Current pattern of drug resistance in new cases of pulmonary tuberculosis at a tertiary care centre in India
DOI:
https://doi.org/10.18203/2349-3933.ijam20150543Keywords:
Pulmonary tuberculosis, New case, Monodrug resistance, Polydrug resistance, Multidrug resistanceAbstract
Background: Drug resistant tuberculosis is a major obstacle in the effective control of tuberculosis. Early diagnosis of drug resistance using drug susceptibility testing can help treat the patient effectively. Drug resistance can be monodrug resistance, polydrug resistance or multidrug resistance. The aim of the study was to determine the current pattern of drug resistance in new cases of pulmonary tuberculosis.
Methods: A prospective observational study was carried out from November 2012 to October 2014 in the Department of Pulmonary Medicine, Era’s Lucknow Medical College and Hospital, Lucknow. The study consisted of 221 new cases of pulmonary tuberculosis which were sputum smear positive for AFB (Acid fast bacilli). One sputum sample from each patient was sent for culture and Drug Susceptibility Testing (DST) to first line anti-tuberculosis drugs on Lowenstein-Jensen medium. Statistical analysis was done with chi-square test.
Results: A total of 221 new sputum positive cases of pulmonary tuberculosis were diagnosed during the study period, of which 189 were culture positive for Mycobacterium tuberculosis. Drug resistance to first line anti-tuberculosis drugs among new cases of pulmonary tuberculosis was observed in 15.3% cases in our study. Multidrug resistant tuberculosis was observed to be 4.2% in these new cases.
Conclusions: Multidrug resistance seems to be on a rise in the new cases of pulmonary tuberculosis in our country.
References
World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis. In: WHO, eds. WHO Guideline. 4th ed. WHO/HTM/TB/2009.422. Geneva: WHO; 2009.
Jacobs RF. Multiple drug resistant tuberculosis. Clin Infect Dis. 1994;19(1):1-10.
Malin AS, McAdam KP. Escalating threat from tuberculosis: the third epidemic. Thorax. 1995;50:S37-42.
Espinal MA, Kim SJ, Suarez PG, Kam KM, Khomenko AG, Migliori GB, et al. Standard short course chemotherapy for drug resistant tuberculosis: treatment outcomes in 6 countries. JAMA. 2000;283(19):2537-45.
Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med. 2003;167(4):603-62.
WHO. Tuberculosis control in South-East Asia region: annual report, 2014. Available at: http://www.searo.who.int/tb/en/.
Sharma SK, Kaushik G, Jha B, George N, Arora SK, Gupta D, et al. Prevalence of multidrug resistant tuberculosis among newly diagnosed cases of sputum positive pulmonary tuberculosis. Indian J Med Res. 2011;133:308-11.
Rai SP, Bhattacharyya D, Kashyap M. Pattern of initial drug resistance and its impact on short course chemotherapy of pulmonary tuberculosis. Lung India. 2007;24:51-3.
Santha T, Thomas A, Chandrasekaran V, Selvakumar N, Gopi PG, Subramani R, et al. Initial drug susceptibility profile of M. tuberculosis among patients under TB programme in South India. Int J Tuberc Lung Dis. 2006;10(1):52-7.
Pereira M, Tripathy S, Inamdar V, Ramesh K, Bhavsar M, Date A, et al. Drug resistance pattern of Mycobacterium tuberculosis in seropositive and seronegative HIV-TB patients in Pune, India. Indian J Med Res. 2005 Apr;121(4):235-9.
World Health Organization (WHO). Global tuberculosis report 2014. Geneva, Switzerland: World Health Organization; 2014.
Government of India. TB India-2014. Revised National TB Control Programme, Annual Status Report. India: Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India; 2014.
