Chest
Original ResearchTuberculosisEmergence of New Forms of Totally Drug-Resistant Tuberculosis Bacilli: Super Extensively Drug-Resistant Tuberculosis or Totally Drug-Resistant Strains in Iran
Section snippets
Setting
The National Research Institute of Tuberculosis and Lung Diseases (NRITLD) (Tehran, Iran) acts as the sole national referral center for TB in Iran. Located inside the NRILTD is a National Reference Tuberculosis Laboratory, which is under the technical supervision of the Supranational Reference Laboratories of the Swedish Institute for Infectious Diseases Control (Solna, Sweden). Under the National Tuberculosis Control program, all the MDR and relapse cases of TB are referred to the NRITLD for
Study Population
From October 2006 to October 2008, 166 MDR-TB patients were referred to the NRITLD for treatment and diagnosis. Of these patients, 20 patients (12%) had infection with mycobacterium other than tuberculosis. The results of susceptibility against first-line drugs were improved resistance to INH and RF in the remaining MTB isolates (n = 146). The results of susceptibility against second-line drugs were as follows: 65 strains (44.5%) were susceptible to all drugs tested, 8 strains were XDR (5.4%),
Discussion
This study represents the first report on the existence and prevalence of TDR strains in Iran. TDR strains not only constitute a deadly threat to the affected patients with TB but also hamper the TB-control program. Previously, we identified two clusters of XDR-TB isolates in both family and community outbreaks.2 These strains were fully capable of being transmitted and causing active diseases in individuals with secondary cases. In the present report, 95% of XDR and TDR strains were isolated
Acknowledgments
Author contributions: Drs. Velayati and Masjedi participated in the study conception and manuscript review. Dr. Farnia designed and implemented the study, and wrote the manuscript. Drs. Tabarsi, Ghanavi, ZiaZarifi, and Hoffner reviewed the data and manuscript.
Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Other contributions: We
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Funding/Support: This research was funded by the Medical Research Council/National Research Institute of Tuberculosis and Lung Disease/World Health Organization grant No. 0116-28–2006.
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