Abstract

ASSOCIATION OF ANTIBIOTIC RESISTANCES AMONG MYCOBACTERIUM TUBERCULOSIS AMONG SALAH-ALDEEN COMMUNITY

*Mohemid Maddallah Al-Jebouri, Khalid Omer Mohammed Ali

Abstract

ackground: Mycobacterium tuberculosis, the etiological agent causing tuberculosis, is one of the most common contagious diseases that poses a serious threat to human health. As per the recent WHO report, TB incidence throughout the world amounts to 10.7 million and the total death cases due to tuberculosis is around 1.23 million. multidrug and extreme drug resistance TB which is around 390,000, adds to the additional burden of TB. Materials and Methods: This study was carried out in the Antituberculosis and Chest Diseases Center in Tikrit city. Sputa of 479 patients referred to the laboratory were examined. All patients complaining of fever, night sweat, weight loss, cough, shortness of breath and haemoptysis. Sociodemographic characters of the patients were record. Patients referred to laboratory were examined by means of X-ray. Eggbase medium, Lowenstein-Jensen medium were used for isolation of bacteria and the isolated pathogen was identified and their sensitivity to antibiotics was carried out. Results: The degree of association between antibiotics using low and high concentration antibiotic discs among 86 isolates of Mycobacterium tuberculosis was studied and the results were analyzed which showed a share resistance between pairs of antibiotics tested using low and high concentrations. The pooled association effect was substantially higher at the low antibiotic concentration (pooled Phi ≈0.94), indicating very strong co-resistance among antibiotic pairs. Conclusions: The frequency of resistances were not symmetrical as determined by the considered resistance e.g. 83.3% of isolates resistant to streptomycin were resistant to isoniazid while 16.1% of isolates resistant to streptomycin were resistant to isoniazid using low concentration of antibiotic discs. The same observation was noticed as 4.1% of isolates resistant to rifampicin were resistant to streptomycin while 66.7% of isolates resistant to streptomycin were resistant to rifampicin. Data analysis shows that the degree of association between pairs of resistance to antibiotic used. The pooled effect at the high antibiotic concentration was moderate (pooled Phi ≈ 0.46), suggesting that increasing the antibiotic concentration markedly reduced the overall strength of phenotypic resistance associations. At the low concentration, the strongest associations were observed for the RMP–EMB, RMP–SM, INH–EMB, and SM–INH pairs, whereas the SM–EMB pair exhibited only a negligible association.

Keywords: Patients, tuberculous agents, antibiotics, paired resistances, association degree.