Abstract

Introduction: As India aims to end Tuberculosis (TB) by 2025, increased prevalence of Multi-Drug Resistant (MDR) strains continues to be a major public health concern.

Methods: New case of Pulmonary TB (PTB) was defined as no history of Anti-Tuberculosis Therapy (ATT) intake in the past or taken ATT for <1 month. Single sputum specimen from 1103 suspected PTB cases was collected at two tertiary care referral centers in North India. All samples were subjected to Ziehl-Neelsen stain, culture using
automated BACTEC MGIT™ 960™ and Drug Susceptibility Testing using Line Probe Assay. Resistance testing for Rifampicin and Isoniazid was done in all culture-positive patients.

Results: Of the total 1108 patients (Median Age 34 years, 59% and 41% males and females respectively), there were 683 new PTB cases with liquid culture positive. From these patients, 62 (9.1%) were resistant to rifampicin, 75 were resistant to isoniazid (11%) and 60 (8.7%) patients were resistant to both drugs.

Conclusion: There is a high burden of MDR strains among new PTB cases. A higher than national MDR prevalence (2.8%) could be because both centers were referral institutes. There is an urgent need for universal drug sensitivity testing to escalate detection and treatment of this subgroup of patients.

Keywords: MDR-TB; Pulmonary tuberculosis; Drug susceptibility