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- W2912400670 abstract "This letter is a reply to the points raised by Dr. Alrajhi regarding our recently published article in CHEST (November 2005).1Al-Tawfiq JA Al-Muraikhy AA Abed MS Susceptibility pattern and epidemiology ofMycobacterium tuberculosisin a Saudi Arabian hospital: a 15-year study from 1989 to 2003.Chest. 2005; 128: 3229-3232Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar The terminology used for resistant tuberculosis (TB) in the literature has included multidrug resistant (MDR), two-drug resistant, and polyresistant. MDR-TB refers to a subgroup of polyresistant organisms. We agree that MDR-TB is usually defined as resistance to at least isoniazid and rifampin with or without resistance to other agents. This is based on the fact that isoniazid and rifampin resistance is the most important type of resistance to first-line agents. However, the term MDR-TB has also been used to describe resistance to any two drugs.2Kritski AL Rodrigues de Jesus LS Andrade MK et al.Retreatment tuberculosis cases: factors associated with drug resistance and adverse outcomes.Chest. 1997; 111: 1162-1167Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar The variable use of MDR-TB was highlighted in an editorial comment by Sbarbaro,3Sbarbaro JA “Multidrug”-resistant tuberculosis: it is time to focus on the private sector of medicine.Chest. 1997; 111: 1149-1151Abstract Full Text Full Text PDF Scopus (22) Google Scholar who noted that the term multidrug-resistant is used to identify organisms that are resistant to both isoniazid and rifampicin in the United States but is used more commonly in the rest of the world to include organisms that are resistant to any two or more antimycobacterial drugs.3Sbarbaro JA “Multidrug”-resistant tuberculosis: it is time to focus on the private sector of medicine.Chest. 1997; 111: 1149-1151Abstract Full Text Full Text PDF Scopus (22) Google Scholar We clearly defined multidrug resistance as resistance to two or more first-line agents. Our data also show that the rate of MDR is very low. If the definition of MDR is restricted to resistance to isoniazid and rifampicin, the rate of MDR-TB in the study would be 0.37 to 0.7%, as shown in Table 2 in our study.1Al-Tawfiq JA Al-Muraikhy AA Abed MS Susceptibility pattern and epidemiology ofMycobacterium tuberculosisin a Saudi Arabian hospital: a 15-year study from 1989 to 2003.Chest. 2005; 128: 3229-3232Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar Unfortunately, the article by Al-Jama et al4Al-Jama AA Borgio FG Al-Qatari KM Patterns of resistance to antituberculous drugs in Eastern Province, Saudi Arabia.Saudi Med J. 1999; 20: 927-930PubMed Google Scholar was not referenced on MEDLINE, and we did not come across that study. It was not our intent to omit the review of any pertinent published data, and we apologize for the omission. We also thank Dr. Alrajhi for bringing this study to our attention. The rate of ethambutol resistance in our study was 7.5%,1Al-Tawfiq JA Al-Muraikhy AA Abed MS Susceptibility pattern and epidemiology ofMycobacterium tuberculosisin a Saudi Arabian hospital: a 15-year study from 1989 to 2003.Chest. 2005; 128: 3229-3232Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar which is higher than the rate found in other studies from Saudi Arabia, including the study by Alrajhi and Al-Barrak.5Alrajhi AA Al-Barrak AM Mycobacterium tuberculosissusceptibility in Saudi Arabia.Saudi Med J. 2002; 23: 1227-1231PubMed Google Scholar However, the resistance rate to ethambutol found in our study is not very different from those reported from at least one region of Saudi Arabia. For example, the rate of ethambutol resistance in Jeddha was 6.9%.6Khan MY Kinsara AG Osoba AO et al.Increasing resistance ofM tuberculosisto anti-TB drugs in Saudi Arabia.Int J Antimicrob Agents Chemother. 2001; 17: 415-418Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar However, the exact reason for such a resistance rate could not be identified from the retrospective study. The rates of resistance to antituberculous medications differ between newly diagnosed patients with TB and those who have received treatment. We could not track the details of any previous treatment. However, the majority of the patients had not received previous treatment for TB during the study period. Although we stated in the abstract of our study1Al-Tawfiq JA Al-Muraikhy AA Abed MS Susceptibility pattern and epidemiology ofMycobacterium tuberculosisin a Saudi Arabian hospital: a 15-year study from 1989 to 2003.Chest. 2005; 128: 3229-3232Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar that “resistance to isoniazid showed decreased rate over the study period from 20 to 5.7%,” the specific data were not shown in the study. We apologize for not including the specific data in the article." @default.
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- W2912400670 date "2006-03-01" @default.
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- W2912400670 title "Mycobacterium tuberculosis in a Saudi Arabian Hospital" @default.
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- W2912400670 doi "https://doi.org/10.1016/s0012-3692(15)52299-x" @default.
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