DRUG RESISTANCE PATTERN AMONG PATIENTS WITH TUBERCULOSIS- A CLINICAL STUDY
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 1
Abstract
Background: Tuberculosis (TB) is a contagious disease caused by the bacillus Mycobacterium (M.) tuberculosis and occasionally by Mycobacterium bovis, and Mycobacterium africanum. There are cases of drug-resistant TB throughout the world. Resistance of M. tuberculosis to drugs is a man-made amplification of spontaneous mutations in the genes of the tubercle bacilli. The present study was to conducted to evaluate the resistance of combinations of isoniazid (INH), rifampicin (RMP), streptomycin (SM), and ethambutol (EMB) and four resistant modes, i.e. mono, double, triple and quadruple resistance among cases of pulmonary tuberculosis patients. Materials & Methods: This study was conducted in Directly Observed Treatment Short-course (DOTS) centre in year 2014. It consisted of 200 newly diagnosed Sputum smear positive (SS+) for acid fast bacilli (AFB) pulmonary tuberculosis patients of both sexes and between the age group of 15 to 60 years. AFB culture and drug susceptibility test were done. Drug resistance was expressed in proportion method, where a strain was considered to be drug resistant if the number of colonies that grew on a drug containing medium was 1% or more of the colonies. Chest radiographs were taken of all the patients at the time of diagnosis of TB at the end of six-month treatment. Patients were evaluated by judging the site of lesions, zone of involvement, nature of the lesion (visible cavitary and non-cavitary area) in both lungs. Results were tabulated and subjected for correct inferences. P value < 0.05 was considered significant. Results: Out of 40 patients, 110 were males and 90 were females. Age group 15-30 years had males (50) and females (40). Age group 30-45 years had males (25) and females (35). Age group 45-60 years had males (35) and females (15). Sputum positivity grade was 1+ (60), 2+ (40), 3+ (45) or scanty (55). The difference was non - significant (P > 0.05). Socio economic status of patients was upper (2), upper middle (4), lower middle (4), upper lower (150) and lower middle (40). The difference was significant (P < 0.05). Lesions were cavitatory (36) and non cavitatory (164). The difference was significant (P <0.05). Culture on LJ medium was growth of bacteria in 185 cases, myobacteria other than tuberculosis in 3 cases, contamination in 10 cases and no growth of mycobacteria in 2 cases. Number of sensitive strains of rifampicin was 195, isoniazide (160), streptomycin (190), ethambutol (189) and resistant strains of rifampicin was 5, isoniazide (40), streptomycin (10), ethambutol (11). The difference of sensitive strains among all 4 drugs was non - significant (P > 0.05). Four most frequent drug resistance patterns of 21.3% strains of M. tuberculosis from mono drug, double drug, triple drug and quadruple drug resistance were 5.9%, 10.7%, 2.4% and 2.4% respectively. MDR was observed in 4.7% isolates. Conclusion: Drug resistant tuberculosis cases are now increasing day by day. It poses challenge to the treatment. Identification of resistant strains helps in proper management of cases of tuberculosis.
Authors and Affiliations
Sanjay Singh, Lalit Kumar Mishra
Keywords
Related Articles
- EP ID EP553712
- DOI -
- Views 125
- Downloads 0
Clinical and Bacteriological Profiles of Early Onset Infection in Hospital Delivered Babies
Background: Neonatal septicemia is a common cause of morbidity and mortality in developing countries. A wide variety of bacteria may be responsible for early onset septicaemia in neonates. Prompt identification of bacter...
A COMPARATIVE STUDY OF SERUM IRON AND FERRITIN BETWEEN PRE-TREATED BREAST CANCER PATIENTS WITH HEALTHY CONTROLS OF THE SAME AGE GROUP
Introduction: Breast cancer is one of the leading cause of cancer related deaths in women and there are differences in breast cancer recurrence, aggressiveness and incidence between premenopausal and postmenopausal women...
Comparison of total I.V. anesthesia using Propofol with an inhalation Technique: A Hospital Based Study
Background: General anesthesia has undergone a vast number of improvements and modifications and even its recently modified form total intravenous anesthesia (TIVA; induction as well as maintenance of anesthesia with int...
A MODIFIED CAP SPLINT FOR PREVENTION OF ORAL TRAUMA IN COMATOSE PATIENT
Trauma to oral soft tissues in comatose patients may be more widespread than reported as no extensive study of this problem has been conducted. These patients exhibited ruminant chewing and bruxism that often resulted in...
SUBCONJUNCTIVAL HAEMORRHAGE FOLLOWING EXTRACTION OF A TOOTH
Extraction of teeth is the most common minor surgical procedure performed. Extraction of teeth is usually performed by either intra-alveolar or trans-alveolar methods. Subconjunctival haemorrhage after tooth extraction...