INVESTIGATION OF FIRST-LINE ANTITUBERCULOSIS DRUG SUSCEPTIBILITY TESTING OF MYCOBACTERIUM TUBERCULOSIS COMPLEX ISOLATES IN A TRAINING AND RESEARCH HOSPITAL AMONG THE 2010-2016 YEARS

Objective: The problem of anti-tuberculosis (anti-TB) drug resistance continually threatens the success of TS control programs all over the world since the beginning of the 1990s. This problem which tends to increase continuously has now reached a global dimension. In this study, 252 Mycobacterium tuberculosis complex (MTC) isolates obtained between January 2010 and December 2016 were analyzed retrospectively and primary and secondary resistance status against first-line anti-TB drugs (isoniazid [INH], rifampicin [RIF], streptomycin [SM], ethambutol [EMB] has been evaluated. Material and Method: Sterile body fluids from clinical specimens accepted and examined directly in the mycobacteriology labotatory; the contaminant clinical samples were firstly subjected to homogenization and decontamination by theN-acetyl-L-cysteine-sodium hydroxide method, followed by culture and antibiotic susceptibility status with the BACTEC MGIT fully automated system Results: Seventy (27.8%) of isolates were found to be resistant to at least one of the four anti-TB drugs. Isolates showing single or combined drug resistance for INH, SM, RIF and EMB were 20.6% (n=52), 12.3% (n=31), 75% (n=19) and 6.7% (n=17) respectively. Single drug resistance was detected in 42 (16.7%) isolates. INH, EMB, SM and RIF resistance rates were 9.5% (n=24), 4.0% (n=10), 2.8% (n=7) and 0.4% 014 respectively. Eighteen (7.1%) isolates were found to be multidrug resistant (MDR) TB strains. We have more than one resistant strain isolate except MDR-TB strain, 4% (1=10). The rate of resistance to all drugs was 1.6% (n=-0). Conclusion: In our study, it is striking that INH resistance is found entirely in at least two drug resistant isolates (n=28) and also in 20.6% of isolates, INH resistance is detected. This result shows that one of every five isolates is resistant to INH. Therefore, maximum protection of the RIF is necessary to prevent further MDR-TB problems in our hospital. Although our MDRTB rates tend to decrease by percentage through previous years, increasing and facilitating travel from countries with high MDR-TB rates to our country and recent increase in immigration numbers from countries in civil war seem to be again growing problem for drug resistant TB and MDR-TB.