Multidrug-resistant pulmonary & extrapulmonary tuberculosis: A 13 years retrospective hospital-based analysis

Abstract

Background & objectives:Multidrug-resistant tuberculosis (MDR-TB) is a public health problem of great significance in India. In the present study an attempt was made to analyse the progression of MDR-TB pattern during a course of 13 years (2000-2012) among the patient population at a tertiary care centre in New Delhi, India.Methods:Mycobacterial isolates obtained on Lowenstein-Jensen (L-J) medium/BacT/ALERT 3D were identified using AccuProbe molecular identification system, routine biochemical tests or GenoType Mycobacteria CM. Antimycobacterial susceptibility testing was performed using resistance ratio method on L-J medium (2000-2004) and one per cent proportion method on BacT/ALERT 3D system (2005-2012).Results:Of the total 14,849 samples subjected to mycobacterial culture, 6569 pulmonary and 8280 extrapulmonary, 2364 were detected positive for mycobacteria. The average percentage positivity rate was 15.9 per cent (18.9 and 13.6% in case of pulmonary and extrapulmonary samples, respectively). Our study revealed a significant increase (P<0.001) in multidrug resistance by 12 per cent (4.7% in 2000 to 19.8% in 2012). MDR-TB was more in case of pulmonary (28.2%) than extrapulmonary (11.6%) TB (P<0.001). Only 6.5 per cent (154) of mycobacterial isolates were non-tuberculous mycobacteria and rapid growers represented by Mycobacterium fortuitum and M. abscessus were the most commonly isolated species.Interpretation & conclusions:Increase in prevalence of MDR-TB by 12 per cent in the past 13 years is alarming. Policy modifications may have to be done to strengthen the existing TB control programmes to encourage contact tracing and culture and drug susceptibility testing for all smear positive pulmonary cases to ensure early and appropriate therapy.

Trends in the Prevalence and Antibiotic Resistance of Non-tuberculous Mycobacteria in Mainland China, 2000–2019: Systematic Review and Meta-Analysis

“…These data indicated that the prevalence of NTM in China is much higher than that in European countries (0.2–2.9/100,000) ( 2 , 12 – 14 ) and in the United States (8.7–13.9/100,000). In addition, the proportion of NTM among mycobacterial isolates in China was higher than that reported in India (6.5%, 2000–2012) ( 15 ) and in Iran (10.2%, 1999–2014) ( 16 ) but lower than that in Northern India (29%, 2013–2015) ( 17 ).…”

Extrapulmonary drug-resistant tuberculosis at a drug-resistant tuberculosis center, Mumbai: Our experience – Hope in the midst of despair!

“…[8910] Their proportion among the DR-TB cases is variable. While laboratory data are available;[1011] for the first time, we present data about the proportion of these cases at a DR-TB center in Mumbai. We report EP cases to consist of 4.4% of our DR-TB center patients.…”

“…Pus and needle aspirates consisted of 23.7%, tissue 11.8%, body fluids 6.4%, urine 3.1%, and blood and bone marrow 2.2%. [11] We had no cases of DR-TB diagnosed on urine samples. Laboratory data on the DST in EP DR-TB are available.…”

“…Laboratory data on the DST in EP DR-TB are available. [1011] However, ours is the first study to give the distribution of these cases as per DST at a DR-TB center. We saw a higher (around 40%) prevalence of Pre-XDR-TB (FQ) cases which is consistent with studies from Mumbai.…”

Peripheral ulcerative keratitis associated with chronic malabsorption syndrome and miliary tuberculosis in a child

“…The recently published data indicated an alarming increase in the prevalence of multidrug-resistant TB ( P < 0.001) by 12% (4.7% in 2000–19.8% in 2012). [ 3 ] Human immunodeficiency virus (HIV) infection is still imposing a great health burden in India. The recently published data showed that the estimated adult HIV prevalence retained a declining trend in India, following its peak in 2002 at a level of 0.41% (within bounds 0.35–0.47%).…”