloz ilaçlara duyarlılık sonuçları, İnfeksiyon Derg 2003;17(3):307-11.
- 19. Uzun M, Şatana D, Dere S: In vitro activities of ofloxacin, levofloxacin and norfloxacin against multi-drug resistant Mycobacterium tuberculosis strains, Türk Mikrobiyol Cem Derg 2004;34(3):171-4.
- 20. World Health Organization: Guidelines for establish DOTS-Plus pilot projects for management of multidrug resistance tuberculosis, WHO/ CDC/TB/2000.279, WHO, Geneva (2000).
- 21. World Health Organization: Global tuberculosis control: surveillance, planning, financing, WHO/HTM/TB/2006.362, WHO, Geneva (2006).