Abstract
Background
The aim of the present study was to evaluate the demographic, clinical and microbiological data of the patients who are followed up by the tuberculosis outpatient clinic, Pulmonary Department of Aristotle University of Thessaloniki.
Patients and methods
Since July 2011, 45 patients (33 men, 12 women, with mean age 47.66±17.82 years) have been monitored. Twenty two are economic migrants, coming mostly from Eastern Europe. Forty patients suffer from tuberculosis, and 5 from infection caused by non-tuberculous mycobacteria (3 by M. intracellular complex and 2 by M. kansasii). Tuberculosis is located in the lung in 34 patients. In 2 patients the lesions are located at the lung as well as the pleura, in 1 at the lung and the bone marrow, in 1 at the pleura and the wrist joint, in 1 on the skin and in 1 at the lung, esophagus and cheek. 90% of patients demonstrate compliance regarding the scheduled meetings of monitoring and their treatment. Ten patients have already successfully completed treatment. Concerning the sensitivity of M. tuberculosis to anti-tuberculosis drugs, drug susceptibility testing (DST) is available for 35 patients. For the remaining 5 patients with unavailable DST results either the treatment had started before a mycobacterium strain was identified or they were referred to the clinic from other hospitals where DST was not possible.
Results
Three patients suffer from MDR tuberculosis and 27 patients from tuberculosis due to strains that are resistant to at least one drug. More specifically M. tuberculosis was resistant to isoniazide at 6 cases (17.14%), to rifampicin at 3 (8.57%), to ethambutol at 4 (11.43%), to pyrazinamide at 17 (48.57%), to streptomycin at 11 (31.43%), and to the low dose of rifampicin at 6 (17.14%). Treatment according to DST is successful in 91% of patients.
Conclusions
In conclusion, resistance to at least one drug was detected in a significant part of the patients (77.14%). It is noteworthy that resistance to pyrazinamide was observed in 48.57% of the strains. It is known that drug susceptibility testing for pyrazinanide is particularly difficult. When the therapeutic regimen is based on DST response to therapy is successful even in resistant cases.