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. intracellulare 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 pyrazimanide is particularly
difficult. When the therapeutic regimen is based on DST response to
therapy is successful even in resistant cases.