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2007, Cilt 21, Sayı 2, Sayfa(lar) 075-080
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SUSPECTIBILITY OF MYCOBACTERIUM TUBERCULOSIS STRAINS TO PRIMARY ANTITUBERCULOSIS DRUGS: A COMPARATIVE STUDY WITH BACTEC 460 AND AGAR PROPORTION METHODS
Gönül ASLAN, Nuran DELİALİOĞLU, Çilem YILDIZ, Şahin DİREKEL, Gürol EMEKDAŞ
Mersin Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Mersin
Keywords: Mycobacterium tuberculosis, agar proportion method, BACTEC 460, primary antituberculous drugs, in vitro susceptibility

The antituberculosis drug treatment is very important in decreasing mortality and preventing transmission. Uneffective drug combinations and patient discordance lead to progressive drug resistance. The purpose of this study was to determine the susceptibility of Mycobacterium tuberculosis to primary antituberculous drugs using the radiometric BACTEC 460 system which is available in routine use and the agar proportion method. Also the results of susceptibility methods were compared and drug resistance level of resistant strains to high drug concentrations were determined. Susceptibility to SM, INH, ETB and RIF were determined using the radiometric BACTEC 460 and the agar proportion method on Middlebrook 7H10 agar (low and high concentrations). In the study, 40 of 84 M. tuberculosis isolates (%47.6) were susceptible to all primary antituberculous drugs with the method of agar proportion method, and percentage of susceptibility was %42.8 (36 strains) when the BACTEC 460 system was used. The concordance between the two methods was %97.3, specificity %97.7, sensitivity %98.6, positive predictive value %92.5, and negative predictive value % 99.6. The concordance of the results of the two methods were lowest for INH (%96.5) and highest for RIF (%98.8). Also drug resistance of five isolates to INH and seven isolates to SM and ETB with low drug concentration were determined with these two methods. Sensitivity with high concentrations by the method of agar proportion was also determined. Knowledge of sensitivity to higher drug concentrations for patients with multidrug resistance is very important for management of tuberculasis. Rapid and standardized susceptibility methods should be preferred in routine laboratories. In epidemiological research studies, easily applicable, cheap and standardized methods should be recommended for use.

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