DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20193942

Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis

Ashok Kumar, Jawahar Lal Joshi, Abdurazack Umathoor, Vishal Chopra, Komaldeep Kaur, Vidhu Mittal

Abstract


Background: To determine the prevalence of primary drug resistance to either rifampicin or isoniazid alone or both in newly diagnosed sputum smear positive pulmonary tuberculosis patients.

Method: A prospective study 100 newly diagnosed sputum smear positive pulmonary TB patients was conducted. The patients with an age of ≥15 years and who had either not taken anti TB treatment or who had taken ATT for less than 1 month were enrolled in this study. Two sputum samples (5ml each), including one early morning sample as per the RNTCP guidelines were collected and subjected to line probe assay (LPA).

Results: Out of 100 cases 6 were having resistance to both rifampicin and isoniazid, 9 has resistance to INH alone and 1 had resistance to rifampicin alone.

Conclusion: The prevalence of primary drug resistance is high. For early and rapid detection of DR-TB newer modality should be used  for the detection of primary drug resistance in sputum smear positive TB patients.


Keywords


Multi-drug-resistant tuberculosis, Prevalence, Resistance

Full Text:

PDF

References


World Health Organization, The World Health Organization. Global tuberculosis report 2016. Geneva: CDC;2016:1.

Central TB Division. TB India-Annual Report 2017. Central TB Division New Delhi; 2017:9.

Zignol M, Hosseini MS, Wright A, Weezenbeek CL, Nunn P, Watt CJ, et al. Global Incidence of Multidrug‐Resistant Tuberculosis. J Infect Dis. 2006 Aug 15;194(4):479-85.

Sharma SK, Kaushik G, Jha B, George N, Arora SK, Gupta D, et al. Prevalence of multidrug-resistant tuberculosis among newly diagnosed cases of sputum-positive pulmonary tuberculosis. Indian J Med Res. 2011 Mar;133(3):308-11.

Van Der Werf MJ, Langendam MW, Huitric E, Manissero D. Multidrug resistance after inappropriate tuberculosis treatment: A meta-analysis. Vol. 39, European Respiratory Journal. 2012.1511-9.

Zhao P, Li XJ, Zhang SF, Wang XS, Liu CY. Social behaviour risk factors for drug resistant tuberculosis in mainland china: A meta-analysis. J Int Med Res. 2012 Apr;40(2):436-45.

Blöndal K. Barriers to reaching the targets for tuberculosis control: Multidrug-resistant tuberculosis. In: Bulletin of the World Health Organization. 2007:85(5):387-90.

Jindani A, Nunn AJ, Enarson DA. Two 8-month regimens of chemotherapy for treatment of newly diagnosed pulmonary tuberculosis: International multicentre randomised trial. Lancet. 2004 Oct;364(9441):1244-51.

Desikan P, Panwalkar N, Mirza SB, Chaturvedi A, Ansari K, Varathe R, et al. Line probe assay for detection of Mycobacterium tuberculosis complex: An experience from Central India. Indian J Med Res. 2017 Jan;145(1):70-3.

Raizada N, Sachdeva KS, Chauhan DS, Malhotra B, Reddy K, Dave PV, et al. A Multi-site validation in India of the line probe assay for the rapid diagnosis of multi-drug resistant tuberculosis directly from sputum specimens. Drews SJ, editor. PLoS One. 2014 Feb 19;9(2):e88626.

Kumar P, Balooni V, Sharma BK, Kapil V, Sachdeva KS, Singh S. High degree of multi-drug resistance and hetero-resistance in pulmonary TB patients from Punjab state of India. Tuberculosis. 2014 Jan;94(1):73-80.

Singla N, Satyanarayana S, Sachdeva KS, Van Den Bergh R, Reid T, Tayler-Smith K, et al. Impact of introducing the line probe assay on time to treatment initiation of MDR-TB in Delhi, India. PLoS One. 2014;9(7):e102989.

WHO. Molecular line probe assays for rapid screening of patients at risk of multidrug-resistant tuberculosis (MDR-TB). Policy statement. 2008;(June):1-9.

World Health Organization 2014. Xpert MTB/RIF implementation manual: technical and operational ‘how-to’; practical considerations. Geneva; 2014. Available at: https://apps.who.int/iris/handle/10665/112469.

Rufai SB, Kumar P, Singh A, Prajapati S, Balooni V, Singh S. Comparison of xpert MTB/RIF with line probe assay for detection of rifampin-monoresistant mycobacterium tuberculosis. J Clin Microbiol. 2014 Jun;52(6):1846-52.