Study of drug resistance in previously treated tuberculosis patients in Gujarat, India

A. R. Shah, S. K. Agarwal, K. V. Shah

Research output: Contribution to journalArticle

Abstract

SETTING: Department of Tuberculosis and Chest Diseases and State Tuberculosis Diagnosis and Training Centre (STDTC), a DOTS centre in Ahmedabad, Gujarat State, India. The study was carried out by retrospectively reviewing patient data between January 2000 and August 2001. OBJECTIVE: To evaluate the pattern of drug resistance among previously treated tuberculosis patients who remained symptomatic or smear-positive despite receiving anti-tuberculosis drugs under DOTS for a minimum of 5 months. DESIGN: A total of 1472 pulmonary tuberculosis patients who had taken anti-tuberculosis treatment were evaluated retrospectively with respect to their drug resistance pattern by sputum culture for acid-fast bacilli (AFB) and sensitivity testing with isoniazid, rifampicin, streptomycin and ethambutol (E). RESULT: Of the 1472 patients evaluated, 804 (54.6%) were treatment failure cases and 668 (45.4%) were relapse cases; 822 patients (373 failure and 449 relapse) were culture-positive. Of these 822 patients, 482 (58.64%, 261 failure and 221 relapse) were resistant to one or more drugs. Resistance to one drug was observed in 86 patients (10.46%), to two drugs in 149 (18.13%), to three drugs in 122 (14.84%) and to four drugs in 125 (15.21%). Single drug resistance was most commonly seen with isoniazid (62 patients, 7.5%), followed by streptomycin (12 patients, 1.4%), rifampicin (eight patients, 0.97%) and ethambutol (four patients, 0.4%). Resistance to isoniazid plus rifampicin alone was seen in 76 patients (9.2%). CONCLUSION: Drug resistance is a major problem in the treatment of pulmonary tuberculosis. Detection of drug resistance patterns and treatment with second-line anti-tuberculosis drugs in appropriate regimens are necessary in the treatment of failure and relapse cases in order to reduce the emergence of multidrug-resistant tuberculosis.

Original languageEnglish (US)
Pages (from-to)1098-1101
Number of pages4
JournalInternational Journal of Tuberculosis and Lung Disease
Volume6
Issue number12
StatePublished - Dec 1 2002
Externally publishedYes

Fingerprint

Drug Resistance
India
Tuberculosis
Pharmaceutical Preparations
Isoniazid
Rifampin
Recurrence
Ethambutol
Streptomycin
Treatment Failure
Pulmonary Tuberculosis
Multidrug-Resistant Tuberculosis
Sputum
Bacillus
Thorax
Therapeutics
Acids

Keywords

  • Acquired
  • Drug resistance
  • India
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Study of drug resistance in previously treated tuberculosis patients in Gujarat, India. / Shah, A. R.; Agarwal, S. K.; Shah, K. V.

In: International Journal of Tuberculosis and Lung Disease, Vol. 6, No. 12, 01.12.2002, p. 1098-1101.

Research output: Contribution to journalArticle

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abstract = "SETTING: Department of Tuberculosis and Chest Diseases and State Tuberculosis Diagnosis and Training Centre (STDTC), a DOTS centre in Ahmedabad, Gujarat State, India. The study was carried out by retrospectively reviewing patient data between January 2000 and August 2001. OBJECTIVE: To evaluate the pattern of drug resistance among previously treated tuberculosis patients who remained symptomatic or smear-positive despite receiving anti-tuberculosis drugs under DOTS for a minimum of 5 months. DESIGN: A total of 1472 pulmonary tuberculosis patients who had taken anti-tuberculosis treatment were evaluated retrospectively with respect to their drug resistance pattern by sputum culture for acid-fast bacilli (AFB) and sensitivity testing with isoniazid, rifampicin, streptomycin and ethambutol (E). RESULT: Of the 1472 patients evaluated, 804 (54.6{\%}) were treatment failure cases and 668 (45.4{\%}) were relapse cases; 822 patients (373 failure and 449 relapse) were culture-positive. Of these 822 patients, 482 (58.64{\%}, 261 failure and 221 relapse) were resistant to one or more drugs. Resistance to one drug was observed in 86 patients (10.46{\%}), to two drugs in 149 (18.13{\%}), to three drugs in 122 (14.84{\%}) and to four drugs in 125 (15.21{\%}). Single drug resistance was most commonly seen with isoniazid (62 patients, 7.5{\%}), followed by streptomycin (12 patients, 1.4{\%}), rifampicin (eight patients, 0.97{\%}) and ethambutol (four patients, 0.4{\%}). Resistance to isoniazid plus rifampicin alone was seen in 76 patients (9.2{\%}). CONCLUSION: Drug resistance is a major problem in the treatment of pulmonary tuberculosis. Detection of drug resistance patterns and treatment with second-line anti-tuberculosis drugs in appropriate regimens are necessary in the treatment of failure and relapse cases in order to reduce the emergence of multidrug-resistant tuberculosis.",
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