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THE PREVALENCE AND SPECTRUM OF MYCOBACTERIUM TUBERCULOSIS CHEMORESISTANCE AMONG TB PATIENTS

ARIADNA PETRONELA FILDAN 1#, IOAN ANTON ARGHIR 2#, GEORGETA GILDA POPESCU 3*, CLARA MATEI 4, ROXANA MARIA NEMES 3, DOINA TOFOLEAN 1#, ELENA DANTES 1, CORINA SILVIA POP 5, SIMONA CLAUDIA CAMBREA 1

1.Faculty of Medicine, “Ovidius” University of Constanța, 124 Mamaia Boulevard, 900527, Constanța, Romania
2 .Pulmonology Department, “Sf. Andrei” Clinical Emergency Hospital, 145 Tomis Boulevard, 900591, Constanța, Romania
3 .Pulmonology Department, “Marius Nasta” Hospital, 90 Viilor Road, 050152, Bucharest, Romania
4 .Department of Dermatology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
5 .Department of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

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Rapid detection of Mycobacterium tuberculosis (MTB) chemoresistance against anti-tuberculosis drugs is a major challenge of any Pulmonology department. The aim of the study was to synthesize the epidemiological features of multidrug resistant (MDR), rifampicin resistant (RR) or extensively drug resistant (XDR) TB, for estimating the extent of MTB resistance pattern and severity of tuberculosis (TB) disease. Between 1st of March 2013 to 31st of December 2017, all 1,643 inpatients with positive diagnosis of pulmonary TB active disease were evaluated by specific methods consisting in phenotypic and genotypic investigation of MTB strains. The frequency and pattern of MTB resistance to anti-TB drugs were assessed. The prevalence of MDR-TB was low (1.95%). Delayed diagnosis of MDR-TB was frequent (71.87%) and more common in active smokers (53.12%), unemployed and uninsured patients. The secondary pattern of chemoresistance was prevalent (62.5%), but primary resistance pattern of MTB was related to younger individuals mean aged 38 years (p < 0.03). The prevalent broad- spectrum of MTB resistance against first line of anti-TB drugs was noticed in majority of cases (87.5%), with the predominance of isoniazid (H) and rifampicin (R) pattern (53.1%), and supplementary gaining XDR profile. Although MDR-TB prevalence was low and HR pattern dominated the spectrum of MTB resistance, the progressive extension of MDR to XDR profile of resistance occurred.