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P Mohajeri, A Tavakoli, S Moghim,
Volume 17, Issue 66 (5-2009)

Background and Objective: Drug resistance to tuberculosis is continuously increasing and is a significant threat to tuberculosis control programs because afew effective drugs are present against Mycobacterium tuberculosis. Although isoniazid (INH) is the most effective drug against tuberculosis, resistance to this drug also develops readily. Mutations in katG, specially the Ser315Thr substitution, are responsible for isoniazid resistance in a large proportion of patients with tuberculosis. However, the frequency of the katG Ser315Thr substitution varies among population samples. This study provided molecular characterization of isoniazid resistance of M. tuberculosis strains and extended our knowledge about molecular basis of M. tuberculosis drug resistance that is widely applicable for rapid drug resistance detection. Materials and Methods: Using 1% proportional method, the sensitivity of 126 strains isolated from patients in Isfahan and Tehran to isoniazid was determined. The katG mutations in codon 315 associated with isoniazid resistance among isoniazid resistant isolates was determined by PCR-RFLP. In this way, 355 bp PCR products were digested by MspI. Results: Out of 126 isolates of M. tuberculosis, 32 (25.4%) strains were determined as INH resistant. Resistance rate was 22.6% (19 strains) in Isfahan and 31% (13 strains) in Tehran. Overall, 72% of isoniazid-resistant isolates could be identified by analysis of just katG 315 loci. Conclusion: The PCR-RFLP using MspI restriction enzyme that detects katG Ser315Thr substitution could be identified in 72% of isoniazid-resistant strains. Elucidation of the molecular characterization of isoniazid resistance in M. tuberculosis has led to the development of different genotypic approaches to the rapid detection of isoniazid resistant in clinical isolates.

F Didgar, H Sarmadian, N Zarin Far, M Rafiee, M Choghae,
Volume 20, Issue 80 (7-2012)

Background and Objective: Brucellosis is an endemic disease in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, in this study we compared the efficiency of the WHO's standard regimen of rifampin-doxycycline (RD) versus ciprofloxacin-doxycycline (CD) for the treatment of brucellosis. Materials and Methods: This randomized controlled trial was performed on 90 patients, affected with brucellosis, who were referred to the Infectious Disease Clinics at Arak University of medical sciences. The patients were randomly divided into two groups: the DR group, received 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks and the CD group, received 100 mg of doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment. Results: In this study, the rate of symptom relief and laboratory findings in both groups were similar. The relief of symptoms was seen in 93.2% and 83.9% of the patients for the DR and CD groups, respectively (P=0.182). The side effects of the drug were not significant in either groups, with no significant difference, and did not lead to discontinuation of the therapy. Conclusion: Due to the similar efficacy of CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate treatment.

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