Antituberculosis drug resistance and associated risk factors in the European section of Turkey.
BACKGROUND
We carried out this study in order to establish the prevalence of antituberculosis drug resistance in Mycobacterium tuberculosis strains and to determine risk factors for the development of resistance in Trakya region of Turkey.


METHODS
Pattern of drug resistance in 214 M. tuberculosis isolates from patients with tuberculosis treated at the regional tuberculosis dispensaries were included in the study.


RESULTS
Isolates of 105 (49.1%) were resistant to only one drug, and 62 (29.0%) were resistant to more than one drug. The total resistance rates to streptomycin, isoniazid, rifampicin, ethambutol and isoniazid + rifampicin were 29.0%, 27.1%, 21.5%, 10.3% and 11.6%, respectively. The secondary resistance rates in all drugs and combinations were higher than primary resistance rates (p<0.001). Step wise logistic regression revealed that (i) non-compliance with treatment increases the chances of development of resistance by 15 times [p<0.00001, 95% confidence intervals (95% CI) : 4.16 to 56.70], and (ii) a regimen of inadequate treatment increases the chance of development of drug resistance by 10.5 times (p<0.01, 95% CI=2.66 to 49.80).


CONCLUSIONS
We propose that specially trained physicians should institute antituberculosis therapy and medication should be practiced under direct observation in this region.
Karabay
Oguz
O
Department of Clinical Bacteriology, Medical Faculty of Trakya University, Edirne, 22030, Turkey. karabay@ibu.edu.tr
Otkun
Metin
M
Akata
Filiz
F
Karlikaya
Celal
C
Tuğrul
Murat
M
Dündar
Volkan
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D014421:Turkey
D000995:Antitubercular Agents