title: First- and second-line anti-tuberculosis drug resistance in Northwest Ethiopia.
abstract: METHODS
  Gondar Hospital, Gondar Health Centre, Metemma Hospital, Bahir Dar Hospital and Debre Markos Hospital in Northwest Ethiopia.
  
  
  OBJECTIVE
  To assess the level of and risk factors for first- and second-line drug resistance among tuberculosis (TB) patients.
  
  
  METHODS
  Drug susceptibility  testing (DST) against first-line drugs, including isoniazid (INH), rifampicin (RMP), streptomycin (SM), ethambutol (EMB) and pyrazinamide (PZA), was performed using the BacT/ALERT 3D system. DST against second-line drugs, including fluoroquinolones and aminoglycocides/cyclic peptides, was  performed using GenoType MTBDRsl.
  
  
  RESULTS
  Of 260 Mycobacterium tuberculosis isolates, 41 (15.8%) were resistant to at least one first-line drug, 13 (5.0%) were multidrug-resistant (MDR) and 9 (3.5%) were resistant to all first-line drugs. Any resistance to INH, RMP, SM, EMB and  PZA was respectively 36 (13.8%), 15 (5.8%), 26 (10.0%), 19 (7.3%) and 12 (4.6%). Of 214 new and 46 previously treated cases, respectively 8 (3.7%) and 5 (10.9%) were MDR. All isolates were susceptible to all second-line drugs.
  
  
  CONCLUSIONS
  A substantial number of new and previously treated  cases harbour MDR-TB. We recommend DST at least for previously treated cases, patients who remain smear-positive at the end of the second month of treatment and patients in close contact with MDR-TB cases. Improved infection control measures need to be implemented in Ethiopia.
authors.affiliation: Department of Medical Laboratory Technology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. bt1488@yahoo.com
authors.forename: B
authors.initials: B
authors.lastname: Tessema
authors.forename: J
authors.initials: J
authors.lastname: Beer
authors.forename: F
authors.initials: F
authors.lastname: Emmrich
authors.forename: U
authors.initials: U
authors.lastname: Sack
authors.forename: A C
authors.initials: AC
authors.lastname: Rodloff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D018570:Risk Assessment; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents