Drug resistance to anti-tuberculotics in children - three years status in Slovakia

摘要

Drug resistant tuberculosis is a serious and increasing problem worldwide, particularly in countries with a highincidence of tuberculosis and HIV infections. Resistant tuberculosis in children is usually due to the transmissionof resistant strains from the environment where they live. Most often it is a transfer from the parents, or otherrelatives. A paucibacillary nature of the disease in children associated with difficulties in a collection of adequatesputum samples means that the samples are often microscopically negative. If the cultivation is negative, any bacteriologicalconfirmation of the drug resistance is impossible. The aim of this study was to review current diagnostic and therapeutic principles in tuberculosis in children andto demonstrate its incidence in population of the Slovak Republic during 2010-2012. We have retrospectively analyzed all children sputum samples from children with diagnosed tuberculosis inSlovakia. The classical bacteriological analysis (culture on solid eggs-based media) was used to confirm the mycobacteriumtuberculosis infection and the proportion method was applied to test its susceptibility or resistance tomostly used antituberculotics. In years 2010-2012, three cases of resistant form of tuberculosis have been diagnosed in Slovakia among 16 childrenwith cultivation positive to tuberculosis. In all of the cases the INH mono-resistance was confirmed (with thesame strains present in their relatives), suggesting primary resistance origin of infection. To ensure an appropriate and successful treatment of tuberculosis in children, accurate and timely diagnosticsand determination of susceptibility to anti-tuberculotics is essential.