Pattern and drug sensitivity of non-specific bacterial population in tuberculosis patients with multiple drug resistance
https://doi.org/10.21292/2075-1230-2019-97-9-11-16
Abstract
The objective: to study the patterns of nonspecific bacterial population isolated in patients with multiple drug resistant tuberculosis in the city of Karaganda and assess its sensitivity to antimicrobial agents.
Subjects and methods. 343 sputum specimens were tested. Microorganisms were identified using mass spectrometry using the MALDI-TOF method (Microflex, BD, Germany). Drug susceptibility was determined by the diffusion method in accordance with CLSI recommendations (2012).
Results. Bacterial growth was observed in 20.99%. More than ⅔ of isolated microorganisms were resistant to three groups of drugs and more, thus it could be classified as MDR. S. aureus prevailed in the structure of secondary bacterial population and made 22.22%, of which 12.5% were MRSA. Among gram-negative bacteria, K. pneumoniae – 12.5% and A. baumannii – 11.11% dominated among isolated species. 10% of K. pneumonia strains and from 40 to 70% of A. baumannii were resistant to carbapenems. The secondary bacterial population isolated in pulmonary tuberculosis is represented by nosocomial strains of ESKAPE group, which are typically resistant to modern drugs.
About the Authors
A. V. LavrinenkoKazakhstan
Researcher of Shared Laboratory within Research Center
I. S. Аzizov
Russian Federation
Doctor of Medical Sciences, Professor, Head of Laboratory Unit
S. I. Kolesnichenko
Kazakhstan
Intern Researcher of Shared Laboratory within Research Center
M. T. Kozhamuratov
Kazakhstan
Assistant of Phthisiology Department
N. S. Tabriz
Kazakhstan
Doctor of Medical Sciences, Professor, Head of Phthisiology Department
Zh. Mutaykhan
Kazakhstan
Associate Professor of Phthisiology Department
References
1. Golokhvastova E., Tsarenko S., Litvinova N., Peregudova А., Leonova T., Shakhgildyan V., Olshanskiy А., Mazus А. Variety of opportunistic diseases in HIV infected patients. Vrach, 2012, no. 6, pp. 26-30. (In Russ.)
2. Ivushkina L.V., Mitrokhin S.D., Mironov А.Yu. Gram-negative opportunistic pathogenic bacterial population – etiologic agents of secondary infection in pulmonary tuberculosis patients. Antibiotiki i Khimioterapiya, 2006, vol. 51, no. 1, pp. 11-13. (In Russ.)
3. Kobeleva G.V., Grigorieva E.А. Somatic diseases as a cause of death in those suffering from the active form of tuberculosis. Probl. Tub., 2001, no. 2, pp. 47-49. (In Russ.)
4. Drug susceptibility tests. Guidelines of the Russian Ministry of Health: MUK 4.2.1890-04 от 04.03.2004. 53 p. (In Russ.)
5. Pletnev G.V., Krasnov V.А., Potashova V.А. Treatment of those suffering from destructive pulmonary tuberculosis and non-specific purulent endobronchitis. Probl. Tub., 2003, no. 2, pp. 33-35. (In Russ.)
6. Priymak А.А., Shesterina M.V., Svistunova А.S. Early diagnostics of concurrent non-specific pulmonary diseases in tuberculosis patients. Probl. Tub., 1987, no. 3, pp. 16-18. (In Russ.)
7. Bizzini A., Durussel C., Bille J., Greub G., Prod'hom G. Performance of matrix-assisted laser desorption ionization–time of flight mass spectrometry for identification of bacterial strains routinely isolated in a clinical microbiology laboratory. J. Clin. Microbiol., 2010, no. 48, pp. 1549-1554.
8. CLSI Publishes New Guideline: Laboratory Quality Control Based on Risk Management (EP23-A).
9. Falzon D., Jaramillo E., Wares F., Zignol M., Floyd K., Raviglione M.C. Universal access to care for multidrug-resistant tuberculosis: an analysis of surveillance data. Lancet Infect. Dis., 2013, no. 13, pp. 690-697.
10. Gröschel M.I., Omansen T.F., de Lange W. et al. Multidrug-resistant tuberculosis complicated by nosocomial infection with multidrug-resistant enterobacteriaceae. Am. J. Trop. Med. Hyg., 2016, vol. 94, no. 3, pp. 517-518.
11. Madaras-Kelly K.J., Remington R.E., Sloan K.L., Fan V.S. Guideline-based antibiotics and mortality in healthcare-associated pneumonia. J. Gen. Intern. Med., 2012, vol. 27, no. 7, pp. 845-852.
12. Magiorakos A.P., Srinivasan A., Carey R.B. et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin. Microbiol. Infect., 2012, vol. 18, no. 3, pp. 268-281.
13. Mitrokhin S.D., Ivushkina L.V., Mironov A.Iu. Rational antimicrobial pharmacotherapy of secondary infections in patients with pulmonary tuberculosis. Antibiot. Khimioter., 2005, vol. 50, no. 7, pp. 32-36.
14. Steingart K.R., Schiller I., Horne D.J., Pai M., Boehme C.C., Dendukuri N. Xpert MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults (Review). Cochrane Database Syst Rev., 2014.
15. van Kampen S.C., Tursynbayeva A., Koptleuova A. et al. Effect of introducing xpert MTB/RIF to test and treat individuals at risk of multidrug-resistant tuberculosis in Kazakhstan: A prospective cohort study. PLoS One, 2015, vol. 10, no. 7, pp. e0132514.
16. World Health Organization. Documentation for World Health Assembly 67. Available: http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_11-en.pdf. Accessed 1 Dec 2015.
17. World Health Organization. Global tuberculosis report 2013. Geneva, WHO, 2013.
18. World Health Organization. Library Cataloguing-in-Publication. Data Global tuberculosis report 2016. Geneva. (http://apps.who.int/iris/bitstream/10665/250441/1/9789241565394-eng.pdf)
Review
For citations:
Lavrinenko A.V., Аzizov I.S., Kolesnichenko S.I., Kozhamuratov M.T., Tabriz N.S., Mutaykhan Zh. Pattern and drug sensitivity of non-specific bacterial population in tuberculosis patients with multiple drug resistance. Tuberculosis and Lung Diseases. 2019;97(9):11-16. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-9-11-16