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

Amaç: Çalışmada ilimizde bulunan Bölge Tüberküloz Laboratuvarı’na 2015-2019 yılları arasında Erzurum ve çevre illerden tüberküloz şüphesi ile gönderilen örneklerden izole edilmiş olan 419 Mycobacterium tuberculosis kompleks suşun(MTK), major anti-tuberküloz ilaçlara karşı direnç durumu araştırıldı. Gereç ve Yöntem: Araştırmamız retrospektif kesitsel bir çalışma olup, Ocak 2015-Aralık 2019 tarihleri arası beş yıllık sürede Bölge Halk Sağlığı Laboratuvarına Tüberküloz şüphesiyle gönderilen klinik örnekler, ilk önce Ehrlich-Ziehl-Neelsen boyama yöntemi kullanılarak değerlendirildi. Daha sonra örnekler eş zamanlı olarak Löwenstein-Jensen besiyeri ile otomatize kültür sistemine (BACTEC MGIT 960) ekimleri yapıldı. Üremesi pozitif tüplerden identifikasyon testi (TBc ID) ile MTK tanımlaması yapılan örneklere BACTEC MGIT 960 sistemi ile izoniazid, rifampisin, streptomisin ve etambutol antibiyotikleri için duyarlılık araştırması yapıldı. Bulgular: Çalışmamızda ilaç duyarlılığı araştırılan 419 MTK suş’un 337’si (%80,4) majör anti-TB ilaçların tümüne duyarlı iken 82’si (%19,6) en az bir majör anti-TB ilaca dirençli bulundu. Direnç oranlarının dağılımı izoniazid (%11,9), streptomisin (%11,7), rifampisin (%4,1), etambutol (%3,6) idi. Çoklu ilaca dirençli(ÇİD)–TB oranı (izoniazid+ rifampisin) (%3.6) olarak bulundu. Sonuç: Çalışmamızda majör anti-TB ilaçlara karşı direnç araştırılan suşlarda en yüksek ilaç direnci izoniazid için belirlendi. En düşük ilaç direnci etambutol için saptandı.

Anahtar Kelimeler:

Mycobacterium tuberculosis, ilaç direnci, çoklu ilaç dirençli(ÇİD) tüberküloz, anti-tuberküloz ilaçlar

Investigation of the Sensitivity of Mycobacterium Tuberculosis Strains Isolated from Various Clinical Samples in Eastern Turkey to Major Anti-tuberculosis Drugs

Objective: In the study, 419 Mycobacterium tuberculosis complex strains (MTC), 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. Methods: Our research is a retrospective cross-sectional 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, rifampicin, streptomycin and ethambutol antibiotics with BACTEC MGIT 960 system to samples defined by MTC identification test (TBc ID) from reproduction positive tubes. Results: In our study, 337 (80.4%) of the 419 MTC 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 isoniazid (11.9%), streptomycin (11.7%), rifampicin (4.1%), ethambutol (3.6%). Multi-drug resistant (MDR)–TB ratio (isoniazid+ rifampicin) 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 isoniazid. The lowest drug resistance was determined for ethambutol.

Keywords:

Mycobacterium tuberculosis drug resistance, , çoklu ilaç dirençli(ÇİD) tüberküloz, anti-tuberküloz ilaçlar,

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