Primary Drug Resistance of <i>Mycobacterium tuberculosis </i>to First Line Antitubercular Agents at Kuwait Chest Diseases Hospital during 1992–1995

Abstract

Objective: Primary drug resistance to Mycobacterium tuberculosis has not been studied previously in Kuwait. The aim of the present study was to investigate factors associated with primary drug resistance at the Chest Diseases Hospital in Kuwait. Methods: We evaluated the clinical data, radiological features and results of susceptibility tests to five antitubercular drugs between 1992 and 1995. Results: Of the 582 patients admitted for newly diagnosed, previously untreated tuberculosis, 465 (79.9%) were non-Kuwaitis. Among the Kuwaitis, primary drug resistance to a single antitubercular agent was noted in isolates from 12 patients (10.3%), 7 (6.0%) for pyrazinamide and 5 (4.3%) for isoniazid. None of the Kuwaiti patients had multiple drug resistance. Regarding non-Kuwaitis, primary resistance was noted in isolates from 71 patients (15.3%). Thirty-nine patients (8.4%) were resistant to isoniazid, 29 (6.2%) to pyrazinamide, 24 (5.2%) to streptomycin, 8 (1.7%) to rifampicin, and 7 (1.5%) to ethambutol. Two drug resistance was detected in 26 patients (5.6%), and three drug resistance was noted in 5 patients (1.1%). One non-Kuwaiti patient was resistant to four antitubercular agents. Conclusion: We conclude that single and multiple drug resistance is more common among non-Kuwaiti patients when compared to Kuwaitis. This is related to the fact that most of the non-Kuwaiti patients originate from countries with high incidence of tuberculosis and high drug resistance.

Demographic Pattern and Clinical Characteristics of Patients with Smear- Positive Pulmonary Tuberculosis in Kuwait

“…Only 1.5% of our smear-positive patients grew mycobacteria resistant to one or more drugs, quite low when compared to the alarming worldwide reports of increasing drug resistance, including neighboring Saudi Arabia [22,[28][29][30] . In an earlier report on drug resistance in Kuwait, primary resistance to isoniazid was seen in 4.3% of Kuwaiti nationals and 6.2% of expatriates [31] . The present fi nding of low incidence may be due to the fact that we are reporting on smear-positive cases only while excluding the smear-negative, culture-positive cases.…”