Drug resistance to anti-tuberculotics in children - three years status in Slovakia

Abstract

Drug resistant tuberculosis is a serious and increasing problem worldwide, particularly in countries with a high incidence of tuberculosis and HIV infections. Resistant tuberculosis in children is usually due to the transmission of resistant strains from the environment where they live. Most often it is a transfer from the parents, or other relatives. A paucibacillary nature of the disease in children associated with difficulties in a collection of adequate sputum samples means that the samples are often microscopically negative. If the cultivation is negative, any bacteriological confirmation of the drug resistance is impossible. The aim of this study was to review current diagnostic and therapeutic principles in tuberculosis in children and to demonstrate its incidence in population of the Slovak Republic during 2010-2012. We have retrospectively analyzed all children sputum samples from children with diagnosed tuberculosis in Slovakia. The classical bacteriological analysis (culture on solid eggs-based media) was used to confirm the mycobacterium tuberculosis infection and the proportion method was applied to test its susceptibility or resistance to mostly used antituberculotics. In years 2010-2012, three cases of resistant form of tuberculosis have been diagnosed in Slovakia among 16 children with cultivation positive to tuberculosis. In all of the cases the INH mono-resistance was confirmed (with the same strains present in their relatives), suggesting primary resistance origin of infection. To ensure an appropriate and successful treatment of tuberculosis in children, accurate and timely diagnostics and determination of susceptibility to anti-tuberculotics is essential.

Keywords

• tuberculosis
• children
• resistance
• anti-tuberculotics
• slovakia