Analysis of Mycobacterium tuberculosis isolates from treatment failure patients living in East Timor
Date
2005
Authors
Kelly, P.
Lumb, R.
Pinto, A.
da Costa, G.
Sarmento, J.
Bastian, I.
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Journal article
Citation
International Journal of Tuberculosis and Lung Disease, 2005; 9(1):81-86
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Abstract
<h4>Setting</h4>In the first 2 years of the East Timor National TB Control Programme, 7960 new patients were treated (2RHZE/6HE) and 224 received a retreatment regimen (2SRHZE/1RHZE/4R3H3Z3E3).<h4>Objective</h4>To determine the nature and extent of drug-resistant tuberculosis (TB) in treatment failure cases in East Timor.<h4>Methods</h4>Sputum specimens from retreatment failure cases were processed and inoculated into a BACTEC MGIT960 tube and onto Löwenstein-Jensen media. Isolates were identified by Ziehl-Neelsen staining, hybridisation with nucleic acid probes and biochemical investigations. Susceptibility testing was performed using the radiometric proportion method. Pyrazinamide testing was performed using the Wayne indirect method.<h4>Results</h4>Eighteen patients failed retreatment (0.7% of new cases) and 14 were available for analysis. Mycobacterium tuberculosis was cultured from all specimens, despite considerable transport delays. Nine (64.3%) had multiple drug resistance (MDR-TB) and four (28.6%) had other drug resistance. All MDR-TB isolates were susceptible to amikacin, capreomycin and ethionamide, with most also susceptible to ciprofloxacin and para-aminosalicylic acid (PAS).<h4>Conclusions</h4>An excellent TB control programme has been established in East Timor. If funds are available, East Timor provides an ideal setting for a small-scale DOTS-Plus programme to treat prevalent cases of MDR-TB, and this study could inform the second-line drug regimen.