Drug resistance trends in Tuberculosis cases: Insights from a decade of surveillance data

Ergin B. B., EKUKLU G.

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2026 (SCI-Expanded, Scopus)

Özet

Purpose This study aimed to examine 10-year trends in anti-tuberculosis drug resistance in T & uuml;rkiye (2010-2020), to evaluate the rates of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB), and to statistically identify potential change points in resistance patterns. Methods A descriptive analysis was conducted using drug susceptibility testing (DST) data from the Ministry of Health's annual tuberculosis control reports. Resistance rates for isoniazid, rifampicin, ethambutol, streptomycin, MDR-TB, and XDR-TB were analyzed. Joinpoint regression identified significant trend changes, calculating Annual Percent Change (APC) and Average Annual Percent Change (AAPC) with 95% confidence intervals. Results Among 59,131 cases tested, isoniazid resistance peaked in 2012 before declining significantly (AAPC: -1.94; p = 0.012). Rifampicin and ethambutol resistance decreased continuously without breakpoints, while streptomycin resistance rose until 2015 then declined. MDR-TB rates declined significantly (AAPC: -7.92; p < 0.001). In 53,197 newly diagnosed cases, breakpoints were observed for isoniazid (2012) and ethambutol (2014) resistance. In 5,934 previously treated cases, significant post-breakpoint declines occurred for rifampicin, ethambutol, streptomycin, and MDR-TB resistance. XDR-TB was detected in 48 of 2,321 MDR-TB cases, with a non-significant upward trend (AAPC: 18.39; p = 0.136). Conclusion Overall, tuberculosis drug resistance rates in T & uuml;rkiye showed significant declines from 2010 to 2020, particularly for MDR-TB. However, persistent resistance in previously treated cases and the continued presence of XDR-TB highlight the need for rapid diagnostics, optimized case management, and increased investment in novel anti-TB drugs to curb resistant strain transmission.