STUDY OF DRUG RESISTANCE PROFILE IN RETREATMENT CASES OF PULMONARY TUBERCULOSIS IN A TERTIARY CARE CENTRE
Main Article Content
Keywords
Drug Resistance, Tuberculosis, CBNAAT, Line Probe Assay, Comorbidities.
Abstract
Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains one of the world’s deadliest communicable diseases, with India accounting for 2.1 million cases annually and ranking second in the global burden of multidrug-resistant (MDR) TB. Approximately 50,000 MDR-TB cases are recorded each year among retreatment pulmonary TB cases in India. This study aims to determine the proportion and pattern of drug resistance in retreatment cases of pulmonary tuberculosis.
Methodology
A prospective observational study was conducted over a period of 18 months at Rajarajeshwari Medical College and Hospital, Bengaluru, including both outpatient and inpatient cases, as well as patients suspected of drug resistance TB at the Revised national tuberculosis control programme (RNTCP) centre/ (National tuberculosis elimination programme (NTEP). All participants regardless of their sputum status ,provided two sputum samples which were analysed by cartridge based nucleic acid amplification test (CBNAAT) and line probe assays (LPA) for first- and second-line drugs and/or drug susceptibility testing at a state-accredited laboratory.
Results
Of 100 patients enrolled, 14 were found to be drug-resistance, twelve with resistance to both rifampicin and isoniazid and two with isoniazid mono-resistance. All other patients were sensitive to both first-line and second-line anti-tubercular drugs. Co-morbidities such as diabetes, HIV, malnutrition and social habits including smoking, alcohol consumption and tobacco use were associated with increased incidence of drug resistance.
Conclusion
Early diagnosis using molecular methods and prompt initiation of appropriate antitubercular therapy are crucial for reducing the morbidity and mortality associated with drug-resistant TB.
References
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Dr. Kanabur Prashanth
Assistant Professor, Department of Respiratory Medicine, BGS Medical College and Hospital (BGSMCH), Bengaluru, Karnataka, India.
Dr. K. Thirthashree
Assistant Professor, Department of Respiratory Medicine, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India.
Dr. Pynuru Lalitha
Microbiologist, Principal of Regional Health and Family welfare training centre, Kurnool, Andhra Pradesh, India.