Resistance Rates of Mycobacterium tuberculosis Complex Strains: A Retrospective Study in Türkiye

Medicina (Kaunas). 2025 Jun 9;61(6):1060. doi: 10.3390/medicina61061060.

Abstract

Background and Objectives: Tuberculosis (TB) is one of the most common infectious diseases in developing countries. The resistance of the causative agent, Mycobacterium tuberculosis, to two or more first-line anti-TB drugs results in multidrug-resistant (MDR) TB, posing a serious challenge to the control of TB worldwide. This study was designed to determine the changes in drug resistance over time in TB strains isolated from patients in all departments of Uludağ University Hospital in western Türkiye. Materials and Methods: We retrospectively analyzed 104,598 clinical samples sent to our laboratory for the investigation of the presence of TB between 1996 and 2023. BACTEC 460 TB, BACTEC MGIT 960 culture systems and Löwenstein-Jensen medium were used for the culture of these samples. The susceptibility of M. tuberculosis complex strains grown in culture to isoniazid (INH) (0.1 μg/mL), rifampicin (RIF) (1.0 μg/mL), ethambutol (ETB) (5.0 μg/mL) and streptomycin (SM) (1.0 μg/mL) antibiotics was studied according to the manufacturer's recommendation. Results: Out of 104,598 patient samples, 2752 (2.6%) were culture-positive, and the susceptibility test results of 1869 of these were analyzed. Of the isolates, 358 (19.2%) were found to be resistant to at least one first-line drug, i.e., INH, RIF, ETB, or SM. In addition, 2.9% were resistant to two or more first-line drugs. Conclusions: Drug susceptibility testing is essential to ensure the optimal treatment and control of drug-resistant TB strains. This study highlights the value of ongoing efforts to control tuberculosis drug resistance in the fight against this disease.

Keywords: Mycobacterium tuberculosis; Türkiye; multidrug resistance.

MeSH terms

  • Adult
  • Antitubercular Agents* / pharmacology
  • Antitubercular Agents* / therapeutic use
  • Ethambutol / pharmacology
  • Ethambutol / therapeutic use
  • Female
  • Humans
  • Isoniazid / pharmacology
  • Isoniazid / therapeutic use
  • Male
  • Microbial Sensitivity Tests / methods
  • Middle Aged
  • Mycobacterium tuberculosis* / drug effects
  • Mycobacterium tuberculosis* / pathogenicity
  • Retrospective Studies
  • Rifampin / pharmacology
  • Rifampin / therapeutic use
  • Streptomycin / pharmacology
  • Streptomycin / therapeutic use
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / epidemiology
  • Turkey / epidemiology

Substances

  • Antitubercular Agents
  • Rifampin
  • Isoniazid
  • Streptomycin
  • Ethambutol