Five-year experience of tuberculosis through the eyes of the laboratory Laboratuvar gözüyle beş yıllık tüberküloz deneyimi


SAĞIROĞLU P., ATALAY M. A., KOÇ A. N.

Pamukkale Medical Journal, cilt.14, sa.3, ss.584-596, 2021 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.31362/patd.809353
  • Dergi Adı: Pamukkale Medical Journal
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.584-596
  • Anahtar Kelimeler: LJ, MGIT, PCR, resistance, Tuberculosis
  • Erciyes Üniversitesi Adresli: Evet

Özet

Purpose: Tuberculosis (TB) is a global health problem that has not lost its importance from past to present. The follow-up and evaluation of the laboratory datas have a critical importance in the fight against TB. This study aims to evaluate the results and clinical reflections obtained from Erciyes University Medical Faculty Hospitals Mycobacteriology Laboratories in the last five years. Materials and methods: Between January 2015-December 2019, 16739 clinical specimens were investigated with the EZN staining method, BACTEC MGIT 960 Culture system, and Lowenstein-Jensen (LJ) solid media. Besides, 2981 specimen was investigated with real time polimerase chain reaction (RT-PCR) for the presence of mycobacteria. Gene Xpert MTB/RIF test was used between January 2015-March 2019, BDMAX MTB test used March 2019-December 2019. BD MGIT TBc ID test was used to identify strains, and sensitivity tests of MTC strains to primary antituberculosis drugs were performed with MGIT 960. Results: Total 239 mycobacteria, 195 (81.59%) MTC and 44 (18.41%) non-tuberculosis mycobacterium (TDM) were isolated from different patients’ clinical specimens. Also, mycobacteria were detected in 15 patients specimens only by PCR. In the laboratory, mycobacterium detected in 254 patients specimens but, 234 of these (92.12%) (210 MTC, 24 TDM) were accepted as TB and treated with antituberculosis drugs. When we evaluated the compatibility of microbiological methods with clinical diagnosis, we found RT-PCR tests had the highest test performance, while EZN staining had the lowest performance. MGIT system detected mycobacterial growth on average 19.65±9.91 days, and LJ medium was on 41.13±13.69 days. 166 (85.12%) of MTC isolates were susceptible to all the drugs tested. 21 (72.4%) isolates had one-drug, six isolates had (20.6%) two-drugs, and two isolates (6.89%) had three-drugs resistance. The resistance rates of the strains to isoniazid, rifampicin, ethambutol, and streptomycin were 7.18%, 2.05%, 5.64%, and 5.13%, respectively. 53.42% of TB patients were male (n=125), 46.58% were female (n=109), and 6.41% (n=15) were children (0-14 age group). In all TB cases, 16 (6.84%) were born outside of Turkey and 62.5% of them were Syrian refugees. 57.26% (n=134) of the TB cases are pulmonary and 42.47% (n=100) were extrapulmonary. Twenty patients (8.55%) were former patients who received TB treatment previously. One patient was HIV positive. 77.7% (n=182) of the patients were accompanied by a chronic disease and hypertension was the first among these diseases with a rate of 23.9% (n=56). 6.83% (n=16) TB cases were died. TB cases mostly isolated in August and at least in December. Conclusion: Laboratory and clinical cooperation is very important in the diagnosis and treatment of TB. Monitoring of the data of the centers will contribute to the epidemiological data of our country and the fight against TB.