Resistance to Antituberculosis Drugs in Pulmonary Tuberculosis

Chand, Kailash; Khandelwal, Rohan; Vardhan, Vasu

doi:10.1016/s0377-1237(06)80097-3

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…treated PTB patients3398.68.353.4Geno-Type® MTBDR plus assayDesignated microscopycentersWEST INDIA62Chand K et al (a), 2000 [95]Pune1995–1998Combined PTB patients112017.11.32.60.14.60.43.0LJTertiary hospital (Armed Forces)63Shah A R et al, 2002 [96]Ahemdabad2000–2001Prev. treated PTB patients82258.67.51.00.51.59.39.3LJDOTS center64Chand K et al (b), 2006 [97]Pune2000–2003Combined PTB patients17212.81.70.60.63.50.62.9LJTertiary hospital (Armed forces)65Pereira M et al, 2005 [98]Pune2000–2004Newly diagnosed PTB patients7018.610.04.34.35.75.7BACTEC MGIT 960Tertiary hospital66Almeida D et al, 2003 [21]Mumbai2003Combined PTB patients30048.73.01.35.726.748.011.4LJTertiary care center67Menon S et al, 2012 [42]Mumbai2005–2009Combined PTB patients67385.92.45.95.847.6DST not spe...…”

Section: Resultsmentioning

confidence: 99%

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

et al. 2017

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BackgroundDrug-resistant pulmonary tuberculosis (DR-TB) is a significant public health issue that considerably deters the ongoing TB control efforts in India. The purpose of this review was to investigate the prevalence of DR-TB and understand the regional variation in resistance pattern across India from 1995 to 2015, based on a large body of published epidemiological studies.MethodsA systematic review of published studies reporting prevalence of DR-TB from biomedical databases (PubMed and IndMed) was conducted. Meta-analysis was performed using random effects model and the pooled prevalence estimate (95% confidence interval [CI]) of DR-TB, multidrug resistant (MDR-) TB, pre-extensively drug-resistant (pre-XDR) TB and XDR-TB were calculated across two study periods (decade 1: 1995 to 2005; decade 2: 2006 to 2015), countrywide and in different regions. Heterogeneity in this meta-analysis was assessed using I2 statistic.ResultsA total of 75 of 635 screened studies that fulfilled the inclusion criteria were selected. Over 40% of 45,076 isolates suspected for resistance to any first-line anti-TB drugs tested positive. Comparative analysis revealed a worsening trend in DR-TB between the two study decades (decade 1: 37.7% [95% CI = 29.0; 46.4], n = 25 vs decade 2: 46.1% [95% CI = 39.0; 53.2], n = 36). The pooled estimate of MDR-TB resistance was higher in previously treated patients (decade 1: 29.8% [95% CI = 20.7; 39.0], n = 13; decade 2: 35.8% [95% CI = 29.2; 42.4], n = 24) as compared with the newly diagnosed cases (decade 1: 4.1% [95% CI = 2.7; 5.6], n = 13; decade 2: 5.6% [95% CI = 3.8; 7.4], n = 17). Overall, studies from Western states of India reported highest prevalence of DR-TB (57.8% [95% CI = 37.4; 78.2], n = 6) and MDR-TB (39.9% [95% CI = 21.7; 58.0], n = 6) during decade 2. Prevalence of pre-XDR TB was 7.9% (95% CI = 4.4; 11.4, n = 5) with resistance to fluoroquinolone (66.3% [95% CI = 58.2; 74.4], n = 5) being the highest. The prevalence of XDR-TB was 1.9% (95% CI = 1.2; 2.6, n = 14) over the 20-year period.ConclusionThe alarming increase in the trend of anti-TB drug resistance in India warrants the need for a structured nationwide surveillance to assist the National TB Control Program in strengthening treatment strategies for improved outcomes.

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Section: Resultsmentioning

confidence: 99%

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

et al. 2017

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“…However, 11.8% of culture positive samples did not found smear positive. The growth of M. tuberculosis on LJ media in cases of smear negative for acid-fast bacilli is a known phenomenon as 10 5 bacilli per mL of sputum are required for the organism to be seen on light microscope but culture may show growth [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia

Demile

Zenebu²,

Shewaye³

et al. 2018

BMC Infect Dis

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BackgroundEthiopia is one of the world health organization defined higher tuberculosis (TB) burden countries where the disease remains a massive public health threat. This study aimed to identify the prevalence and associated factors of multidrug-resistant tuberculosis (MDR-TB) using all armed force and civilian TB attendants in a tertiary level armed force hospital, where data for MDR-TB are previously unpublished.MethodsCross-sectional study was conducted from September 2014 to August 2015 in a tertiary level Armed Force Referral and Teaching Hospital (AFRTH), Ethiopia. Armed force members (n = 251) and civilians (n = 130) which has been undergone TB diagnosis at AFRTH were included. All the specimens collected were subjected to microscopic smear observation, culture growth and drug susceptibility testing. Data were analyzed using statistical package for social sciences following binary logistic regression and Chi-square. P-values < 0.05 were considered statistically significant.ResultsAmong 381 TB patients, 355 (93.2%) new and 26 (6.8%) retreatment cases were identified. Culture and smear positive TB cases were identified in 297 (77.9%) and 252 (66.1%) patients, respectively. The overall prevalence of MDR-TB in AFRTH was found 1.8% (1.3% for armed force members and 0.5% for civilian patients) all of which were previously TB treated cases. The entire treatment success rates were 92.6% achieved highest in the armed force (active and pension) than the civilian patients. The failure and dead cases were also found 2.5 and 4.6%, respectively. Using bivariate analysis, category of attendants and TB contact history were strong predictors of MDR-TB in armed force and civilian patients. Moreover, human immunodeficiency virus (HIV) infection also identified a significant (OR = 14.6; 95% CI = 2.3–92.1; p = 0.004) predicting factor for MDR-TB in armed force members. However, sex, age and body mass index were not associated factor for MDR-TB.ConclusionsIn AFRTH, lower prevalence of MDR-TB was identified in armed force and civilian patients that were significantly associated with category of attendants, HIV infection and TB contact history. Considering armed force society as one segment of population significantly helps to plan a better MDR-TB control management, especially for countries classified as TB high burden country.

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“…Our findings of 8% MDR and 16% resistance to at least one drug of Group C are in agreement with the results of Northern Kerala (2006), i.e., 8.8% and 17.7% resistance to more than one drug[ 21 ] from Pune (2006) which shows 2.9% MDR. [ 22 ] The drug susceptibility test (DST) undertaken by TRC, Chennai in North Arcot, Raichur, Jabalpur, and Wardha districts during 2000–2002 reports MDR-TB in 2.8%, 2.5%, 1.1%, and 0.5%, respectively. [ 4 23 24 ]…”

Section: Discussionmentioning

confidence: 99%

Drug resistance pattern of mycobacterial isolates in HIV and non-HIV population in South India

Shivaswamy

Neelambike

2016

Lung India

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Background:Emergence of drug resistance has complicated the treatment of tuberculosis (TB). WHO reports India to be one among 27 “high burden” multidrug-resistant (MDR) TB countries.Objective:To diagnose TB and detect drug resistance of mycobacterial isolates in acid-fast bacilli (AFB) smear negative HIV reactive patients (Group A) and compare them with HIV seropositive AFB smear positive (Group B) and HIV-seronegative AFB positive cases (Group C).Materials and Methods:Clinical specimens collected in all groups were processed as per the standard protocol except blood, which was processed by lysis centrifugation technique. They were then inoculated with Lowenstein-Jensen media and the isolates obtained were subjected to drug susceptibility test (DST) by proportion method and genotype MTBDR plus assay.Results:In Group A, 162 patients were included. Of the 443 clinical samples collected, 76 mycobacterial strains were obtained from 67 (41%) patients. Of these, 50 (65.8%) were sensitive to all drugs and 26 (34.2%) resistant to one or more anti-tubercular drugs. Antibiogram of Group A when compared with Group B and C showed that the MDR rate 6.6%, 6.7% and 8% respectively) did not differ much; but resistance to at least single drug was (26 [34.2%], 3 [10%], and 8 [16%]), respectively.Conclusion:Our study suggests that HIV has no influence on the anti-tubercular resistance pattern, but increased MDR rate along with HIV in high TB burden setting stresses the need for early diagnosis and DST in providing proper regimens and improve prognosis.

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Resistance to Antituberculosis Drugs in Pulmonary Tuberculosis

Cited by 4 publications

References 9 publications

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis

Risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in a tertiary armed force referral and teaching hospital, Ethiopia

Drug resistance pattern of mycobacterial isolates in HIV and non-HIV population in South India

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