Research Article
BibTex RIS Cite

Investigation of Amikacin, Moxifloxacin and Kanamycin Susceptibility in Mycobacterium tuberculosis Complex Clinical Isolates Susceptible and Multidrug resistant to First-Line Antituberculosis Drugs with Resazurin Microtiter Plate Method

Year 2022, Volume: 36 Issue: 3, 92 - 100, 30.12.2022
https://doi.org/10.54962/ankemderg.1216208

Abstract

Tuberculosis (TB) is one of the most common causes of death worldwide. Multidrug-resistant tuberculosis (MDR-TB) cases are an important problem with low treatment success, poor prognosis and high treatment costs. In our study, it was aimed to investigate the susceptibility of amikacin (AK), moxifloxacin (MOX) and kanamycin (KAN) from MTC isolates susceptible to first-line anti-TB drugs and MDR-TB isolates by using the resazurin microtiter plate method.
A total of 31 MTC isolates, including 19 isolates susceptible to first-line anti-TB drugs and 12 isolates resistant to isoniazid and rifampicin (MDR-TB), from the culture collection of mycobacteriology laboratory were included in the study.
No resistance was found to all three drugs in susceptible isolates. For the MDR-TB isolates, three (3/12) were resistant to AK, two (2/12) to MOX, and four (4/12) to KAN. In the MDR-TB isolates, one of them was found to be resistant to all three drugs. Extremely drug resistant tuberculosis (XDR-TB) among MDR-TB isolates was 8% (1/12).
The emergence of XDR-TB after the development of multi-drug resistance is an important problem in the success of TB treatment and it is necessary to determine the resistance profiles in order to follow an effective treatment. We believe that the AK, MOX and KAN resistance detected in MDR-TB isolates in our study will contribute to the closer follow-up of anti-TB treatment and further studies.

References

  • 1. Aslan G, Direkel Ş, Otağ F, Akdenizli E, Emekdaş G. Mersin Bölgesinde izole edilen Mycobacterium tuberculosis suşlarında amikasin ve siprofloksasin duyarlılığı. ANKEM Derg. 2006;20(3):164-8.
  • 2. Avkan Oğuz V, Akbal H, Sarıbaş S, Karagöz T, Öztürk R. Edinsel çok ilaca dirençli Mycobacterium tuberculosis suşlarının major ve minör antitüberküloz ilaçlara duyarlılığı. İnfeksiyon Derg. 2000;14(3):383-6.
  • 3. Bektöre B, Haznedaroğlu T, Baylan O, ve ark. Çok İlaca Dirençli Tüberküloz İzolatlarında Yaygın İlaç Direncinin Araştırılması. Mikrobiyol Bul. 2013;47(1):59-70.
  • 4. Bozok T, Kayar B, Yakıcı G, ve ark. Klinik Örneklerden Elde Edilen Mycobacterium tuberculosis İzolatlarının Moksifloksasin MİK Değerlerinin Tespiti ve Moleküler Analizi. Mikrobiyol Bul. 2019;53(3):245-53.
  • 5. Bwanga F, Joloba ML, Haile M, Hoffner S. Evaluation of seven tests for the rapid detection of multidrug-resistant tuberculosis in Uganda. Int J Tuberc Lung Dis. 2010;14(7):890-5.
  • 6. Caviedes L, Delgado J, Gilman RH. Tetrazolium microplate assay as a rapid and inexpensive colorimetric method for determination of antibiotic susceptibility of Mycobacterium tuberculosis. J Clin Microbiol. 2002;40(5):1873-4.
  • 7. Centers for Disease Control and Prevention. Drug Resistant TB. https://www.cdc.gov/tb/topic/drtb/default.htm. (Erişim tarihi: 26.09.2022)
  • 8. Centers for Disease Control and Prevention. Multidrug-Resistant Tuberculosis (MDR TB) Fact Sheet. https://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm. (Erişim tarihi: 26.09.2022)
  • 9. Coban AY, Cekic Cihan C, Bilgin K, et al. Rapid susceptibility test for Mycobacterium tuberculosis to isoniazid and rifampin with resazurin method in screw-cap tubes. J Chemother. 2006;18(2):140-3.
  • 10. Espinal MA, Kim SJ, Suarez PG, et al. Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries. JAMA. 2000;283(19):2537-45.
  • 11. Isenberg HD (ed). Clinical Microbiology Procedures Handbook. Vol. 2, ASM Press, Washington, ABD, (2004).
  • 12. Jain A, Dixit P, Prasad R. Pre-XDR & XDR in MDR and Ofloxacin and Kanamycin resistance in non-MDR Mycobacterium tuberculosis isolates. Tuberculosis. 2012;92(5):404-6.
  • 13. Kayali R, Cöplü N, Ceyhan I, Ocak F, Citil BE, Esen B. The rates of resistance to second-line drugs in multidrug resistant Mycobacterium tuberculosis strains. Mikrobiyol Bul. 2006;40(1-2):1-7.
  • 14. Martin A, Camacho M, Portaels F, Palomino JC. Resazurin microtiter assay plate testing of Mycobacterium tuberculosis susceptibilities to second-line drugs: rapid, simple, and inexpensive method. Antimicrob Agents Chemother. 2003;47(11):3616-9.
  • 15. NCCLS. National Committee for Clinical Laboratory Standards, Antimycobacterial susceptibility testing for Mycobacterium tuberculosis, Tentative standard M24-T, Wayne, PA, ABD, (1995).
  • 16. Özkütük N, Sürücüoğlu S, Gazi H, Coşkun M, Özkütük A, Özbakkaloğlu B. Second-line drug susceptibilities of multidrug-resistant Mycobacterium tuberculosis isolates in Aegean region-Turkey. Turk J Med Sci. 2008;38(3):245-50.
  • 17. Palomino JC, Martin, A, Camacho M, Guerra H, Swings J. Portaels F. Resazurin microtiter assay plate: simple and inexpensive method for detection of drug resistance in Mycobacterium tuberculosis. Antimicrobial Agents and Chemotherapy. 2002;46(8):2720-2.
  • 18. Paramasivan CN, Rehman F, Wares F, et al. First-and second-line drug resistance patterns among previously treated tuberculosis patients in India. Int J Tuberc Lung Dis. 2010;14(2):243-6.
  • 19. Ramachandran R, Nalini S, Chandrasekar V, et al. Surveillance of drug-resistant tuberculosis in the state of Gujarat, India. Int J Tuberc Lung Dis. 2009;13(9):1154-1160.
  • 20. Ruh E, Öcal HY, Yurdakul P, Saribaş Z, Alp A. Dirençli Mycobacterium tuberculosis İzolatlarında Siprofloksasin Direncinin Saptanmasında Tetrazolyum Moru ve Resazurin Testlerinin Etkinliğinin Değerlendirilmesi. Mikrobiyoloji Bul. 2013;47(1): 49-58.
  • 21. Sharma SK, George N, Kadhiravan T, Saha PK, Mishra HK, Hanif M. Prevalence of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: A retrospective hospital-based study. Indian J Med Res. 2009;130(4):392-5.
  • 22. Singh U, Akhtar S, Mishra A, Sarkar D. A novel screening method based on menadione mediated rapid reduction of tetrazolium salt for testing of anti-mycobacterial agents. J Microbiol Methods. 2011;84(2):202-7.
  • 23. Şatana D, Yeğenoğlu Y. Çoğul ilaca dirençli Mycobacterium tuberculosis kompleksi suşlarının sekonder ilaçlara duyarlılığının BACTEC ve agar proporsiyon yöntemleri ile araştırılması, 4. Ulusal Mikobakteri Simpozyumu Kitabı, s. 198, Abant, Türk Mikrobiyoloji Cemiyeti Yayın No: 45, İstanbul, (2002).
  • 24. Toungoussova OS, Mariandyshev AO, Bjune G, Caugant DA, Sandven P. Resistance of multidrug-resistant strains of Mycobacterium tuberculosis from the Archangel oblast, Russia, to second-line anti-tuberculosis drugs. Eur J Clin Microbiol Infect Dis. 2005;24(3):202-6.
  • 25. Ulusal Mikrobiyoloji Standartları, Ulusal Tüberküloz Tanı Rehberi (UTTR). T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu Başkanlığı Mikrobiyoloji Referans Laboratuvarları Daire Başkanlığı Ankara 2019. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf. (Erişim tarihi 25.09.2022)
  • 26. Van Ingen J, Simons S, de Zwaan R, et al. Comparative study on genotypic and phenotypic second-line drug resistance testing of Mycobacterium tuberculosis complex isolates. J Clin Microbiol. 2010;48(8):2749-53.
  • 27. World Health Organization. Global tuberculosis report 2021. https://www.who.int/publications/i/item/9789240037021. (Erişim tarihi 14.3.2022)
  • 28. World Health Organization. Guidance for the surveillance of drug resistance in tuberculosis, sixth edition. 2020. https://www.who.int/publications/i/item/9789240018020 (Erişim tarihi 25.09.2022)
  • 29. World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis-5th ed. 2015. https://www.who.int/publications/i/item/9789241549134 (Erişim tarihi 1.1.2019).
  • 30. World Health Organization. Technical manual for drug susceptibility testing of medicines used in the treatment of tuberculosis. World Health Organization, 2018. https://www.who.int/publications/i/item/9789241514842. (Erişim tarihi 1.11.2019)
  • 31. Zhang Z, Liu M, Wang Y, Pang Y, Kam KM, Zhao Y. Molecular and phenotypic characterization of multidrug-resistant Mycobacterium tuberculosis isolates resistant to kanamycin, amikacin, and capreomycin in China. Eur J Clin Microbiol Infect Dis. 2014;33(11):1959-66.
  • 32. Zheng H, He W, Jiao W, et al. Molecular characterization of multidrug-resistant tuberculosis against levofloxacin, moxifloxacin, bedaquiline, linezolid, clofazimine, and delamanid in southwest of China. BMC Infectious Diseases. 2021;21:330.

BİRİNCİ SEÇENEK ANTİTÜBERKÜLOZ İLAÇLARA DUYARLI VE ÇOK İLACA DİRENÇLİ MYCOBACTERIUM TUBERCULOSIS KOMPLEKS KLİNİK İZOLATLARINDA AMİKASİN, MOKSİFLOKSASİN VE KANAMİSİN DUYARLILIKLARININ RESAZURİN MİKROTİTRE PLAK YÖNTEMİ İLE ARAŞTIRILMASI*

Year 2022, Volume: 36 Issue: 3, 92 - 100, 30.12.2022
https://doi.org/10.54962/ankemderg.1216208

Abstract

Tüberküloz (TB) dünya çapında en yaygın ölüm nedenlerinden biridir. Çok ilaca dirençli tüberküloz (ÇİD-TB) olguları düşük tedavi başarısı, kötü prognoz ve yüksek tedavi maliyetleri ile önemli bir sorundur. Çalışmamızda birinci seçenek anti-TB ilaçlara duyarlı Mycobacterium tuberculosis kompleks (MTC) izolatlarının ve ÇİD-TB izolatlarının amikasin (AK), moksifloksasin (MOKS) ve kanamisin (KAN) duyarlılıklarını resazurin mikrotitre plak yöntemi ile araştırılması amaçlanmıştır.
Mikobakteriyoloji laboratuvarı kültür koleksiyonundan birinci seçenek ilaçlara duyarlı 19 izolat ile izoniazid ve rifampisine dirençli (ÇİD-TB) 12 izolat olmak üzere toplam 31 adet MTC izolatı çalışmaya dahil edilmiştir.
Duyarlı izolatlarda her üç ilaca da direnç saptanmamıştır. ÇİD-TB izolatlarından üçü (3/12) AK’a, ikisi (2/12) MOKS’a ve dördü (4/12) KAN’a dirençli bulunmuştur. ÇİD-TB izolatlarından bir tanesinin her üç ilaca da dirençli olduğu saptanmıştır. ÇİD-TB izolatları arasında yaygın ilaç direnci (YİD-TB) %8 (1/12) olarak tespit edilmiştir.
Çok ilaca direnç gelişiminden sonra YİD-TB görülmesi TB tedavi başarısında önemli bir sorundur ve tedavide etkin yol izleyebilmek için direnç profillerini belirlemek gereklidir. Çalışmamızda ÇİD-TB izolatlarında saptanan AK, MOKS ve KAN direncinin hem anti-TB tedavisinin daha sıkı takip edilmesine hem de yapılacak olan çalışmalara katkı sağlayacağı kanaatindeyiz.

References

  • 1. Aslan G, Direkel Ş, Otağ F, Akdenizli E, Emekdaş G. Mersin Bölgesinde izole edilen Mycobacterium tuberculosis suşlarında amikasin ve siprofloksasin duyarlılığı. ANKEM Derg. 2006;20(3):164-8.
  • 2. Avkan Oğuz V, Akbal H, Sarıbaş S, Karagöz T, Öztürk R. Edinsel çok ilaca dirençli Mycobacterium tuberculosis suşlarının major ve minör antitüberküloz ilaçlara duyarlılığı. İnfeksiyon Derg. 2000;14(3):383-6.
  • 3. Bektöre B, Haznedaroğlu T, Baylan O, ve ark. Çok İlaca Dirençli Tüberküloz İzolatlarında Yaygın İlaç Direncinin Araştırılması. Mikrobiyol Bul. 2013;47(1):59-70.
  • 4. Bozok T, Kayar B, Yakıcı G, ve ark. Klinik Örneklerden Elde Edilen Mycobacterium tuberculosis İzolatlarının Moksifloksasin MİK Değerlerinin Tespiti ve Moleküler Analizi. Mikrobiyol Bul. 2019;53(3):245-53.
  • 5. Bwanga F, Joloba ML, Haile M, Hoffner S. Evaluation of seven tests for the rapid detection of multidrug-resistant tuberculosis in Uganda. Int J Tuberc Lung Dis. 2010;14(7):890-5.
  • 6. Caviedes L, Delgado J, Gilman RH. Tetrazolium microplate assay as a rapid and inexpensive colorimetric method for determination of antibiotic susceptibility of Mycobacterium tuberculosis. J Clin Microbiol. 2002;40(5):1873-4.
  • 7. Centers for Disease Control and Prevention. Drug Resistant TB. https://www.cdc.gov/tb/topic/drtb/default.htm. (Erişim tarihi: 26.09.2022)
  • 8. Centers for Disease Control and Prevention. Multidrug-Resistant Tuberculosis (MDR TB) Fact Sheet. https://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm. (Erişim tarihi: 26.09.2022)
  • 9. Coban AY, Cekic Cihan C, Bilgin K, et al. Rapid susceptibility test for Mycobacterium tuberculosis to isoniazid and rifampin with resazurin method in screw-cap tubes. J Chemother. 2006;18(2):140-3.
  • 10. Espinal MA, Kim SJ, Suarez PG, et al. Standard short-course chemotherapy for drug-resistant tuberculosis: treatment outcomes in 6 countries. JAMA. 2000;283(19):2537-45.
  • 11. Isenberg HD (ed). Clinical Microbiology Procedures Handbook. Vol. 2, ASM Press, Washington, ABD, (2004).
  • 12. Jain A, Dixit P, Prasad R. Pre-XDR & XDR in MDR and Ofloxacin and Kanamycin resistance in non-MDR Mycobacterium tuberculosis isolates. Tuberculosis. 2012;92(5):404-6.
  • 13. Kayali R, Cöplü N, Ceyhan I, Ocak F, Citil BE, Esen B. The rates of resistance to second-line drugs in multidrug resistant Mycobacterium tuberculosis strains. Mikrobiyol Bul. 2006;40(1-2):1-7.
  • 14. Martin A, Camacho M, Portaels F, Palomino JC. Resazurin microtiter assay plate testing of Mycobacterium tuberculosis susceptibilities to second-line drugs: rapid, simple, and inexpensive method. Antimicrob Agents Chemother. 2003;47(11):3616-9.
  • 15. NCCLS. National Committee for Clinical Laboratory Standards, Antimycobacterial susceptibility testing for Mycobacterium tuberculosis, Tentative standard M24-T, Wayne, PA, ABD, (1995).
  • 16. Özkütük N, Sürücüoğlu S, Gazi H, Coşkun M, Özkütük A, Özbakkaloğlu B. Second-line drug susceptibilities of multidrug-resistant Mycobacterium tuberculosis isolates in Aegean region-Turkey. Turk J Med Sci. 2008;38(3):245-50.
  • 17. Palomino JC, Martin, A, Camacho M, Guerra H, Swings J. Portaels F. Resazurin microtiter assay plate: simple and inexpensive method for detection of drug resistance in Mycobacterium tuberculosis. Antimicrobial Agents and Chemotherapy. 2002;46(8):2720-2.
  • 18. Paramasivan CN, Rehman F, Wares F, et al. First-and second-line drug resistance patterns among previously treated tuberculosis patients in India. Int J Tuberc Lung Dis. 2010;14(2):243-6.
  • 19. Ramachandran R, Nalini S, Chandrasekar V, et al. Surveillance of drug-resistant tuberculosis in the state of Gujarat, India. Int J Tuberc Lung Dis. 2009;13(9):1154-1160.
  • 20. Ruh E, Öcal HY, Yurdakul P, Saribaş Z, Alp A. Dirençli Mycobacterium tuberculosis İzolatlarında Siprofloksasin Direncinin Saptanmasında Tetrazolyum Moru ve Resazurin Testlerinin Etkinliğinin Değerlendirilmesi. Mikrobiyoloji Bul. 2013;47(1): 49-58.
  • 21. Sharma SK, George N, Kadhiravan T, Saha PK, Mishra HK, Hanif M. Prevalence of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: A retrospective hospital-based study. Indian J Med Res. 2009;130(4):392-5.
  • 22. Singh U, Akhtar S, Mishra A, Sarkar D. A novel screening method based on menadione mediated rapid reduction of tetrazolium salt for testing of anti-mycobacterial agents. J Microbiol Methods. 2011;84(2):202-7.
  • 23. Şatana D, Yeğenoğlu Y. Çoğul ilaca dirençli Mycobacterium tuberculosis kompleksi suşlarının sekonder ilaçlara duyarlılığının BACTEC ve agar proporsiyon yöntemleri ile araştırılması, 4. Ulusal Mikobakteri Simpozyumu Kitabı, s. 198, Abant, Türk Mikrobiyoloji Cemiyeti Yayın No: 45, İstanbul, (2002).
  • 24. Toungoussova OS, Mariandyshev AO, Bjune G, Caugant DA, Sandven P. Resistance of multidrug-resistant strains of Mycobacterium tuberculosis from the Archangel oblast, Russia, to second-line anti-tuberculosis drugs. Eur J Clin Microbiol Infect Dis. 2005;24(3):202-6.
  • 25. Ulusal Mikrobiyoloji Standartları, Ulusal Tüberküloz Tanı Rehberi (UTTR). T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu Başkanlığı Mikrobiyoloji Referans Laboratuvarları Daire Başkanlığı Ankara 2019. https://hsgm.saglik.gov.tr/depo/birimler/tuberkuloz_db/haberler/Tuberkuloz_Tani_Ve_Tedavi_Rehberi_/Tuberkuloz_Tani_ve_Tedavi_Rehberi.pdf. (Erişim tarihi 25.09.2022)
  • 26. Van Ingen J, Simons S, de Zwaan R, et al. Comparative study on genotypic and phenotypic second-line drug resistance testing of Mycobacterium tuberculosis complex isolates. J Clin Microbiol. 2010;48(8):2749-53.
  • 27. World Health Organization. Global tuberculosis report 2021. https://www.who.int/publications/i/item/9789240037021. (Erişim tarihi 14.3.2022)
  • 28. World Health Organization. Guidance for the surveillance of drug resistance in tuberculosis, sixth edition. 2020. https://www.who.int/publications/i/item/9789240018020 (Erişim tarihi 25.09.2022)
  • 29. World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis-5th ed. 2015. https://www.who.int/publications/i/item/9789241549134 (Erişim tarihi 1.1.2019).
  • 30. World Health Organization. Technical manual for drug susceptibility testing of medicines used in the treatment of tuberculosis. World Health Organization, 2018. https://www.who.int/publications/i/item/9789241514842. (Erişim tarihi 1.11.2019)
  • 31. Zhang Z, Liu M, Wang Y, Pang Y, Kam KM, Zhao Y. Molecular and phenotypic characterization of multidrug-resistant Mycobacterium tuberculosis isolates resistant to kanamycin, amikacin, and capreomycin in China. Eur J Clin Microbiol Infect Dis. 2014;33(11):1959-66.
  • 32. Zheng H, He W, Jiao W, et al. Molecular characterization of multidrug-resistant tuberculosis against levofloxacin, moxifloxacin, bedaquiline, linezolid, clofazimine, and delamanid in southwest of China. BMC Infectious Diseases. 2021;21:330.
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Medical Microbiology
Journal Section Research Articles
Authors

Mahmut Ülger 0000-0001-6649-4195

Nurbanu Yaşar This is me 0000-0001-8461-6723

Hamide Kaya This is me 0000-0002-2956-8762

Eyyüp Kaya 0000-0001-9328-0088

Osman Sezer This is me 0000-0002-4938-9761

Gönül Aslan 0000-0002-1221-7907

Publication Date December 30, 2022
Published in Issue Year 2022 Volume: 36 Issue: 3

Cite

Vancouver Ülger M, Yaşar N, Kaya H, Kaya E, Sezer O, Aslan G. BİRİNCİ SEÇENEK ANTİTÜBERKÜLOZ İLAÇLARA DUYARLI VE ÇOK İLACA DİRENÇLİ MYCOBACTERIUM TUBERCULOSIS KOMPLEKS KLİNİK İZOLATLARINDA AMİKASİN, MOKSİFLOKSASİN VE KANAMİSİN DUYARLILIKLARININ RESAZURİN MİKROTİTRE PLAK YÖNTEMİ İLE ARAŞTIRILMASI*. ANKEM Derg. 2022;36(3):92-100.

88x31.png

This work is licensed under a https://creativecommons.org/licenses/by-nc-nd/4.0/ license.