الفهرس 
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Abstract
Tuberculosis (TB) is one of the major unresolved global health problems. Over the past two decades, two major obstacles to global TB control have emerged. The first is the high prevalence of human immunodeficiency virus among TB patients in certain regions, and the second is the growing problem of anti-tuberculous drug resistance.
The World Health Organization estimates that, in 2008, 2 billion people have latent TB, while another 3 million people worldwide die of TB each year.
Rapid diagnosis of pulmonary TB as well as rapid detection of drug resistance is essential for both the treatment and control of the disease.
Multi-drug resistant (MDR) TB is defined as resistance to at least isonaizid and rifampicin (RMP). Rapid and early detection of RMP resistance, which is an important marker of multidrug resistance, may be useful from the clinical point of view, as it identifies patients who do not respond to chemotherapy and need to be treated with appropriate regimens including second-line drugs. Also, it helps to reduce disease transmission.
Current standard methods for the detection of MDR-TB include the proportional method which performed on Lowenstein-Jensen (LJ) medium, absolute concentration resistance ratio methods and the radiometric method in BACTEC-640 system are lengthy, laborious and produce radioactive waste that is difficult to manage in low resource countries.
Commercial methods, such as the mycobacteria growth indicator tube (MGIT) and molecular methods, have been introduced, however, athough they are rapid, these methods are expensive and could not be easily implemented in developing countries and require sophisticated laboratory infra structure and trained personnel.
Therefore there is an urgent need to develop accurate, rapid and low cost alternative diagnostic tests for antimicrobial susceptibility testing of M.Tuberculosis.
The purpose of our study was evaluation of nitrate reductase assay method as a rapid and inexpensive method as a drug susceptibility for detecting Rifampicin resistant myobacterial tuberculosis.
The current study proves Nitrate reductase assay as a rapid test of high accuracy that could be an alternative to conventional methods in the diagnosis and susceptibility testing of Rifampicin resistant M. tuberculosis.