Prevalence and drug resistance profile of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients attending two public hospitals in East Gojjam zone, northwest Ethiopia

摘要

Background The spread of multidrug-resistant tuberculosis (MDR-TB) strains has become a challenge to the global TB control and prevention program. In Ethiopia, particularly in rural areas, information on drug-resistant TB is very limited. In this study, we determined the drug resistance patterns of Mycobacterium tuberculosis ( M. tuberculosis ) isolates from pulmonary TB patients attending two public hospitals in the East Gojjam zone of northwest Ethiopia. Methods A cross-sectional study was conducted between May 2011 and January 2012 using Region of difference-9 (RD9) typing for the identification of species mycobacterium. Drug susceptibility testing (DST) of M. tuberculosis isolates to the first-line drugs: isoniazid, rifampicin, ethambutol and streptomycin was performed by the indirect proportion method on Middle brook 7H10 Agar media. Results Out of 385 pulmonary TB suspects studied, 124 (32.2?%) were culture positive among which 120 were M. tuberculosis strains. Susceptibility testing was performed for 89 isolates. Resistance to at least one drug was 15.58?% ([12/77], 95?% CI: 7.48-23.68) among newly diagnosed and 50.0?% ([6/12], 95?% CI: 21.71-78.29) among previously treated cases. Resistance among newly diagnosed patients was most common for streptomycin 5.19?% (4/77) and ethambutol 5.19?% (4/77) followed by rifampicin 3.89?% (3/77). Among retreatment cases, isoniazid resistance was most frequent in which 33.33?% (4/12) of the isolates were resistant. MDR prevalence was 1.29?% (1/77) for newly diagnosed and 16.67?% (2/12) for retreatment cases. In a multivariate logistic regression analysis, age group of 25–34 years (adjusted OR?=?4.24; 95?% CI: 1.02-17.5; P?=?0.046) and previous history of treatment (adjusted OR?=?5.42; 95?% CI: 1.56-27.49; P?=?0.01) were independently associated with anti-TB drug resistance. Conclusions In general, the magnitude of anti-TB drug resistance including MDR-TB was comparable to previous studies in other areas of Ethiopia. However, rifampicin resistance was high, which could suggest the potential for a rise in the incidence of MDR. Therefore, re-enforcing TB control programs should be considered by the concerned public health authorities.