Drug Susceptibility Patterns of Mycobacterium tuberculosis Isolates from Tuberculosis Patients in Coastal Kenya
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Date
2017
Authors
Yonge, Shadrack A.
Otieno, Michael F.
Sharma, Rekha R.
Nteka, Sarah S.
Journal Title
Journal ISSN
Volume Title
Publisher
Scientific Research Publishing
Abstract
Background: Tuberculosis (TB) is an infectious disease caused by the bacillus
Mycobacterium tuberculosis . Anti-tuberculosis drug resistance is an emerging
health problem in Kenya and especially in Coastal region. This is a major
challenge in tuberculosis control. Diagnosis is based on Ziel-Neelsen staining
alone and patients are treated without information on sensitivity patterns.
Aim: This study aimed to determine drug susceptibility patterns of Mycobacterium
tuberculosis in Coastal Kenya. Study Design: Hospital and laboratory
based cross-sectional study was carried between April 2015 and July 2016 at
Coast General Referral hospital; Tudor, Port-Reitz, Likoni Sub-County hospitals;
Mlaleo, Kongowea and Mikindani health centers. Methodology: Sputum
samples from patients with bacteriological confirmed TB on microscopy
were cultured on Lowenstein Jensen (LJ) media. Strains of MTB complex
from Lowenstein Jensen (LJ) slopes were subjected to drug susceptibility testing
(DST) to first-line drugs including isoniazid (H), rifampicin (R), streptomycin
(S) and Ethambutol (E) using proportional method on the Mycobacterium
Growth Indicator Tube (MGIT) conventional method. Participants were
offered diagnostic testing and counselling for HIV testing. Results: Drug sensitivity
test was performed for a total of 210 Mycobacterium tuberculosis isolates
for the first line anti-TB drugs. About seventy eight percent and twenty
nine percent of the strains from new patients and previously treated patients
were fully sensitive to all the drugs tested respectively. Prevalence of any resistance
to one drug was 102 (48.6%, 95% CI: 20.45 - 28.23). Any single drug
resistance was most frequent in isoniazid 30 (16.0%), Ethambutol 20 (10.0%),
Streptomycin 18 (18.3%) and Rifampicin 4 (2.1%) in newly diagnosed patients. Among previously treated patients any resistance to streptomycin, ethambutol,
isoniaziad and rifampicin was 10 (58.8%), 9 (52.9%), 7 (41.2%) and 4
(23.5%) respectively. Prevalence of MDR-TB defined as resistant to at least
both isoniazid and rifampicin was 10 (4.8%) among new and previously
treated patients respectively. Conclusion: The current study reveals that the
overall resistance to first line anti-TB drugs was high. Although the rate of
MDR-TB was relatively low, this signifies that conditions favouring the spread
of MDR-TB are on high rise. Therefore, it is essential to address the problems
of development of drug resistant strains of TB by establishing good TB programmes
(DOTS). Patients’ adherence to anti-TB drugs and introducing drug
sensitivity testing (DST) services at County level hospitals will minimize occurrence
of drug resistant.
Description
Research Article
Keywords
Tuberculosis, Resistance Patterns, Susceptibility Tests, Multidrug Resistance
Citation
Yonge, S.A., Otieno, M.F., Sharma, R.R. and Nteka, S.S. (2017) Drug Susceptibility Patterns of Mycobacterium tuberculosis Isolates from Tuberculosis Patients in Coastal Kenya. Journal of Tuberculosis Research, 5, 201-219. https://doi.org/10.4236/jtr.2017.54022