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Article
RISK FACTORS FOR MULTI-DRUG RESISTANT TUBERCULOSIS: A REVIEW
عوامل الخطر لمقاومع مرض السل لادوية المتعدد - استعراض

Authors: MUAYAD A. MERZA مؤيد اغالي ميرزا --- AHMAD M. SALIH احمد محمدصالح
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2010 Volume: 4 Issue: 2 Pages: 1-7
Publisher: University of Dohuk جامعة دهوك

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Abstract

The current review aims to determine the risk factors associated with multi-drugs resistant TB (MDR-TB). Previous treatment is the most important risk factor for inducing MDR-TB.Other important associated factors are: immigration, age 45-64 year, male sex, HIV infection, alcoholism, smoking, diabetes mellitus, and poor socio-economic factors. Effective treatment, control and prevention of emergence and transmission of drug-resistant TB are required in all countries. To achieve this, the World Health Organization (WHO) recommended the adoption of Directly Observed Therapy Short-Course (DOTS) programme which involves giving effective and regular anti-TB drug supply, government security and financing commitment, case detection and diagnosis by smear microscopy, and monitoring the performance and outcome. It is highly recommended to strictly follow the appropriate WHO treatment guidelines, to ensure adequate success rate of treatment in drug-susceptible and drug-resistant strains; this will limit emergence of resistant strains and prevent spread of the disease. The emergence of aggressive new forms of drug-resistant TB is worrying thatrequires reinforcement of control measures. This demands special attention to case detection and prompt treatment of MDR-TB, extensively drug resistant TB (XDR-TB), and totally drug resistant TB (TDR-TB) to prevent transmission of the disease and further development of drug-resistant strains beyond this stage.


Article
Isolation of Mycobacterium tuberculosis and testing their susceptibility to antimicrobial agents by using Bactec 960.

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Abstract

Abstract:This study was done from 3/7/2011 to 1/1/2012 , different clinical samples were collectedfrom (1235) patients that coming to the Specialized center for chest and respiratory diseases /Baghdad to investigate Mycobacterium tuberculosis and study their resistant to first and secondline antimicrobial agents by using Bactec 960.The results obtained from direct smear examination with Ziehl – Neelsen stain in (294)patients that indicated these patients are Infected with tuberculosis .These samples has beencultured on solid medium Lowenstein Jensen media (L.J.) and liquid medium ( middle brook 7H8broth base) in the Mycobacteria Growth Indicator Tubes (MGIT) using a device (BACTECMGIT 960 System).Results of (275) samples that represented (22.27%) from total samples wereshowed a significant real growth that belong to bacteria Mycobacterium tuberculosis.From (275) isolates tested to 1st line anti TB (streptomycin (SM), isoniazid (INH),rifampin (RMP) and ethambutol (EMB)), (196) isolates were resistant to the first lineantimicrobial agents that used in the treatment of tuberculosis by using Bactec 960. (125) isolates(63.77%) showed resistance to multiple antimicrobial drugs (MDR-TB).Furthermore, the sensitivity test was done on thirty isolates that characterized by multipledrug resistance criteria (MDR-TB) on second line antimicrobial agents to investigate ExtensivelyDrug-Resistant Tuberculosis(XDR-TB) between these isolates. The results showed that the bestantibiotics in their impact on the isolates (MDR-TB) is (PAS) P-aminosalicylic acid as thepercentage of resistance was (3.3%).

الخلاصة:جمعت 1235 عینة سریریة مختلفة من المرضى الوافدین الى معھد الامراض الصدریة والتنفسیة / بغداد تراوحت2012 لعزل بكتریا -1 - 2011 لغایة 1 -7 - اعمارھم بین ( 4 أشھر الى 70 سنة) من كلا الجنسین للفترة من 3.Bactec ودراسة حساسیتھا لمضادات التدرن الخط الاول والثاني بأستعمال تقنیة 960 Mycobacterium tuberculosisأظھرت نتائج الفحص المباشر للمسحات المصبوغة بصبغة زیل – نیلسون ان ( 294 ) مریضاً یعاني من مرضModified والوسط الزرعي السائل Lowenstein Jensen media (L.J) التدرن، زرعت العینات على الوسط الصلبباستعمال (MGIT) Mycobacteria Growth indicator Tube في انابیب خاصة middlebrook 7 H8 broth baseوقد اظھرت النتائج ان ( 275 ) عینة ( 22.27 %) من المجموع الكلي للعینات (BACTEC MGIT 960 System) منظومة. Mycobacterium tuberculosis نموا حًقیقیا وتبین انھا تعود لبكتریاأختبرت حساسیة ھذه العزلات لمضادات التدرن الخط الاول (الایزونیازید والستربتومایسین والاثیمبتولوالریفامبسین) باستعمال تقنیة الباكتیك 960 ، وأظھرت النتائج ان ( 196 ) عزلة من اصل ( 275 ) كانت مقاومة لمضادات.(MDR-TB) التدرن. من جانب اخر كانت ( 125 ) عزلة من اصل ( 196 ) بنسبة (% 63.77 ) مقاومة متعددة للمضادات


Article
Molecular detection of multidrug-resistant mycobacterium tuberculosis in Al Muthanna province

Author: Haider H. Mitab
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2018 Volume: 5 Issue: 1 Pages: 1-11
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Multidrug-resistant tuberculosis (MDR-TB) is a global problem that many countries are challenged with. Rapid and accurate detection of MDR-TB is critical for appropriate treatment and controlling of TB. The aims is detection of multidrug-resistant Tuberculosis from cultured samples by using Polymerase Chain Reaction. A total of 30 M. tuberculosis isolates from cases with diagnosed TB by GeneXpert, AFB and Culture on L. J media after incubation period from 3-8 weeks, DNA extraction from bacteria colonies. Resistant isolates were tested for characterization of mutations in the rpoB, KatG InhA1 and IhA2 genes by Real Time PCR. The results of the real time PCR showed that mutations of genes (rpoB, katG, inhA1 and inhA2) that were responsible for resistance to rifampicin and isoniazid. The test showed positive results for resistance genes (20%, 10%, 6.6%, 10% Respectively) as well as note that the values ​​of Ct for this test ranged from (12-38.25), and the melting points of the genes were between (85-88.5 Co). Real time PCR results identified three mutations of MDR (rifampicin and isoniazide) resistance genes, whereas there was one MDR mutation of molecular diagnostic results with the GeneXpertMTB/RIF test for rifampicin. When comparing the results of the Real time PCR and GeneXpert tests at the level of the genetic mutation with rifampicin, the real time PCR test showed four resistance mutations for the rpoB gene for both new cases and relapse tuberculosis as well as one rpoB mutant for under treatment patient. Both molecular tests have agreed to identify one rpoB mutant in the case of failure TB treatment.


Article
Health-related quality of life of tuberculosis Patients in Bagdad and Socio-demographic Factors Associated with Multiple Drug Resistant Tuberculosis (MDR TB)
نوعية حياة مرضى التدرن في بغداد وعلاقة بعض العوامل الاجتماعية والديموغرافية في الاصابة بالتدرن المقاوم

Author: Ahmed Abed Marzook احمد عبد مرزوك
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2016 Volume: 10 Issue: 1 Pages: 9-15
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Tuberculosis is a highly infectious disease that primarily affects the lungs. It can also affect other organs. TB was once called “consumption.” It is the world’s second-most fatal infectious agent, after HIV/AIDSObjective: To evaluate the effect of sodium nitrate, vitamin E and vitamin C administration on liver enzymes, alanine transaminase, aspartate transaminase and alkaline phosphatase. This research aimed to study the effect of tuberculosis (TB) on quality (QOl) of life of MDR and non DR TB patients, it also to explore any possible association between getting MDR TB and socio- demographic variablesMaterials and Methods: A cross-sectional study was conducted in Chest and Respiratory Diseases Center (CRDC) –Baghdad during 2015. The World Health Organizations Quality of Life Assessment (WHOHQL-BREF) was used to asses QOL of 50 MDR and 50 Non DR sputum positive pulmonary TB patients. Socio-demographic variables were studied. SPSS V. 22, was used in statistical analysis, Chi-square and Mann-Whitney-U tests were used to test significance of differences, PV≤ 0.05 was considered significant.Results: The mean age was 43.46 ± 14.8 and 37 ± 16.16 for MDR-TB and non-DR-TB respectively. The age difference was significant (p=0.048). Males constitute a majority in both groups (DR-TB 64% and non-DR-TB 59%). Smoking was higher in DR-TB than non-DR-TB (57% and 38% respectively) and difference was significant (P =0 .016). Significant differences between DR-TB and non-DR-TB in global QOL, global health, physical, psychological, social and environmental domains (P=0.004, 0.014, 0.001, .0019, 0.001 and 0.001 respectively).Conclusion: Patients with MDR-TB had lower mean scores than non-DR-TB for overall HRQOL domains. There is association between getting MDR TB and being older in age, lower educational level, smokers and being jobless.

خلفية الدراسة: داء السل (التدرن ) يعد من الامراض الخطيرة التي تؤثر بدرجة اساسية في الرئة ويعد من المسبات المؤدية للموت بعد مرض النقص المناعي.اهداف الدراسة: دراسة تاثير التدرن والتدرن المقاوم للادوية على نوعية حياة المرضى وعلاقة بعض العوامل الاجتماعية والديموغرافية بالاصابة بالتدرن المقاوم.المرضى والطرائق : دراسة مقطعية مقارنة اجريت في مركز الامراض الصدرية في بغداد عام 2015 شملت 50 مريضا مصابا بالتدرن الرئوي المقاوم و50 مريضا غير مقاوم وتم قياس نوعية حياة المرضى باستخدام مقياس نوعية الحياة المختصر لمنظمة الصحة العالمية مع قياس العلاقة بين بعض العوامل الاجتماعية والديموغرافية وحصول التدرن المقاوم .تم استخدام اختبار كاي ومان وتني لقياس الفروق بين المجاميع مع اعتبار pv≤0.05 قيمة دالة احصائيا.النتائج: كان متوسط العمر للحالات المقاومة للعلاج وغير المقاومة هو 43.46±14.8 و 37.36 ±16.15 على التوالي (pv=0.043) وقد شكل الرجال اغلبية في المجموعتين 66% و 59% مقارنة بغير المقاومين للعلاج وتبين ان التدخين كان اكثر انتشارا بين المقاومين للعلاج 57% مقابل 39% (pv=0.016) وكان مستوى التعليم والعمل افضل لدى غير المقاومين وبفارق معنوي دال احصائيا (pv=0.045).كما بينت الدراسة ان نوعية حياة المرضى كانت اسوأ لدى المرضى المقاومين للعلاج في جميع المجالات مع تأثر مجال البيئة والمجال الاجتماعي اكثر من بقية المجالات وكان مستوى القناعة بالحالة الصحية ونوعية الحياة افضل لدى المرضى غير المقاومين لادوية التدرن وبفارق دال احصائيا.الاستنتاجات: كان المرضى الذين يعانون من السل المقاوم للأدوية أقل متوسطات درجات من غير DR-TB-للنطاقات HRQOL الشاملة. هناك ارتباط بين حدوث السل المقاوم للأدوية و كبار السن في العمر، المستوى التعليمي المنخفض, المدخنين و العاطلين عن العمل

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