First-Line Anti-Tubercular Drug Resistance of Mycobacterium tuberculosis in IRAN: A Systematic Review.

Babak Pourakbari,Shima Mahmoudi,Setareh Mamishi,Mona Mohammadzadeh

doi:10.3389/fmicb.2016.01139

Abstract

Background: The spread of drug-resistant tuberculosis (TB) is one of the major public health problems through the world. Surveillance of anti-TB drug resistance is essential for monitoring of TB control strategies. The occurrence of drug resistance, particularly multi-drug resistance Mycobacterium tuberculosis (MDR), defined as resistance to at least rifampicin (RIF) and isoniazid (INH), has become a significant public health dilemma. The status of drug-resistance TB in Iran, one of the eastern Mediterranean countries locating between Azerbaijan and Armenia and high-TB burden countries (such as Afghanistan and Pakistan) has been reported inconsistently. Therefore, the aim of this study was to summarize reports of first-line anti-tubercular drug resistance in M. tuberculosis in Iran.Material and Methods: We systematically reviewed published studies on drug-resistant M. tuberculosis in Iran. The search terms were “Mycobacterium tuberculosis susceptibility” or “Mycobacterium tuberculosis resistant” and Iran.Results: Fifty-two eligible articles, published during 1998–2014, were included in this review. Most of the studies were conducted in Tehran. The most common used laboratory method for detecting M. tuberculosis drug resistant was Agar proportion. The highest resistance to first-line drugs was seen in Tehran, the capital city of Iran. The average prevalence of isoniazid (INH), rifampin (RIF), streptomycin (SM), and ethambotol (EMB) resistance via Agar proportion method in Tehran was 26, 23, 22.5, and 16%, respectively. In general, resistance to INH was more common than RIF, SM, and EMB in TehranConclusions: In conclusion, this systematic review summarized the prevalence and distribution of first-line anti-tubercular drug resistance of M. tuberculosis in Iran. Our results suggested that effective strategies to minimize the acquired drug resistance, to control the transmission of resistance and improve the diagnosis measures for TB control in Iran.

Highlights

Tuberculosis (TB) remains as one of the most common infectious disease in developing countries (Nasiri et al, 2014)
There is not a complete data about first-line antitubercular drug resistance of Mycobacterium tuberculosis in Iran, one of the eastern Mediterranean countries locating between Azerbaijan and Armenia and high-TB burden countries
A study which was conducted by Velayati et al (2014), in years 2010–2011, has been investigated drug resistant in various places in Iran (Tehran, Sistan ba Balochestan, Khozestan, Khorasan, Ardebil, Qom, Golestan, Isfahan, Gilan, Fars, Hormozgan, Mazandaran, Semnan, Lorestan, Hamedan, Kerman, Kordestan, Kermanshah, Markazi, Yazd, and Qazvin (Velayati et al, 2014), but we identified it as 1 study in search flow diagram, it was considered for Nasiri et al study too (Nasiri et al, 2014)

Summary

Introduction

Tuberculosis (TB) remains as one of the most common infectious disease in developing countries (Nasiri et al, 2014). There is not a complete data about first-line antitubercular drug resistance of Mycobacterium tuberculosis in Iran, one of the eastern Mediterranean countries locating between Azerbaijan and Armenia and high-TB burden countries (such as Afghanistan and Pakistan). Based on national wide survey conducted in 1999, among all M. tuberculosis isolates tested for drug susceptibility, 10.9% were resistant to = 1 anti-TB drug, and 6.7% were resistant to both INH and RIF (Organization, 2000). The occurrence of drug resistance, multi-drug resistance Mycobacterium tuberculosis (MDR), defined as resistance to at least rifampicin (RIF) and isoniazid (INH), has become a significant public health dilemma. The status of drug-resistance TB in Iran, one of the eastern Mediterranean countries locating between Azerbaijan and Armenia and high-TB burden countries (such as Afghanistan and Pakistan) has been reported inconsistently. The aim of this study was to summarize reports of first-line anti-tubercular drug resistance in M. tuberculosis in Iran

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Conclusion