医療微生物学と診断

Prevalence of Primary Pulmonary Multi-Drug Resistant Tuberculosis in and around Aligarh Region

Abstract

Maryam Faridi, Indu Shukla, Nazish Fatima, Sumit Varshney and Mohammad Shameem

Tuberculosis (TB) is one of the most ancient diseases of mankind and has co-evolved with humans for many thousands of years or perhaps for several million years. M. tuberculosis strains that are resistant to the two most potent anti-TB drugs Isoniazid and Rifampicin, are termed as multidrug-resistant TB (MDR-TB) strains. Drug resistance is broadly classified as primary and acquired. Drug resistance in a patient who has never received anti-TB treatment previously or has taken treatment for less than a month is termed as primary resistance. Acquired resistance is the resistance which arises as a result of specific previous treatment. This study was aimed to determine the prevalence of primary MDR-TB in and around Aligarh region by molecular diagnostic method of Line probe assay (LPA). This two year study was carried out in culture and DST Laboratory (RNTCP certified), Department of Microbiology, J.N. Medical College AMU, Aligarh on the sputum samples received of the primary pulmonary tuberculosis suspected patients (according to PMDT guidelines) from the outpatient and inpatient departments of the hospital and from various tuberculosis units in and around Aligarh region from October 2015 to October 2017. Sputum samples were collected from suspected cases of primary pulmonary TB. These samples were subjected to routine microscopy and culture on LJ medium to detect Mycobacterium tuberculosis. Positive cases were subjected to drug sensitivity test by GenoType MTBDRplus Assay. Out of the total 514 samples collected, 265 (51.56%) samples and 326 (63.43%) samples were positive by ZN microscopy and fluorescent microscopy respectively. 312 (60.70%) samples were positive on culture on LJ medium. Total 326 samples which were positive on fluorescent microscopy were subjected to LPA and 47 (9.14%) samples were resistant to both rifampicin and isoniazid, 21 (4.08%) samples were rifampicin mono-resistant and 31 (6.03%) samples were isoniazid mono-resistant.