DRUG RESISTANCE PATTERN AMONG AFB SMEAR POSI-TIVE RETREATMENT COMPLETED CASES

DRUG RESISTANCE PATTERN AMONG AFB SMEAR POSI-TIVE RETREATMENT COMPLETED CASES

Authors

  • Muhammad Khalid Ch.
  • Sajjad Hassan
  • Muhammad Saqib Saeed
  • Muhammad Younus
  • Rizwan Iqbal

DOI:

https://doi.org/10.21649/akemu.v21i1.687

Abstract

Abstract

Background: Worldwide, multidrug resistance (MDR TB) is a serious issue. It has increased over the last decade. Re-treatment completed sputum smear posi-tive cases have much higher incidence of MDR-TB as compared to primary MDR - TB.

Objective:  To estimate the incidence of drug resis-tance pattern among AFB smear positive re-treatment completed cases.

Study Design:  Evidence based prospective study.

Study Setting:  Institute of Chest Medicine, Mayo

 

 Khalid M. Ch.1

Associate Professor, Department of Chest Medicine

KEMU / Mayo Hospital, Lahore

 Hassan S.2

Registrar, Department of Chest Medicine

Mayo Hospital, Lahore

 Saeed M.S.3

Chairman, Department of Chest Medicine

KEMU / Mayo Hospital, Lahore

Younus M.4

Senior Registrar, Dept of Chest Medicine

Mayo Hospital, Lahore

 Iqbal R.5

Senior Research Officer

Pakistan Medical Research Council

Hospital Lahore, Tertiary care hospital affiliated with King Edward Medical University, Lahore, Pakistan.

Methodology:  A total 50 (Male 22, Female 28) pul-monary TB patients who had completed Re- treatment regimen  in the past and are still sputum smear positive for acid fast Bacilli were included in the study. Three consecutive sputum specimens were collected at Aga Khan University collection center at Lahore. The spe-cimen were sent to Agha Khan University Lab Karachi for AFB smear, culture and drug sensitivity both for essential and reserve drugs. Reports for AFB smear were received within a week, while culture and drug sensitivity reports after 6 weeks. Reports data was analyzed for essential and reserve anti tuberculous drug sensitivity for mycobacterium tuberculosis.

Results:  Data Analysis revealed MDR TB in 31(62%) patients which include 11 males and 23 females. Indi-vidual drug resistance to essential drugs was INH - 62%, Rifampicin - 68%, Ethambutol - 24%, PZA - 25% and Streptomycin - 21%. Poly drug resistance was determined in 38% cases. Individual drug resis-tance to reserve drugs - kanamycin, Amikacin, ofloxa-cin, Ethionamide and PAS was 4%, 4%, 36%, 10% and 2% respectively.

Conclusion:  There is a very high proportion of MDR TB in sputum smear AFB positive retreatment cases.

Suggestion:  Comprehensive measures including DO-TS PLUS are needed to control MDR TB in Pakistan.

Key words:  MDR TB, XDR TB, Re-treatment regi-men, Essential drugs, Reserve drugs, AFB - acid fast bacilli.

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How to Cite

Khalid Ch., M., Hassan, S., Saeed, M. S., Younus, M., & Iqbal, R. (2015). DRUG RESISTANCE PATTERN AMONG AFB SMEAR POSI-TIVE RETREATMENT COMPLETED CASES. Annals of King Edward Medical University, 21(1), 5. https://doi.org/10.21649/akemu.v21i1.687

Issue

Section

Medicine & Allied

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