Pattern of Drug Resistance Among Patients Presenting with Relapse of Pulmonary Tuberculosis

Authors

  • Muhammad Hammad Department of Medicine, Pak Emirates Military Hospital, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Sharjeel Mayo Hospital Lahore
  • Imran Fazal Department of Medicine, Pak Emirates Military Hospital, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Amna Aziz Department of Haematology, Armed Forces Institute of Pathology/ National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Farhan Shahid Department of Medicine, Pak Emirates Military Hospital, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Mahmood Iqbal Department of Medicine, Pak Emirates Military Hospital, Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.7772

Keywords:

Antitubercular Agents, Drug Resistance, Drug Susceptibility Testing, Extensively Drug-resistant Tuberculosis, Multidrug-resistant Tuberculosis

Abstract

Objective: To assess the patterns of drug resistance (DR) among patients previously treated for pulmonary tuberculosis (TB).

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Medicine, Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2020 to Mar 2021.

Methodology: Patients with previously treated pulmonary TB were included, based on their clinical history and characteristic chest X-ray findings. Patients were evaluated through an examination of sputum and/or bronchoalveolar washings for acidfast bacilli (AFB), Mycobacterium TB-GeneXpert/RIF (Rifampicin) assay, and mycobacterial culture with drug susceptibility testing (DST). Patients with resistance to any anti-TB drug were classified as cases of DR-TB, and a pattern of drug resistance was documented.
Results: One hundred twenty patients were identified as having been previously treated for TB. DST demonstrated DR-TB among 38(31.7%) cases, while isoniazid (INH) resistance was the most commonly reported problem in 29(24.2%) cases. Up to 26(21.6%) relapsing cases were resistant to Rifampicin (RFM). Moreover, 15(12.5%) instances of resistance against second-line anti-TB drugs (fluoroquinolones and aminoglycosides) were documented. Multidrug-resistant TB (MDR-TB) was the most prevalent resistance pattern in 20(16.7%) cases, followed by mono-drug-resistant TB in 7(5.8%) and extensively resistant TB (XDR-TB) in 2(1.6%) cases. No definitive resistance pattern was evident among 9(7.5%) cases.

Conclusion: MDR-TB constitutes a major barrier in the line of TB eradication in Pakistan. Strict compliance with anti-TB protocols, along with a universal application of DST, can minimize the overall prevalence of relapsing cases of TB

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Published

29-04-2024

How to Cite

1.
Hammad M, Muhammad Sharjeel, Imran Fazal, Amna Aziz, Farhan Shahid, Mahmood Iqbal. Pattern of Drug Resistance Among Patients Presenting with Relapse of Pulmonary Tuberculosis. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):362-6. Available from: https://pafmj.org/PAFMJ/article/view/7772

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