الفهرس 
Mycobacterium Tuberculosis
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Abstract
Tuberculosis is a growing international health concern, since it is the biggest killers among the infectious diseases in the world today, despite the use of a live attenuated vaccine and several antibiotics. After years of decline,TB has re-emerged as a serious public health problem worldwide, especially with increased drug resistance among MTB strains which hinders the success of TB control programs. Isolation, identification, and drug susceptibility testing of MTB and other clinically important mycobacteria can take several weeks because of its slow growth rate. The aim of this study is to diagnose drug resistant tuberculosis using the molecular technique, DNA sequencing. Out of 153 tuberculous patients, 50 resistant cases to one or more of the first line antituberculous drugs (isoniazid, rifampicin, ethambutol and streptomycin) were selected after drug susceptibility testing by BACTEC 460. from 50 resistant cases, genotypic analysis was done only for 23 rifampicin resistant cases (rpoB gene) and 26 isoniazid resistant cases (KatG gene) to detect mutation responsible for drug resistance by automated DNA sequencer (ABI Prism 310 Genetic Analyzer). Conclusions:The percentage of drug resistant tuberculosis in this study was 32.7% and 70% of them had received previous antituberculous treatment compared to 30% new cases.The most common form of drug resistant TB was for INH& RIF and the most common point mutation for INH was at codon 315, while for rifampicin was at codon 531.Rifampicin resistance could be used as a useful surrogate marker for estimation of multidrug resistance and indicated that the second line drugs are urgently required. The molecular technique, automated DNA sequencing, inspite of its high cost is of value in rapid detection of drug resistance (8 hours) resulting in improving the ability of clinicians to optimize early therapy.