Pattern of Drug Resistance Among Patients Presenting with Relapse of Pulmonary Tuberculosis
DOI:
https://doi.org/10.51253/pafmj.v74i2.7772Keywords:
Antitubercular Agents, Drug Resistance, Drug Susceptibility Testing, Extensively Drug-resistant Tuberculosis, Multidrug-resistant TuberculosisAbstract
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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