Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis

This study was carried out to isolate M. tuberculosis from smear positive sputum samples by MB/BacT automated culture system and investigate the drug resistance pattern. Among 101 smear positive cases 96 (95.05 %) yielded growth of Mycobacteria, 3 (02.97 %) were contaminated and 2 (01.98 %) showed no growth. Culture positive detection time for M. tuberculosis was lowest 7 days and highest 36.3 days and average detection time was11.3 days. Detection time for NTM was 19.2 days. Among 96 isolates 95 (98.96 %) were M. tuberculosis and remaining 1 (1.04 %) was photochromogen Non-tuberculous Mycobacteria (NTM). Out of 95 M. tuberculosis 51 (53.84 %) were resistant to at least one drug, 38 (40.00 %) to INH, 31 (32.63%) to RMP, 13(13.68 %) to SM, 11 (11.58 %) to EMB and 10 (10.53 %) to PZA and multi-drug resistant tuberculosis (MDR-TB) was 21 (22.11 %). Resistance to one drug was 21 (22.11%), two drugs 15 (15.79 %), to three drugs 10 (10.53 %) and resistant to four or more drugs 5(5.26 %) cases.Bangladesh J Med Microbiol 2010; 03 (02): 13-17

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Pattern of drug resistance in multi drug resistant tuberculosis patients in Punjab, Pakistan

International Journal of Biosciences (IJB) ◽

10.12692/ijb/11.1.372-379 ◽

2017 ◽

Vol 11 (1) ◽

pp. 372-379

Keyword(s):

Drug Resistance ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis

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Drug-resistant Tuberculosis: First Line Drug Resistance Pattern among Mycobacterium Tuberculosis Strains Isolated from a Reference Laboratory in Kerala State, India

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.4.09 ◽

2021 ◽

Author(s):

Neetha S Murthy ◽

Sanjeev Nair ◽

PK Ramya ◽

Renu Susan George ◽

B Ravikrishnan ◽

...

Keyword(s):

Drug Resistance ◽

Resistance Mutation ◽

Resistance Pattern ◽

Reference Laboratory ◽

Drug Resistant ◽

Isoniazid Resistance ◽

Drug Resistant Tuberculosis ◽

Resistant Tuberculosis ◽

Drug Resistance Pattern ◽

S531l Mutation

Resistance to antimycobacterial agents consistently remains a major obstacle to end TB in India. Geographical prevalence data regarding drug-resistant evolutionary genetics of M. tuberculosis (MTB) remains sparse in India. Our objective was to determine the genotypic drug resistance mutation pattern for Rifampicin and Isoniazid of MTB isolates to gain an understanding of the prevailing molecular epidemiology of drug-resistant tuberculosis. In this study 2528 M. tuberculosis DNA isolates from presumptive DRTB suspects received at the nodal TB reference laboratory in Kerala were tested for Rifampicin and Isoniazid resistance by sequence-based diagnostic Line Probe assay (LPA). Geographical prevalence and associations of rpoB, katG, inhA resistance codons was analyzed from January 2019 to March 2020. Among the 2528 DNA samples subjected for Rifampicin and Isoniazid resistance determination by LPA, 146 (5.8%) isolates were resistant to both drugs. Isoniazid mono-resistance was found in 164 (6.5%) and Rifampicin mono-resistance in 38 (1.5%) isolates. The most frequent rpoB mutation was S531L (60.32%) followed by S531W/L533P mutations seen in 8.15% of the isolates. S315T1 KatG mutation was seen in 97.33% of Isoniazid resistant isolates. 84.68% isolates with rpoB S531L mutation were found to be multidrug-resistant. 82.9% of isolates with rpoB S531L mutation showed katG S315T1 mutation. Mono isoniazid-resistant isolates were significantly higher compared to mono rifampicin-resistant isolates among the DNA isolates studied in our region. The molecular epidemiological pattern most frequently associated with multidrug resistance was rpoB S531L which was significantly associated with the co-presence of S315T1 mutation.

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Drug resistance and its risk factors among extrapulmonary tuberculosis in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0258295 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258295

Author(s):

Getu Diriba ◽

Habteyes Hailu Tola ◽

Ayinalem Alemu ◽

Bazezew Yenew ◽

Dinka Fikadu Gamtesa ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Drug Resistance ◽

Meta Analysis ◽

Extrapulmonary Tuberculosis ◽

Multidrug Resistant ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis

Background Drug-resistant tuberculosis and extrapulmonary tuberculosis are the world major public health issues. Although some primary studies have been reported on the burden of drug-resistant tuberculosis in extrapulmonary tuberculosis patients in Ethiopia, there is no systematic review and meta-analysis that attempt to summarize the available literature. Thus, we aimed to estimates the prevalence of drug-resistance in extrapulmonary tuberculosis patients and summarize the risk factors associated with the occurrence of extrapulmonary tuberculosis in Ethiopia. Methods We conducted a systematic review of the published primary studies on extrapulmonary drug-resistant tuberculosis in Ethiopia. Results Eight observational studies were included in this review from different regions of Ethiopia. The overall pooled prevalence of rifampicin resistance was 6% (95% CI 0.03–0.10), while isoniazid resistance was 7% (95% CI 0.03–0.12). The pooled prevalence of multidrug-resistant tuberculosis was 4% (95% CI 0.01–0.07). Previous tuberculosis treatment history and male gender are frequently reported risk factors for developing drug-resistant tuberculosis in extrapulmonary tuberculosis patients. Conclusion The current review has identified a high proportion of resistance to rifampicin, isoniazid, and multidrug-resistant tuberculosis in patients with extrapulmonary tuberculosis in Ethiopia. Clinicians should request drug susceptibility testing for all patients with presumptive extrapulmonary tuberculosis to detect drug-resistance.

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Risk Factors and Treatment Outcome Analysis Associated with Second-Line Drug-Resistant Tuberculosis

Journal of Respiration ◽

10.3390/jor2010001 ◽

2021 ◽

Vol 2 (1) ◽

pp. 1-12

Author(s):

Muralidhar Aaina ◽

Kaliyaperumal Venkatesh ◽

Brammacharry Usharani ◽

Muthukumar Anbazhagi ◽

Gerard Rakesh ◽

...

Keyword(s):

Risk Factors ◽

Drug Resistance ◽

Drug Resistant ◽

First Line ◽

Drug Resistant Tuberculosis ◽

Factors Associated ◽

Resistant Tuberculosis ◽

Increased Risk ◽

Mdr Tb ◽

Line Drug

The present study aimed at analyzing the treatment outcomes and risk factors associated with fluoroquinolone drug resistance having mutations in the gyrA and gyrB genes. A total of 258 pulmonary tuberculosis samples with first-line drug-resistant (H, R, or HR) were subjected to GenoType MTBDRsl assay for the molecular detection of mutations. Among the 258 samples, 251 were drug-resistant tuberculosis and seven were sensitive to all first-line TB drugs. Out of 251 DR-TB cases, 42 cases were MDR TB, 200 were INH mono-resistant and nine cases were RIF mono-resistant tuberculosis. Out of 251 DR-TB cases performed with a MTBDRsl assay, 14 had Pre-XDR-FQ, one patient had pre-XDR-SLID, one had extensively drug-resistant tuberculosis (XDR-TB) and 235 cases were sensitive to both FQ and SLID drugs. The study group had a mean average of 42.7 ± 16.4 years. The overall successful treatment outcomes among the MDR, INH mono-resistant, and pre-XRD patients were 70.6%, 82.0%, and 51%, respectively. The percentage of risk for the unfavorable outcomes in the pre-XDR, INH -mono-resistant, and XDR cases were 113.84% increased risk with RR 2.14; 95% CI 0.7821–5.8468. The independent risk factor associated with the unfavorable outcomes to failure was 77.78% increased risk with RR 1.78; 95% CI 0.3375–9.3655. Logistic regression analysis revealed that the percentage relative risk among MDR-TB patients for gender, male (RR: 1.85), age ≥ 61 years (RR: 1.96), and diabetics (RR: 1.05) were 84.62%, 95.83%, and 4.76%, respectively. The independent risk factors associated with INH mono-resistant cases of age 16–60 (RR: 1.86), ≥61 year (RR: 1.18), and treated cases (RR: 5.06). This study presaged the significant risk of INH mono-resistant, pre-XDR, and MDR among males, young adults, diabetics, and patients with previous treatment failure. Timely identification of high-risk patients will give pronounced advantages to control drug resistance tuberculosis diseases.

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Drug Resistant Tuberculosis in the Northern Region of Zambia: A Retrospective Study

Frontiers in Tropical Diseases ◽

10.3389/fitd.2021.735028 ◽

2021 ◽

Vol 2 ◽

Author(s):

Ngula Monde ◽

Mildred Zulu ◽

Mathias Tembo ◽

Ray Handema ◽

Musso Munyeme ◽

...

Keyword(s):

Drug Resistance ◽

Susceptibility Testing ◽

Drug Susceptibility ◽

Drug Susceptibility Testing ◽

Multi Drug Resistance ◽

Drug Resistant ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis

BackgroundZambia like many countries in sub-Saharan Africa is affected with drug resistant tuberculosis. However, the drug resistant tuberculosis situation over the years has not been described in various regions of the country. Consequently, this study aims to determine the drug resistant tuberculosis burden in northern regions of Zambia over a four-year period based on data generated from a Regional Tuberculosis Reference Laboratory.MethodTwo hundred and thirty two (232) Tuberculosis Drug Susceptibility Testing results over a four-year period (2016-2019) were reviewed. Data was collected from tuberculosis registers and patient request forms and entered into a pre-tested standardized checklist and later entered in Excel Computer software. Double blinded checking was done by two independent data clerks to minimize duplication of cases. Cleaned data was then imported in R programme for analysis. Bivariant and descriptive statistics were performed and reported.ResultsOf 232 Drug Susceptibility Testing results, 90.9% were drug resistant TB while 9% were drug susceptible. Fifty three percent (53%) of these were multi-drug resistant Tuberculosis and 32% were confirmed as Rifampicin Mono-resistance. Only 1.7% of the Multi-drug resistant Tuberculosis patients were Pre-extensively drug-resistant Tuberculosis. Copperbelt province had the largest proportion (46.0%) of multi-drug resistant tuberculosis patients followed by Luapula (8.1%) and North-Western (4.7%) provinces. In new and previously treated patients, the proportion of Multi-drug resistant tuberculosis was 71.8% and 28.7% respectively. History of previous anti-tuberculosis treatment and treatment failure were associated with multi-drug resistance TB.Conclusion and RecommendationThis study has shown a small increase in the proportions of drug resistant tuberculosis cases over the four years under review with high rates being recorded on the Copperbelt Province. Previous treatment to first line TB treatment and treatment failure were associated with development of Multi-drug resistance. We therefore recommend strengthened routine laboratory surveillance and improved case management of multi-drug resistant tuberculosis patients in the region.

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STUDY OF DRUG SUSPECTIBILITY AND RESISTANCE PATTERN OF MULTI-DRUG RESISTANT TUBERCULOSIS PATIENTS AT A TERTIARY CARE CENTRE-A RETROSPECTIVE STUDY

10.36106/ijsr/0406860 ◽

2021 ◽

pp. 30-31

Author(s):

Robin John ◽

Hafiz Deshmukh ◽

Sunil Jadhav ◽

Ashish Deshmukh ◽

Shivprasad Kasat ◽

...

Keyword(s):

Tertiary Care ◽

Resistance Pattern ◽

Drug Resistant ◽

Care Centre ◽

Tertiary Care Centre ◽

Drug Resistant Tuberculosis ◽

Tuberculosis Patients ◽

Resistant Tuberculosis ◽

Multi Drug Resistant Tuberculosis ◽

Mdr Tb

OBJECTIVE: To study the sensitivity and resistance pattern of multi-drug resistant tuberculosis patients at a tertiary care centre. METHODS: Retrospective study will be conducted at tertiary care centre in Aurangabad from which data of patients will be collected who have registered under RNTCP from Jan 2018 to Jan 2020.Drug resistant patterns will be studied over a span of 3 years. RESULTS: In this study most of the patients of MDR-TB patients were of female gender with maximum involvement of pulmonary origin. Rifampicin resistance was most common. CONCLUSION: The present study emphasizes on the need for strengthening of laboratory services in diagnosis of MDR-TB, adequate and strict drug regimes to be followed in order to curtain the MDR-TB cases.

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