DRUG-RESISTANT MYCOBACTERIUM-TUBERCULOSIS AND ATYPICAL MYCOBACTERIA ISOLATED FROM PATIENTS WITH SUSPECTED PULMONARY TUBERCULOSIS IN HONDURAS

Background: Tuberculosis is a major health problem in Central America. In Honduras, with an incidence rate of 81/100,000, it is an increasin gly common cause of morbidity and hospitalization. This study was cond ucted to examine drug-resistant tuberculosis and prevalence of infecti on with atypical mycobacteria in Honduran patients with suspected pulm onary tuberculosis. Methods: Pulmonary specimens from 235 Honduran pat ients with suspected tuberculosis were examined by acid-fast smears an d culture. The 95 mycobacterial strains isolated were identified to sp ecies level and drug susceptibility tests were carried out. Resistant Mycobacterium tuberculosis strains were tested for susceptibility to s ix additional drugs. Their possible relationship was studied by DNA re striction fragment length polymorphism. Results: Drug-resistant strain s were found in 13 of 85 culture-verified tuberculosis patients, inclu ding 10 with isolates of multidrug-resistant bacteria. Seven of the pa tients with multidrug-resistant tuberculosis had smear-positive diseas e. Nine of them had a history of specific therapy. Two patients with d rug-resistant disease were shown to be infected by identical strains. Only one of 11 HIV-positive patients had drug-resistant tuberculosis. Most resistant strains were susceptible to ciprofloxacin, amikacin, ka namycin, and pyrazinamide. Atypical mycobacteria were isolated from 10 patients with suspected tuberculosis. Seven of them were receiving an tituberculosis chemotherapy and five had smear-positive samples. Concl usions: These results illustrate the importance of mycobacterial cultu re and subsequent species identification and in vitro susceptibility t esting for identification of patients with drug-susceptible or drug-re sistant tuberculosis and those infected or colonized with other mycoba cteria.