DRUG RESISTANT TUBERCULOSIS - THE EMERGING SCENARIO

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) remains a significant global health challenge.
• Drug resistance in Mycobacterium tuberculosis complicates treatment and control efforts.
• Understanding drug resistance patterns is crucial for effective TB management strategies.

Purpose of the Study:

• To determine the prevalence of drug resistance in Mycobacterium tuberculosis isolates from pulmonary TB patients.
• To identify common drug resistance patterns, including single and multidrug resistance.
• To differentiate between initial and acquired drug resistance in the patient cohort.

Main Methods:

• Retrospective analysis of 2288 pulmonary tuberculosis patients treated between April 1992 and September 1994.
• Isolation and identification of Mycobacterium tuberculosis from sputum samples.
• Indirect drug susceptibility testing using drug-incorporated Lowenstein-Jensen medium.

Main Results:

• Mycobacterium tuberculosis was isolated from 45.3% of patients.
• Overall drug resistance was observed in 13.7% of isolates.
• Streptomycin resistance (8.3%) was most frequent, followed by isoniazid (5.7%) and rifampicin (5.0%).
• Single drug resistance occurred in 8.3% and resistance to two or more drugs in 5.4% of patients.
• Initial drug resistance (83 cases) was more common than acquired drug resistance (59 cases).
• Multidrug resistance was predominantly acquired (71.4% of drug-resistant isolates).

Conclusions:

• A significant proportion of pulmonary tuberculosis cases exhibited drug resistance during the study period.
• Streptomycin, isoniazid, and rifampicin resistance are key concerns in this population.
• The high rate of acquired multidrug resistance highlights the need for improved treatment adherence and monitoring.