A Comparative Study on the Resistance of Mycobacterium Tuberculosis in two Era: An Egyptian Experience
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- Category: Vol. 81, September 2013
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A Comparative Study on the Resistance of Mycobacterium Tuberculosis in two Era: An Egyptian Experience, EL-SAYED SALEM, AYMAN SALEM and AMAL ABD EL-RASHEED
Abstract
Resistance to the antimycobacterial therapy (AMT) re-mains problematic as far as the control of tuberculosis combat is concerned. The figures available are contradictory and hence not conclusive. Hence it was decided to probe this problem, and also to detect interval changes in its magnitude, in two era, by both a retrospective and a prospective study. The retrospective study focused on the years 2006-2007 and included 57 cases. The prospective study comprised 31 cases during the years 2011-2012. All cases were originally smear positive. Culture and sensitivity testing was performed: For reading the test results, the proportion method was used. The AMT in the second era included pyrazinamide (PZ) and ethambutol (ETH) for which susceptibility testing was done besides the testing for the usual antituberculous drugs namely; Rifampicin, INH and streptomycin in both era. It was possible to perform susceptibility testing in only 22 of the patients who received PZ & ETH. The results were classified according to wether the patients were new cases receiving their treatment as fresh cases who received AMT for the first time or as old retreatment cases who received AMT before retesting. Results refer to an overall resistance of 38.7% in the prospective group as compared to 31.6% in retrospective group, of which 3.2% and 7.0% had initial primary resistance and 35.5% and 24.6% had secondary resistance in either group respectively. 29.0% showed monoresistance and 9.6% showed multiple drug resistance (MDR) in the prospective group. The analogous figures for the retrospective group were 22.8% and 8.8% respectively. The figures in the present study were compared to other available national Egyptian figures and also to figures from some developing countries; whose figures were rather high and are mentioned in the text. The whole situation is alarming and needs proper attention. Conclusions and recom-mendations are forwarded.