study of mycobacterium tuberculosis drug resistance in pulmonary tuberculosis

Tuberculosis remains a major public health problem in both developing and developed countries. Drug-resistant tuberculosis is an increasing health problem and serious challenge to tuberculosis [TB] control programs. Information about the susceptibility pattern of Mycobacterium tuberculosis isolates against anti-tuberculosis drugs is an important aspect to TB control. The objectives of the study were to evaluate the frequency of drug-resistance and to survey the nature of drug resistance among patients with pulmonary tuberculosis. Ninety-one M. tuberculosis strains were isolated from sputum samples of patients referred to Cerrhapasa Medical Faculty Hospital, Istanbul, Turkey, during a 9 month period. Drug susceptibility testing was performed to isoniazid [INH], streptomycin [SM], ethambutol [EMB] and rifampin [RMP] on Lowenstein-Jensen medium according to proportion method. Total resistance was identified in 40 of 91 patients [44%]. The highest rate of primary resistance was to SM [21.1%], followed by INH [15.8%], RMP [5.3%] and EMB [2.6%]. Secondary resistance was most frequent to INH [33.3%], followed by SM [28.6%], RMP [23.8%] and EMB [14.3%]. Mu1tidrug resistance [MDR] was observed in 6 of the 91 cases [6.6%]. Due to the high prevalence of drug resistance, particularly in developing countries, further studies should be conducted regularly to monitor resistance in these countries

Species identification and investigation of vancomycin and high-level aminoglycoside among clinical isolates of enterococcal strains

A study was performed to determine the species and antimicrobial susceptibility of 100 enterococcus strains from various clinical specimens as etiological agents at the Clinical Microbiology Laboratory, Istanbul University, Medical Faculty Hospital. Out of 100 enterococcal isolates, 86 were identified as E. faecalis, 11 as E. faecium, 1 as E. avium and 2 as E. raffinosus. By the disk diffusion tests 36 of 100 strains were found to be resistant to erythromycin, 32 to penicillin, 30 to ampicillin, 7 to ciprofloxacin, 6 to norfloxacin and 5 to nitrofurantoin. No resistance was observed to vancomycin or teicoplanin. Twenty-six strains showed high-level resistance to streptomycin [2000 [micro]g/mL] and 13 strains exhibited high-level resistance to gentamicin [500 [micro]g/mL]. Ten of these strains had high-level resistance to both aminoglycosides. None of the strains produced beta-lactamase.

Evaluation of direct microscopy, culture, and polymerase chain reaction for the diagnosis of tuberculous meningitis

In view of the importance of early diagnosis of tuberculous meningitis [TBM], the efficiency of the polymerase chain reaction [PCR], one of the most reliable and sensitive DNA-based assays, was compared with conventional methods [acid-fast microscopy and culture] for the detection of M. tuberculosis in cerebrospinal fluid [CSF] specimens from patients suspected of TBM. Of the 29 CSF specimens from highly probable TBM patients [based on clinical features], 25 were positive by PCR [86.2%], whereas only one out of 29 was acid-fast microscopy [AFM] positive [3.4%], and 5 out of 29 were culture positive [17.2%]. No positive results were found by AFM culture or PCR in the nontuberculous control group. The results of this study indicate that application of PCR should be extremely useful for the diagnosis of TBM

Lacervicotomie a visee diagnostic bilan de 320 cervicotomies 1983-1987

In a study of 320 cases of cervicotomy carried out in the ORL department in the specialised hospital in Rabat, we have tried to show the importance of this operation in the setting-up of a sure diagnosis based on an anatomo-pathological study. So, cervicotomy has given a sure diagnosis in 65%, has corrected the presumed diagnosis in 10%, Has confirmed the presumed diagnosis in 25% we have a global efficiency of 75%. The etiology of chronic cervical tumefactions are varied, but they remain predominated by ganglion tuberculosis, however they may reveal a blood disease or unknown cancer