Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi

Introduction: In Kenya, which ranks thirteenth of 27 high tuberculosis burden countries, diagnosis is based on Ziehl-Neelsen staining alone and patients are treated without information on sensitivity patterns. This study aimed to determine resistance patterns of Mycobacterium tuberculosis isolated f...

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Main Authors: Perpetual Wangui Ndung'u, Samuel Kariuki, Zipporah Ng'ang'a, Gunturu Revathi
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2011-12-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/2281
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author Perpetual Wangui Ndung'u
Samuel Kariuki
Zipporah Ng'ang'a
Gunturu Revathi
author_facet Perpetual Wangui Ndung'u
Samuel Kariuki
Zipporah Ng'ang'a
Gunturu Revathi
author_sort Perpetual Wangui Ndung'u
collection DOAJ
description Introduction: In Kenya, which ranks thirteenth of 27 high tuberculosis burden countries, diagnosis is based on Ziehl-Neelsen staining alone and patients are treated without information on sensitivity patterns. This study aimed to determine resistance patterns of Mycobacterium tuberculosis isolated from pulmonary samples. Methodology: Pulmonary tuberculosis patients in Nairobi were randomly sampled after informed consent and recruited into the study using a structured questionnaire. Specimens were cultured in liquid and solid media, and drug susceptibility tests were performed for first-line drugs including (isoniazid, rifampin, streptomycin, ethambutol and pyrazinamide). Results: Eighty-six (30%) of 286 isolates were resistant to at least one of five antibiotics tested. Thirty-seven (30.2%) isolates were resistant to isoniazid; 15 (11.6%) to streptomycin; 13 (4.5%) to ethambutol; four (1.4%) to rifampin ; and 30 (10.4%) to pyrazinamide. Double resistance was seen as follows: four (1.4%) isolates were resistant to both isoniazid and pyrazinamide; four (1.4%) to streptomycin and isoniazid; and one (0.3%) to rifampin and streptomycin. Two isolates (0.7%) were multidrug resistant, and one was triple resistant with an additional resistance to ethambutol. Results also showed 88.7% of patients were below the age of 40 years, while 26.3% were HIV positive. The majority of the patients (66.5%) were unemployed or self-employed in small businesses, with 79.4% earning less than 100 USD per month. Conclusion: The high resistance observed in isoniazid, which is a first-line drug, could result in an increase in multidrug resistance unless control programs are strengthened. Poverty should be addressed to reduce infection rates.
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spelling doaj-art-a82e7ec9295b49e8b6fb7478bb6bef372025-08-20T02:16:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802011-12-0160110.3855/jidc.2281Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in NairobiPerpetual Wangui Ndung'u0Samuel Kariuki1Zipporah Ng'ang'a2Gunturu Revathi3Institute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, KenyaCentre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, KenyaInstitute of Tropical Medicine and Infectious Diseases (ITROMID), Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, KenyaDepartment of Pathology, Aga Khan University Hospital (AKUH), Nairobi, KenyaIntroduction: In Kenya, which ranks thirteenth of 27 high tuberculosis burden countries, diagnosis is based on Ziehl-Neelsen staining alone and patients are treated without information on sensitivity patterns. This study aimed to determine resistance patterns of Mycobacterium tuberculosis isolated from pulmonary samples. Methodology: Pulmonary tuberculosis patients in Nairobi were randomly sampled after informed consent and recruited into the study using a structured questionnaire. Specimens were cultured in liquid and solid media, and drug susceptibility tests were performed for first-line drugs including (isoniazid, rifampin, streptomycin, ethambutol and pyrazinamide). Results: Eighty-six (30%) of 286 isolates were resistant to at least one of five antibiotics tested. Thirty-seven (30.2%) isolates were resistant to isoniazid; 15 (11.6%) to streptomycin; 13 (4.5%) to ethambutol; four (1.4%) to rifampin ; and 30 (10.4%) to pyrazinamide. Double resistance was seen as follows: four (1.4%) isolates were resistant to both isoniazid and pyrazinamide; four (1.4%) to streptomycin and isoniazid; and one (0.3%) to rifampin and streptomycin. Two isolates (0.7%) were multidrug resistant, and one was triple resistant with an additional resistance to ethambutol. Results also showed 88.7% of patients were below the age of 40 years, while 26.3% were HIV positive. The majority of the patients (66.5%) were unemployed or self-employed in small businesses, with 79.4% earning less than 100 USD per month. Conclusion: The high resistance observed in isoniazid, which is a first-line drug, could result in an increase in multidrug resistance unless control programs are strengthened. Poverty should be addressed to reduce infection rates. https://jidc.org/index.php/journal/article/view/2281tuberculosisresistance patternssusceptibility testsmultidrug resistance
spellingShingle Perpetual Wangui Ndung'u
Samuel Kariuki
Zipporah Ng'ang'a
Gunturu Revathi
Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
Journal of Infection in Developing Countries
tuberculosis
resistance patterns
susceptibility tests
multidrug resistance
title Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
title_full Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
title_fullStr Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
title_full_unstemmed Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
title_short Resistance patterns of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Nairobi
title_sort resistance patterns of mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in nairobi
topic tuberculosis
resistance patterns
susceptibility tests
multidrug resistance
url https://jidc.org/index.php/journal/article/view/2281
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