Frequency of secondary Multidrug Resistance Pulmonary Tuberculosis in Category-II Failure Patients

Abstract

Objective:  Multi-drug resistant tuberculosis (MDR TB), defined as resistance of Mycobacterium tuberculosis (MTB) to both isoniazid and rifampicin, is an emerging world health problem. This study was conducted to determine the frequency of secondary multi drug resistance tuberculosis in Category-II (Retreatment regimen) failure patients.Materials & Methods:  This was cross-sectional descriptive study conducted at Department of Pulmonology, Lady Reading Hospital, Peshawar - Pakistan. Patients of either gender, on category-II pulmonary-TB treatment, with productive cough and fever (>99ºF) and positive Sputum AFB at the end of 5th month were included. Patients on quinolones, smear negative and those who have not used ATT in the past were excluded. Culture and drug sensitivity testing against rifampicin, isoniazid, pyrazinamide, ethambutol and streptomycin was done on sputum samples fromthese patients.Results:  Out of 159 patients, 69 (43.3%) were males and 90 (56.7%) females. Age of patients ranged from 9-70 years with a mean age of 28.87 years (±12.73SD). Mean duration of the Category-II treatment was 26.164 (±2.49 SD) weeks ranging from20 to 32 weeks.Among 159 sputum specimens, 122 (76.7 %) were culture positive and 37 (23.3 %) culture negative. 5 specimen grew Non-TB Mycobacteria. Among the MTB culture positive patients, 50 (42.7%) were males and 67(57.3%) females. Among culture negative patients, 17 (45.9%) were males and 20 (54.1%) females. 75(64.15%) patients were MDR among 117 samples. remaining42(35.9%) didn't fulfill theMDRcriteria.Conclusion:  There is high MDR-TB rate of 64.3% in our study. Risk factors were females, young age.