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Drug resistance among Mycobacterium tuberculosis isolates in Lebanon
Objective:
To determine the prevalence and patterns of drug resistance among Mycobacterium tuberculosis isolates recovered from tuberculosis (TB) cases in Lebanon.
Design:
A total of 96 isolates were collected from the same number of TB cases between October 1994 and December 1995. These isolates were obtained from cases with newly diagnosed (81.3%) and previously treated (18.7%) cases of TB, and tested against isoniazid (INH), rifampicin (RIF), streptomycin (STM) and ethambutol (ETH), using the BACTEC-TB susceptibility procedure and system.
Results:
The male to female ratio was 2:1 and the mean ages of males and females were almost similar, 34.1 and 32.7 years, respectively. Resistance to one or more drugs was found in 25 of 96 (26%) isolates. The overall percentages of single drug resistance against INH, RIF, STM and ETH were 23.9%, 12.5%, 7.3% and 3.1%, respectively. These percentages were higher, for all drugs, in isolates recovered from previously treated compared to new cases of TB: INH (50% vs 17.9%), RIF (33.3% vs 7.7%), STM (22.2% vs 3.8%) and ETH (11.1% vs 1.3%). Of the 25 resistant isolates, 11 were resistant to one drug only (10 to INH and 1 to STM), 10 were resistant to two drugs (7 to INH and RIF, 2 to INH and STM, 1 to STM and RIF), 2 were resistant to three drugs (1 to INH, RIF and ETH, 1 to INH, RIF and STM) and 2 were resistant to the four tested drugs.
Conclusion:
These data show that M. tuberculosis isolates in Lebanon have high rates of single and multidrug resistance, and speaks for the need to establish surveillance and monitoring programs in this country as part of the global effort to control TB.