title: Drug resistance pattern of Mycobacterium tuberculosis in the province with highest incidence of tuberculosis in Iran.
abstract: OBJECTIVE
  Incidence of tuberculosis (TB) in Golestan Province is consistently higher than other provinces of Iran. This study aimed to determine the rate of drug resistance to first-line antibiotics in Mycobacterium tuberculosis (MTB) isolates recovered from new cases in this province.
  
  
  METHODS
  The sputum and broncho-alveolar lavage samples from 3828 patients who were suspected for active TB were collected from March 2015 to July 2015. All specimens were subjected to smear microscopy and culture. Drug susceptibility testing to rifampicin, isoniazid, ethambutol, and streptomycin was performed on Löwenstein-Jensen medium using proportion method.
  
  
  RESULTS
  Of 3828 clinical specimens, 40 were culture-positive for MTB. The mean age of patients was 48.6±17.5years and 23 (57%) patients were male. Thirty-eight patients were native Iranians while two (5%) were immigrant patients from Turkmenistan and Afghanistan. A set of 34 (85%) isolates were pan-susceptible, six (15%) were resistant to at least one drug, and one isolate (2.5%) was multidrug resistant.
  
  
  CONCLUSIONS
  The rate of drug resistance in this study area point to the necessity for further enforcement of TB treatment and disease control management. Future studies are recommended for assessments of drug resistance pattern of MTB isolates in Golestan Province.
authors.affiliation: Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Mansoori
authors.affiliation: Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mdouraghi@tums.ac.ir.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Douraghi
authors.affiliation: Departments of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Vaziri
authors.affiliation: Tuberculosis Reference Laboratory of Golestan Province, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: A A
authors.initials: AA
authors.lastname: Rajabloo
authors.affiliation: Tuberculosis Reference Laboratory of Golestan Province, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Sheikhi
authors.affiliation: Tuberculosis Reference Laboratory of Golestan Province, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Taziki
authors.affiliation: Tuberculosis Reference Laboratory of Golestan Province, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Atarjalali
keywords: Iran; Multidrug resistant; Mycobacterium tuberculosis; Tuberculosis