Culture and sensitivity of mycobacterial isolates from cases of pulmonary tuberculosis classified as treatment failures in a teaching hospital.
BACKGROUND
The level of drug resistance in mycobacterial isolates from previously treated cases in Ghana is not known although drug resistant tuberculosis threatens efforts to control the disease.


OBJECTIVE
To identify and determine the susceptibility of mycobacterial isolates from tuberculosis cases with clinical treatment failure.


METHODS
This prospective survey was undertaken at the Chest Clinic of Korle Bu Teaching Hospital in Accra, Ghana. The participants were twenty-eight cases referred to the hospital with clinical treatment failure. Two sputum specimens from each case were stained by Ziehl-Neelsen method, cultured, identified and sensitivity tests performed by the proportion method.


RESULTS
Eighteen isolates of mycobacteria were identified from 28 failed treatment cases. Five were atypical mycobacteria. Approximately fifty percent (13/28) of cases had Mycobacterium tuberculosis, 5(18%) had atypical mycobacteria, 7(25%) had pure fungal growth and 3(11% 8) had no growth. Fifteen isolates were resistant to two or more drugs, of which 6 were resistant to all four drugs tested.


CONCLUSIONS
Continuous drug resistance monitoring must be instituted as part of the tuberculosis control programme.
Newman
M J
MJ
Department of Microbiology, University of Ghana Medical School, Accra, Ghana. microb@africaonline.com.gh
Addo
K K
KK
Aboagye
S
S
Bonsu
F A
FA
Caulley
P
P
Hesse
I F A
IF
Neequaye
A R
AR
Kudzawu
S
S
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D004198:Disease Susceptibility; D024881:Drug Resistance, Bacterial; D005260:Female; D005869:Ghana; D006306:Health Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D009161:Mycobacterium / Q000187:drug effects* / Q000302:isolation & purification; D011446:Prospective Studies; D013183:Sputum; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000382:microbiology*
D000900:Anti-Bacterial Agents