Frequency of Multi-Drug Resistant Mycobacterium tuberculosis among Patients with Pulmonary tuberculosis in Khartoum State

Abstract

Tuberculosis continues to be one of the most prevalent diseases and is the leading cause of mortality from a single disease worldwide. In the developing countries the disease is mainly influenced by poverty while in the developed world it is influenced by AIDS. In Sudan, tuberculosis represents a major health problem. One hundred sputum samples were collected from suspected pulmonary tuberculosis patients at Al Shaab Teaching Hospital, Abu Anga Hospital and the National Health Laboratory in Khartoum State during the period from November 2008 to May 2009. In this study, male were found to be more affected than females (67%). All age groups were affected, but with variable degrees, the age at most risk were found to be 21 – 50 years, which comprised (72%) patients. The highest infection rate according to occupation of the patients was found among labours (29%), where as the lowest infection rate was found among unemployed people (7%). The majority of patients came to the above mentioned health institutions from other states. It was found that most of the patients were from Western and Southern Sudan, where the economic and health status are more deteriorated. Of The 100 sputum samples, 83 gave growth Mycobacterium tuberculosis complex , 10 gave growers and 7 gave no growth. of rapid Isolate of Mycobacterium tuberculosis complex were identified according to their ziehl-Neelsen stain, cultural characteristics and biochemical proprieties. Lowenstein Jensen proportion method was used to test the antimicrobial sensitivity of the 83 isolates of Mycobacterium tuberculosis complex against four drugs: Isoniazid (INH), Rifampicin (RIF), Streptomycin (STM) and Ethambutol (ETH), only (36%), isolate were sensitive to the four drugs, (38%) isolates were resistant to INH, (24%) isolates were resistant to RIF, (37%) isolates were resistant to STM and (29%) isolates were resistant to ETH, while (3%) isolates were resistant to INH and RIF, Resistant to INH + RIF + STM (4%) , INH + RIF + ETH (1%) , INH + STM + ETH ( 2%) , RIF + STM + ETH (1%) . Twenty two (22%) isolates were resistant to the four drugs. The results obtained from this study revealed the existence of Multi- Drug resistant Mycobacterium tuberculosis among Sudanese TB patients thus, clinicians should give more attention for treatment follow up.