title: High prevelance of rifampin-monoresistant tuberculosis: a retrospective analysis among Iranian pulmonary tuberculosis patients.
abstract: We determined the prevalence of rifampin-monoresistant tuberculosis (RMR-TB) in Iran. Because development of RMR-TB is not common, we also identified the major risk factors associated with RMR-TB reported from different provinces of Iran. Data for 3,020 TB patients who remained or became smear positive after two, four, six, and nine months of standard first-line chemotherapy were retrospectively analyzed. Of 3,020 patients, 1,242 patients (41.1%) were culture and DNA positive for Mycobacterium tuberculosis. Of these patients, 73 (7.4%) patients had monoresistant isolates to rifampin, which was significantly higher than that for multidrug-resistant TB (5.8%). The average rate of RMR-TB in the studied population ranged from 5% to 10%. Classical investigation showed that 33.6% of patients had either a previous or family history of TB. Molecular epidemiology methods (i.e., spoligotyping and Mycobacterium interspersed repetitive unit-variable number tandem repeat), defined transmission link in three clusters (13%). These results outline the urgent need for a comprehensive plan for detection and treatment of RMR-TB cases.
authors.affiliation: Mycobacteriology Research Centre, Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; World Health Organization Supranational Reference Laboratory for Tuberculosis, Swedish Institute for Communicable Disease Control, Stockholm, Sweden.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Velayati
authors.forename: Parissa
authors.initials: P
authors.lastname: Farnia
authors.forename: Mohadese
authors.initials: M
authors.lastname: Mozafari
authors.forename: Maryam Fatemeh
authors.initials: MF
authors.lastname: Sheikholeslami
authors.forename: Mona Afraei
authors.initials: MA
authors.lastname: Karahrudi
authors.forename: Payam
authors.initials: P
authors.lastname: Tabarsi
authors.forename: Sven
authors.initials: S
authors.lastname: Hoffner
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics; D010802:Phylogeny; D012189:Retrospective Studies; D012293:Rifampin / Q000494:pharmacology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D012293:Rifampin