Evaluation of Drug Resistance from Sputum Specimens of Suspected Tuberculosis Patients attending a District Hospital, Abuja

Abstract

Background: This study evaluated the prevalence of drug resistant tuberculosis infection among suspected tuberculosis patients attending Asokoro District Hospital (ADH), Abuja, Nigeria. Methods: A total of 301 AFB+/- sputum specimens from suspected TB patients were collected for the study following study approval from Asokoro District Hospital Ethic Committee. Eighty-nine (89) identified Mycobacterium tuberculosis complex were isolated after morphological and biochemical testing. Sputum specimens collected from the patients were processed, cultured on Lowenstein-Jensen (LJ) media and subjected to in-vitro antimicrobial susceptibility testing. The eighty-nine (89) identified M. tuberculosis complex isolates were challenged with Rifampicin (RIF), Isoniazid (INH), Ethambutol (EMB) and Streptomycin (SM) drugs respectively. Results: Out of the total 89 samples analyzed, 13 (14.6%) showed resistance to the first-line drugs while 76 (85.4%) were susceptible. Drug resistance was identified in 10 (11.8%) of the new tuberculosis case (primary drug resistance cases) and 3 (75%) in re-treatment cases (secondary or acquired resistance). Prevalence of mono-resistant, double resistant and triple resistant patterns were 5 (5.7%), 6 (6.7%) and 2 (2.2%) respectively. Multi-drug resistant (resistant to both RIF and INH, the two most potent anti-tuberculosis drugs, with or without resistant to other drugs) was 1.1%. No isolate was resistant to all the four drugs. Conclusion: Drug resistance were observed in the cultures of M. tuberculosis complex, however no isolate showed resistance to all the four first-line drugs used. This study therefore recommends strict adherent to medication for tuberculosis patients as poor compliance or inappropriate use of drugs could induce resistance. Keywords: Drug resistance, M. tuberculosis complex, antimicrobial susceptibility, Abuja, sputum, first-line drugs.