Frequency of Primary Multidrug-Resistance to Anti-Tuberculous drugs in patients presented to tertiary care hospital
Keywords:Multidrug resistant tuberculosis, Primary drug resistance, LRH, Pakistan
AbstractObjective: To determine the frequency of primary multidrug resistance to antituberculous drugs among patients diagnosed for the first time with pulmonary tuberculosis.Methodology: This was a hospital based descriptive, cross sectional study performed in Pulmonology Department, PGMI, Govt. Lady Reading Hospital, Peshawar from December 28, 2013 to June 27, 2014. A total of 124 smear positive pulmonary tuberculosis patients with no history of previous anti tuberculosis treatment were selected and sputum samples were collected for culture and drug sensitivity against rifampicin, isoniazid, pyrazinamide, ethambutol and streptomycin. Susceptibility testing was performed using standard agar proportion method RESULTS: Out of 124 patients, 56 (45.2%) were males and 68 (54.8 %) female. Mean age of the patients was 35.59 years 15.523 SD. 106 cultures (85.5%) were fully sensitive while 18 (14.5 %) samples showed primary resistance to one or more drugs. 9 (7.2%) isolates were resistant to a single drug, 3 (2.4%) were resistant to 2 drugs, 4 (4%) to 3 drugs, 1 (0.8%) to 4 drugs while none to all 5 first line agents. Resistance to Streptomycin was seen in 7 (5.6%), Isoniazid in 12 (9.7%), Rifampicin in 6 (4.8%), Ethambutol in 2 (1.6%) and Pyrazinamide in 4 (4,0%) samples. Primary Multidrug resistance was 4.8 %.Conclusion: The frequency of Primary MDR amongst never treated patients is 4.8%, which is a cause of concern and should be addressed through effective TB control programmes with DOTS strategy.