Drug Resistance Patterns among XDR-TB Patients visiting a TB Centre at a Tertiary Health Care Facility
DOI:
https://doi.org/10.18311/mvpjms/2020/v7i1/22963Keywords:
Diabetes, Drug Sensitivity, Fluoroquinolones, XDR TB, MDR TBAbstract
Background: Resistance to MDR TB has additional resistance to fluoroquinolones and second line injectables it is defined as XDR-TB. The present study is designed to evaluate drug resistance patterns in such XDR patients. Aims and Objectives: To study drug resistance patterns in XDR-TB patients. Material and Methods: Researcher carried out a cross-sectional study over a period of two years. In this study, 43 patients were studied. The criteria used to observe was that – Newly diagnosed cases of XDR-TB patients by using the second line Drug Sensitivity Testing (DST). This method was used at an accredited RNTCP lab regardless of age and gender of the patients. Further, demographic, clinical and treatment data were analyzed in terms of drug sensitivity of the patients. Results: 48.83% of patients showed resistance with fluoroquinolone, 20.93% showed resistance with XDR with Second line injectables, 30.23% with flouroquinolones + second line injectibles. Maximum resistance was seen in Ofloxacin (81.4%) followed by kanamycin (44.2%). 41.86% patients were diabetics showing that drug resistance was more prevalent in these population. Maximum defaulters (80%) were from the lower class. Conclusion: Flouroquinolones and second-line drugs must be administered rationally and considerately to prevent the widespread drug resistance. The role played by diabetes and lower socio economic status in the emergence of drug resistance must not be undermined.Downloads
Published
Issue
Section
References
Mesfin EA, Beyene D, Tesfaye A, Admasu A, Addise D, Amare M, Dagne B, Yaregal Z, Tesfaye E, Tessema B. Drug-resistance patterns of Mycobacterium tuberculosis strains and associated risk factors among multi drugresistant tuberculosis suspected patients from Ethiopia. PLoS One. 2018 Jun 4; 13(6):e0197737. PMid: 29864118 PMCid: PMC5986145. https://doi.org/10.1371/journal.pone.0197737.
World Health Organization. Global Tuberculosis control surveillance, planning, financing; WHO report 2010; Geneva; World Health Organization WHO/HTM/TB/2010.393. Geneva, Switzerland: WHO. 2010.
Central TB Division. TB India 2010: RNTCP status report. Nirman Bhavan, New Delhi, India: Directorate of General Health Services, Ministry of Health and Family Welfare, 2006. Revised National TB Programme, TB India. TB India 2010. http://www.tbcindia.org.AccessedJuly2010.
Ahmad N, Javaid A, Sulaiman SA, Ming LC, Ahmad I, Khan AH. Resistance patterns, prevalence and predictors of fluoroquinolones resistance in multidrug resistant tuberculosis patients. Brazilian Journal of Infectious Diseases. 2016 Feb; 20(1):41–7. PMid: 26626164. https:// doi.org/10.1016/j.bjid.2015.09.011.
Sharma SK, Chaubey J, Singh BK, Sharma R, Mittal A, Sharma A. Drug resistance patterns among extrapulmonary tuberculosis cases in a tertiary care Centre in North India. The International Journal of Tuberculosis and Lung Disease. 2017 Oct 1; 21(10):1112–7. PMid: 28911354.
https://doi.org/10.5588/ijtld.16.0939.
Heyckendorf J, Andres S, Koser CU, Olaru ID, Schon T, Sturegard E, Beckert P, Schleusener V, Kohl TA, Hillemann D, Moradigaravand D. What is resistance? Impact of phenotypic versus molecular drug resistance testing on therapy for multi-and extensively drug-resistant tuberculosis. Antimicrobial Agents and Chemotherapy. 2018 Feb 1; 62(2). PMid: 29133554 PMCid: PMC5786814. https://doi.org/10.1128/AAC.01550-17.
Ullah I, Javaid A, Tahir Z, Ullah O, Shah AA, Hasan F, Ayub N. Pattern of drug resistance and risk factors associated with development of drug resistant Mycobacterium tuberculosis in Pakistan. PloS One. 2016 Jan 25; 11(1):e0147529. PMid: 26809127 PMCid: PMC4726587. https://doi.org/10.1371/ journal.pone.0147529.
Kim CK, Shin SY, Kim HJ, Lee K. Drug resistance patterns of multidrug and extensively drug-resistant tuberculosis in Korea: Amplification of resistance to oral secondline drugs. Annals of Laboratory Medicine. 2017 Jul 1; 37(4):323–6. PMid: 28445012 PMCid: PMC5409022. https://doi.org/10.3343/alm.2017.37.4.323.
Shah I, Shah F. Changing prevalence and resistance patterns in children with drug-resistant tuberculosis in Mumbai. Paediatrics and International Child Health. 2017 Apr 3; 37(2):135–8. PMid: 27686119. https://doi.org/10.1080/204 69047.2016.1214796.
Dean AS, Cox H, Zignol M. Epidemiology of drug-resistant tuberculosis. Strain variation in the Mycobacterium tuberculosis complex: Its role in biology, epidemiology and control. (pp. Springer, Cham. 2017. p. 209–20. PMid: 29116637. https://doi.org/10.1007/978-3-319-64371-7_11.
MyneeduVP, Visalakshi P, Verma AK, Behera D, Bhalla M. Prevalence of XDR-TB cases –A retrospective study from a tertiary care TB hospital. Indian J Tuberc. 2011; 58:54–9.
Lan Y, Li Y, Chen L, Zhang J, Zhang H. Drug resistance profiles and trends in drug-resistant tuberculosis at a major hospital in Guizhou Province of China. Infection and Drug Resistance. 2019; 12:211. PMid: 30666136 PMCid: PMC6330984. https://doi.org/10.2147/IDR.S188538.
Sinha P, Srivastava GN, Gupta A, Anupurba S. Association of risk factors and drug resistance pattern in tuberculosis patients in North India. Journal of Global Infectious Diseases. 2017 Oct; 9(4):139. PMid: 29302148 PMCid: PMC5750437. https://doi.org/10.4103/jgid.jgid_167_16.
Argita D. Salindri, Maia Kipiani, Russell R. Kempker,Neel R.Gandhi, Lasha Darchia, Nestani Tukvadze, Henry M.Blumberg, Matthew J. Magee. Diabetes Reduces the Rate of Sputum Culture Conversion in Patients With Newly Diagnosed Multidrug-Resistant Tuberculosis. Open forum of infectious diseases. 2016 Jun1 14; 1.
Saira Zai, Tyaba Haroon, Khawaja Tahir Mehmood. Socioeconomic Factors Contributing to MultidrugResistant Tuberculosis. Biomed Sci and Res. 2010; 2(4):279–83.
Mogashoa T, Melamu P, Derendinger B, Ley SD, Streicher EM, Iketleng T, Mupfumi L, Mokomane M, Kgwaadira B, Rankgoane-Pono G, Tsholofelo TT. Detection of second line drug resistance among drug resistant Mycobacterium Tuberculosis Isolates in Botswana. Pathogens. 2019 Dec; 8(4):208. PMid: 31661825 PMCid: PMC6963291. https://doi.org/10.3390/pathogens8040208