Resistance patterns of myocobacterium tuberculosis complex to antituberculosis drugs, in Jeddah region

ABSTRACT

This study reviews the resistance patterns of Mycobacterium tuberculosis complex [MTBC] isolates obtained from 578 patients [369 Saudi and 209 non-Saudi] in the period between the first of January 2001 and the end of December, 2006. Four hundred thirty nine of the isolates were from respiratory sources while the remaining [139] were from non-respiratory sites. The isolates were tested for their susceptibility to isoniazid [INH], rifampin [RIF], ethambutol [EMB], streptomycin [SM] and pyrazinamide [PZA] using the BACTEC MGIT 960 system [Becton Dickinson Medical Systems, Sparks, MD]. The turnaround time for antimicrobial susceptibility testing [to SM, INH, RIF and EMB] ranged from 4.0 to 13.0 days with an average of 8.3 +/- 2.1 days. The turnaround time for susceptibility testing to PZA ranged from 4.04 to 14.25 days with an average of 7.2 +/- 2.2 days. The percentages of resistance to anti-tuberculosis drugs in Saudi and non-Saudi patients respectively were 25.5% and 35.9% for INH; 13.6% and 21.1% for RIF, 18.4% and 23.4% for SM, 19.5% and 15.3% for EMB, 19.2% and 9.7% for PZA and 10.6% versus 16.7% for multidrug resistant [MDR] TB [resistant at least to INH and RIF]. Resistance to INH and RIF was significantly higher in non-Saudi patients [p < 0.05]. The percentages of resistance to anti-tuberculosis drugs in respiratory samples from Saudi and non-Saudi patients respectively were 25.5% and 37.6% for INH; 15.0% and 24.2% for RIF, 21.5% and 25.5% for SM, 20.1% and 15.8% for EMB, 16.7% and 10.0% for PZA and 12.4% versus 19.4% for MDRTB. Regarding non-respiratory samples, the percentages of resistance to anti-tuberculosis drugs from Saudi and non-Saudi patients respectively were 25.3% and 29.5% for INH; 9.5% and 9.1% for RIF, 9.5% and 15.9% for SM, 17.9% and 13.6% for EMB, 25.0% and 8.3% for PZA and 5.3% versus 6.8% for MDR-TB. The overall percentages of resistance to anti-tuberculosis drugs in respiratory and non-respiratory samples respectively were 30.1% and 26.6% for INH; 18.5% and 9.4% for RIF, 23.0% and 11.5% for SM, 18.5% and 16.5% for EMB, 13.5% and 19.4% for PZA and 15.0% versus 5.8% for MDR-TB. Differences were statistically significant only in cases of RIF, SM and MDR-TB. In general, resistance was higher in respiratory samples obtained from non-Saudi patients. These variations may be mainly due to the differences in the prevalence of MTBC variants between Saudi and non- Saudi patients