Pattern and trends of drug sensitivity in MDR-TB cases in Delhi (2009-2014): A record based study

This study was conducted with the objective to understand pattern and trends in drug sensitivity among MDR-TB cases in Delhi from 2009 to 2014 using existing records.

A retrospective record-based study was conducted at three Drug-resistant TB (DR-TB) treatment centers in Delhi. For data collection, patient treatment cards and TB registers were accessed. All multidrug-resistant (DR) TB patients registered, and initiated on treatment from January 2009 to December 2014 in three DR-TB centers were included in the study.

A cumulative total of 2958 MDR-TB cases were registered in the three DR-TB centers during the period from Jan 2009 to December 2014. The median value time interval between culture test result and initiation of treatment was 82 days. High resistance was found against Streptomycin (70%), Ethambutol (40.1%), Ofloxacin (42.4%) and Kanamycin (12%). Favorable treatment outcomes ranged from 52.5% to 56.9% in cases resistant to only first-line anti-TB drugs but was much lower in the pre XDR-TB cases (26.3%) and XDR-TB cases (12.5%).

The proportion of cases with additional resistance to ofloxacin, kanamycin, ethionamide, and streptomycin increased over time from 2009 to 2014. Reducing the time to treatment initiation from initial diagnosis of MDR-TB could further improve treatment outcomes.