ABSTRACT
OBJECTIVE@#To determine the patterns of resistance to first line anti-tuberculosis (TB) drugs among a collection of Mycobacterium tuberculosis (MTB) isolates from 5 provinces of Iran.@*METHODS@#A total of the 6 426 clinical specimens from patients suspected of active TB were collected from March 2010 to June 2012. All specimens were subjected for microscopy and culture tests in the TB centers of studies provinces. Drug susceptibility testing to the first line anti-TB drugs for culture positive MTB was performed on Löwenstein-Jensen (LJ) medium using proportion method.@*RESULTS@#Of 6 426 clinical specimens, 261 were culture positive for mycobacteria, of which 252 were MTB and 9 were MOTT (mycobacteria other than tuberculosis). Of 252 MTB isolates, 211 (83.7%) were pan-susceptible and 41 (16.3%) were resistant to at least one drug. Resistance was most common to streptomycin, 30 isolates (12.0%), followed by isoniazid, 20 isolates (8.0%), rifampin, 15 isolates (6.0%) and ethambutol, 14 isolates (5.5%). Sixteen (6.3%) MTB isolates were MDR. A clear evidence of heterogeneity amongst the 5 provinces in the proportions with resistance to one or more drugs was observed [χ(2); = 12.209 (4 degrees of freedom), P values = 0.015 9].@*CONCLUSIONS@#The prevalence of drug resistance in this study area underscoring the need for further enforcement of TB control strategies in the Iran. Drug susceptibility testing for all TB cases to provide optimal treatment, establishing advanced diagnostic facilities for rapid detection of MDR-TB and continuous monitoring of drug resistance are recommended for prevention and control of drug-resistant TB.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Humans , Middle Aged , Young Adult , Antitubercular Agents , Pharmacology , Bronchoalveolar Lavage Fluid , Microbiology , Chi-Square Distribution , Cross-Sectional Studies , Iran , Microbial Sensitivity Tests , Mycobacterium tuberculosis , Sputum , Microbiology , Tuberculosis, Multidrug-Resistant , MicrobiologyABSTRACT
Antimicrobial resistance in pathogens not only in hospitals but also in the community has become an important public health problem. The aim of this study was to determine the antimicrobial resistance patterns of predominant pathogens from hospitalized and outpatients in a university hospital in Tehran, Iran. A total of 820 samples of common Gram-negative and Gram-positive bacteria were collected from a major referral and teaching hospital affiliated to Tehran University of Medical Sciences in Iran during April 2010 to February 2011. The pattern of antibiotic resistance was determined by disk diffusion test as recommended by the Clinical Laboratory and Standards Institute [CLSI]. Gram-negative bacilli were the most isolated pathogens. Acinetobacter spp. and Pseudomonas aeruginosa [P. aeruginosa] was the most antibiotic-resistant pathogens. Imipenem and piperacillin/tazobactam were the most active antimicrobials against gram-negative bacilli whereas vancomycin was the antimicrobial agent most consistently active against the Gram-positive cocci. Community-acquired organisms were more susceptible to antimicrobial drugs tested than nosocomial isolates. The rates of antibiotic resistance among isolated pathogens in this study were approximately similar to other studies. However, high rates of antibiotic resistance amongAcinetobacter spp and P. aeruginosa, the most isolated pathogens, indicating that antibiotic policy is urgently needed to prevent the resistance development ago