Detection of Drug Resistance among Suspected Tuberculosis Cases Attending a Tertiary Care Hospital in Western Rajasthan, India

Kavita Yedale, Vijaya Lakshmi Nag, Nidhima Aggarwal, Jitu Mani Kalita

Abstract: Background: In spite of newer modalities for diagnosis and treatment of tuberculosis (TB), unfortunately, it is among the top 10 killer infectious diseases worldwide. India has a high burden of drug-resistant tuberculosis (DR-TB). The National Drug Resistance Survey (2018) results showed that the rates of multidrug resistance (MDR) among new TB patients are 2.84 % and that in previously treated to be 11.60 %. Methods: Out of total 180 samples received during 2016-2017 for mycobacterium culture, 31 culture samples confirmed for Mycobacterium tuberculosis were randomly selected and 12 smear positive direct samples were also included in the present study and line probe assay (LPA) was performed to detect first line as well as second line anti tubercular drug resistance. Results: Out of total 43 cases subjected to first line drug susceptibility testing, 2 (4.65 %) were resistant to only rifampicin, 4 (9.30 %) were resistant to only isoniazid and 3 (6.98 %) were resistant to both rifampicin and isoniazid. So, according to WHO definition, total 3 (6.98 %) cases were diagnosed as multidrug resistance tuberculosis (MDR-TB). One case (2.33 %) was detected as extensively drug resistant TB (XDR-TB). Conclusions: LPA plays an important role before initiation of anti-tubercular drug and for early detection of DR-TB cases.

Keywords: Tuberculosis, MDR-TB, XDR-TB, Line probe assay LPA, GeneXpert