Abstract
Multidrug-resistant tuberculosis has become common all over the world, necessitating the inclusion of second-line drugs in treatment regimens. In the present study, the susceptibility of a selection of multidrug-resistant strains of Mycobacterium tuberculosis isolated in the Archangel oblast, Russia, to second-line anti-tuberculosis drugs was analysed. Susceptibility testing of 77 Mycobacterium tuberculosis strains was performed by the Bactec method using the following recommended drug concentrations: capreomycin 1.25 μg/ml; ethionamide 1.25 μg/ml; kanamycin 5 μg/ml; and ofloxacin 2 μg/ml. The majority of strains (92.2%) were resistant to ethionamide. High rates of drug resistance were also found for capreomycin (42.9%) and kanamycin (41.6%), while nearly all strains (98.7%) were susceptible to ofloxacin. The high rates of resistance to ethionamide, capreomycin, and kanamycin show the real burden of drug resistance in the region and pose a serious problem for the treatment of patients with multidrug-resistant tuberculosis.
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References
World Health Organization (2003) Guidelines for surveillance of drug resistance in tuberculosis. Document no. WHO/TB/2003.320–WHO/CDS/CSR/RMD/2003.3. WHO, Geneva, p71
World Health Organization/International Union Against Tuberculosis and Lung Disease (2004) Anti-tuberculosis drug resistance in the world. Report no 3. WHO, Geneva, p129
World Health Organization (1996) TB: groups at risk. WHO report on the tuberculosis epidemic. Document no. WHO/TB/96.198. WHO, Geneva, p28
Dye C, Espinal MA, Watt CJ, Mbiaga C, Williams BG (2002) Worldwide incidence of multidrug-resistant tuberculosis. J Infect Dis 185:1197–1202
Toungoussova OS, Mariandyshev AO, Bjune G, Sandven P, Caugant DA (2003) Molecular epidemiology and drug resistance of Mycobacterium tuberculosis isolates in the Archangel prison, Russia: predominance of the W-Beijing clone family. Clin Infect Dis 37:665–672
Laing RO, McGoldrick KM (2000) Tuberculosis drug issues: prices, fixed-dose combination products and second-line drugs. Int J Tuberc Lung Dis 4:5194–5207
World Health Organization (2003) Treatment of tuberculosis: guidelines for national programmes. Document no. WHO/CDS/TB/2003.312. WHO, Geneva, p112
Sterling TR, Lehmann HP, Frieden TR (2003) Impact of DOTS compared with DOTS-Plus on multidrug resistant tuberculosis and tuberculosis deaths: decision analysis. BMJ 326:574–577
World Health Organization (2001) Guidelines for drug susceptibility testing for second line anti-tuberculosis drugs for DOTS-Plus. Document no. WHO/CDS/TB/2001.288. WHO, Geneva, p12
Pfyffer GE, Bonato DA, Ebrahimzadeh A, Gross W, Hotaling J, Kornblum J, Laszlo A, Roberts G, Salinger M, Wittwer F, Siddiqi S (1999) Multicenter laboratory validation of susceptibility testing of Mycobacterium tuberculosis against classical second-line and newer antimicrobial drugs by using the radiometric BACTEC 460 technique and the proportion method with solid media. J Clin Microbiol 37:3179–3186
Inderlied CB, Pfyffer GE (2003) Susceptibility test methods: mycobacteria. In: Murray PR, Baron EJ, Pfaller MA, Jorgensen JH, Yolken RH (eds) Manual of clinical microbiology. American Society for Microbiology, Washington DC, pp1149–1177
Toungoussova OS, Caugant DA, Sandven P, Mariandyshev AO, Bjune G (2002) Drug resistance of Mycobacterium tuberculosis strains isolated from patients with pulmonary tuberculosis in Archangels, Russia. Int J Tuberc Lung Dis 6:406–414
Enarson DA, Rieder HL, Arnadottir T, Trebucq A (1996) Tuberculosis guide for low-income countries. International Union Against Tuberculosis and Lung Diseases, Paris, p65
World Health Organization/International Union Against Tuberculosis and Lung Disease (2001) Revised international definitions in tuberculosis control. Int J Tuberc Lung Dis 5:213–215
Toungoussova OS, Sandven P, Mariandyshev AO, Nizovtseva NI, Bjune G, Caugant DA (2002) Spread of drug-resistant Mycobacterium tuberculosis strains of the Beijing genotype in the Archangel oblast, Russia. J Clin Microbiol 40:1930–1937
Siddiqi SH (1995) BACTEC 460 TB System. Product and procedure manual revision. Becton Dickinson Microbiology Systems, Sparks, MD, USA
Suarez PG, Floyd K, Portocarrero J, Alarcon E, Rapiti E, Ramos G, Bonilla C, Sabogal I, Aranda I, Dye C, Raviglione M, Espinal MA (2002) Feasibility and cost-effectiveness of standardised second-line drug treatment for chronic tuberculosis patients: a national cohort study in Peru. Lancet 359:1980–1989
Musser JM (1995) Antimicrobial agent resistance in mycobacteria: molecular genetic insights. Clin Microbiol Rev 8:496–514
Acknowledgements
We thank Elisabet Rønnild, Ann Christine Øvrevik, and Kjersti Haugum for skilful technical assistance. Funding was provided by grant no. 49711 from the Norwegian Ministry of Health and Social Affairs to P.S. and D.A.C
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Toungoussova, O.S., Mariandyshev, A.O., Bjune, G. et al. Resistance of multidrug-resistant strains of Mycobacterium tuberculosis from the Archangel oblast, Russia, to second-line anti-tuberculosis drugs. Eur J Clin Microbiol Infect Dis 24, 202–206 (2005). https://doi.org/10.1007/s10096-005-1284-z
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DOI: https://doi.org/10.1007/s10096-005-1284-z