ABSTRACT
Objectives: To determine the frequency of successful outcome of multidrug-resistant tuberculosis treated as outpatient in a tertiary care center. Subject and methods: This was a descriptive cross-sectional study done from 13 April, 2018 to 13 Oct, 2018. All the patients fulfilling inclusion criteria having age 20-60 years of either gender under treatment of MDR-TB for more than six months were enrolled in study the from Programmatic Management of Drug Resistance Tuberculosis (PMDT) site at Department of Pulmonology. Informed consent was taken from patients. Strictly exclusion criteria i.e. patients having neurological or psychological problems before diagnoses of MDR-TB (as per medical record in history), co-infection with HIV, was followed to exclude potential confounder and biases. Education status was evaluated and the response of treatment was checked in matriculate & under matric patients, also socioeconomic status was evaluated by asking about monthly salary whether below or above 12000, and subsequently their effect on treatment outcome. HIV screening is done through ICT method and DST for tuberculosis done on sputum of the patients in the Provincial Reference Lab in Hayat Abad Medical Complex Peshawar for diagnosis. Results: A total of 151 patients were included in this study, among which males were 94, and females were 57. The mean age was 41 years and S.D 10.82. As per the results, 110 (72.84%) patients were having a successful outcome. Conclusion: This study concludes that the out-patient treatment strategy success rate was 72.84% and it is feasible and safe for the treatment of MDR-TB patients.
ABSTRACT
To study the transmission of Salmonella and resistance genes,116 Salmonella isolates were tested the sero types,antimicrobial susceptibility,resistant genes on SG1 including β-1actamase genes,and multilocus sequence typing (MLST).Results showed that Salmonella isolates from the chicken belonged to ST11 clone,S.enteritidis,and ST17 clone,S.indiana,and from the pig belonged to ST40,S.derby mostly.ST11 clone showed multidrug-resistant (MDR),resistance to ampicillin,nalidixic acid,tetracycline,and cefoperazone,mostly.ST17 clone showed resistance to nine or more kinds of antibiotics including cephalosporins and fluouoquinolones,a super-MDR clone.ST11 clone carried bla TEM-l-like highly,whereas blaOXA-1-like,blaCTX-M,blaTEM-1-like,and floR,aadA2,sul1,and aac (6')-1b were highly carried in ST17 clone,a new super-MDR clone.The antibiotic abuse and misuse in food supply chains were the main origin of MDR and super-MDR Salmonella,which were transmitted by the chains.It is significance that the control of substance abuse,especially cephalosporins and fluouoquinolones,in food supply chains.
ABSTRACT
Antecedentes: La incidencia de la multidrogorresistencia (MDR) adquirida a drogas antituberculosas de Mycobacterium tuberculosis en el Ecuador es aproximadamente del 27,83 %. Objetivo: Detectar las mutaciones asociadas con la resistencia a los fármacos en cepas de M. tuberculosis resistentes a fármacos utilizando la PCR-RFLP y PCR en tiempo real. Materiales y métodos: En cepas de M. tuberculosis drogorresistentes (DR) aisladas de muestras provenientes de 18 provincias del Ecuador (2006-2012), se analizaron mutaciones en los genes rpoB y KatG que conducen a la resistencia a rifampicina e isoniazida, respectivamente. EL ADN fue amplificado por Reacción en Cadena de la Polimerasa (PCR), siendo luego analizado por RFLP (40 cepas), qPCR (346 cepas). Resultados: Nuestros resultados demostraron una correlación entre la resistencia fenotípica a rifampicina e isoniazida y las mutaciones encontradas en los genes rpoß (91,6 %) y katG (90,3 %) en cepas ecuatorianas de M. tuberculosis. Conclusiones: Las mutaciones asociadas a la drogorresistencia de aislados del M. tuberculosis en el Ecuador fueron similares a las reportadas en otros países.
Background: The incidence of multidrug-resistance (MDR) acquired in Mycobacterium tuberculosis antituberculosis drugs in Ecuador is approximately 27,83 %. Objective: To detect mutations associated with drug resistance in drug-resistant M. tuberculosis using PCR-RFLP and real-time PCR. Materials and methods: Mutations in rpoB and KatG genes leading to resistance to rifampicin and isoniazid, respectively, were analyzed in isolates of M. tuberculosis (DR) isolated from samples from 18 provinces of Ecuador (2006-2012). The DNA was amplified by Polymerase Chain Reaction (PCR) and then analyzed by RFLP (40 strains), qPCR (346 strains) and Results: Our results demonstrated a correlation between the phenotypic resistance to rifampicin and isoniazid and the mutations found in the rpoß (91, 6 %) and katG (90,3%) genes in Ecuadorian M. tuberculosis strains. Conclusions: Mutations associated with the drug resistance of M. tuberculosis isolates in Ecuador were similar to those reported in other countries.