全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis

DOI: 10.4236/jtr.2017.52012, PP. 106-117

Keywords: Tuberculosis, Pulmonary Tuberculosis, Anti-Tuberculosis Drug Resistance, MDR-TB

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB.

References

[1]  Moamcp, D.A. (2007) Evaluation of Direct Detection of Mycobacterium tuberculosis Rifampin. Journal of Clinical Microbiology, 2123-2125.
[2]  Fauci, A.S., NIAID Tuberculosis Working Group (2008) Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis: The National Institute of Allergy and Infectious Diseases Research Agenda and Recommendations for Priority Research. The Journal of Infectious Disease, 1493-1498.
[3]  National Tuberculosis Programme (2014) National Tuberculosis Programme Annual Report 2014. Annual Report. National Tuberculosis Programme, Department of Health Sciences, Thimi, Bhaktapur.
[4]  Department of Health Services (2014) Annual Report Department of Health Services 2013/2014. Teku, Kathmandu.
[5]  Patra, S.K., Jain, A., Sherwal, B.L. and Khanna, A. (2010) Rapid Detection of Mutation in RRDR of rpo B Gene. Indian Journal of Clinical Biochemistry, 315-318.
[6]  Ormerod, L.P. (2005) Multidrug-Resistant Tuberculosis (MDR-TB): Epidemiology, Prevention and Treatment. British Medical Bulletin, 17-24.
https://doi.org/10.1093/bmb/ldh047
[7]  Range, N., Friis, H., Mfaume, S., Magnussen, P., Chanualucha, J., Kilale, A., Mugomela, A. and Andersen, A.B. (2012) Anti-Tuberculosis Drug Resistance Pattern among Pulmonary Tuberculosis Patients with or without HIV infection in Mwanza, Tanzania. Tanzania Journal of Health Research, 1-6.
[8]  Bang, D. (2010) The Management of Tuberculosis: Epidemiology, Resistance and Monitoring. Dansh Medical Bulletin, 4213.
[9]  Marahatta, S. (2010) Multi-Drug Resistant Tuberculosis Burden and Risk Factors: An Update. Kathmandu University Medical Journal, 8, 116-125.
https://doi.org/10.3126/kumj.v8i1.3234
[10]  Sbammpsc, N.C. (2012) Pattern of Drug-Resistance and Treatment Outcome in Multidrug-Resistant Pulmonary Tuberculosis. Indian Journal of Chest Diseases & Allied Sciences, 23-26.
[11]  SAARC TB and HIV/AIDS Centre (2011) SAARC Training Modules for AFB Smear Microscopy and Quality Assurance in AFB Smear Microscopy. Trainer’s Manual. SAARC TB and HIV/AIDS Centre, SAARC TB and HIV/AIDS Centre, Thimi, Bhaktapur.
[12]  European Center for Disease Prevention and Control (2011) Mastering the Basics of TB Control. ECDC Technical Report, European Center for Disease Prevention and Control, European Center for Disease Prevention and Control.
[13]  Programme RNTC (2009) Revised National TB Control Programme Training Manual for Mycobacterium tuberculosis Culture & Drug Susceptibility Testing. Training Manual, Indian Council of Medical Research) and National Tuberculosis Institute, Central TB Division, Nirman Bhawan, New Delhi.
[14]  Abebe, G., et al. (2012) Relatively Low Primary Drug Resistant Tuberculosis in Southwestern Ethiopia. BMC Research Notes, 5, 225.
https://doi.org/10.1186/1756-0500-5-225
[15]  Gebeyehu, M., Lemma, E. and Eyob, G. (2001) Prevalence of Drug Resistant Tuberculosis in Arsi Zone, Ethiopia. Ethiopian Journal of Health Development, 15, 11- 16.
https://doi.org/10.4314/ejhd.v15i1.9891
[16]  Sanchez-Padilla, E., et al. (2013) Multidrug- and Isoniazid-Resistant Tuberculosis in Three High HIV. The International Journal of Tuberculosis and Lung Disease, 17, 1036-1042.
https://doi.org/10.5588/ijtld.12.0842
[17]  Out, A., et al. (2013) Drug Resistance among Pulmonary Tuberculosis. Pulmonary Medicine, 2013, Article ID: 235190.
[18]  Seyoum, B., Demissie, M., Worku, A., Bekele, S. and Aseffa, A. (2014) Prevalence and Drug Resistance Patterns of Mycobacterium tuberculosis among New Smear Positive Pulmonary Tuberculosis Patients in Eastern Ethiopia. Tuberculosis Research and Treatment, 2014, Article: ID 753492.
https://doi.org/10.1155/2014/753492
[19]  Lee, J.H. and Chang, J.H. (2001) Drug-Resistant Tuberculosis in a Tertiary Referral Teaching Hospital of Korea. The Korean Journal of Internal Medicine, 16, 173-179.
https://doi.org/10.3904/kjim.2001.16.3.173
[20]  Zhao, Y., et al. (2012) National Survey of Drug-Resistant Tuberculosis in China. The New England Journal of Medicine, 366, 2161-2170.
https://doi.org/10.1056/NEJMoa1108789
[21]  Cucunawangsih, Wiwing, V., Widysanto, A. and Lugito, N.P.H. (2015) Mycobacterium tuberculosis Resistance Pattern against First-Line Drugs in Patients from Urban Area. International Journal of Mycobacteriology, 4, 302-305.
https://doi.org/10.1016/j.ijmyco.2015.08.002
[22]  Ndung’u, P.W., et al. (2012) Resistance Patterns of Mycobacterium tuberculosis Isolates from Pulmonary Tuberculosis Patients in Nairobi. The Journal of Infection in Developing Countries, 61, 33-39.
[23]  Magana-Arachchi, D.N., Perera, A.J., Senaratne, V. and Chandrasekharan, N.V. (2010) Patterns of Drug Resistance and RFLP Analysis of Mycobacterium tuberculosis Strains Isolated from Recurrent Tuberculosis Patients in Sri Lanka. Southeast Asian Journal of Tropical Medicine and Public Health, 41, 583-589.
[24]  Nunes, E.A., et al. (2008) Mycobacterium tuberculosis and Non-Tuberculous Mycobacterium Isolates among Patients with Recent HIV Infection in Mozambique. Jornal Brasileiro de Pneumologia, 34, 822-828.
https://doi.org/10.1590/S1806-37132008001000011
[25]  Liu, Q., et al. (2013) Rates and Risk Factors for Drug Resistance Tuberculosis in Northeastern China. BMC Public Health, 13, 1171.
https://doi.org/10.1186/1471-2458-13-1171
[26]  Rijal, K.R., Ghimire, P., Rijal, B. and Bam, D.S. (2005) The Pattern of Anti-Tuber- culosis Drug Resistance in Pulmonary Tuberculosis Patients. Journal of Institute of Medicine, 27, 26-28.
[27]  Khoharo, H.K. and Shaikh, I.A. (2011) Drug Resistance Patterns in Pulmonary Tuberculosis. Journal of the Pakistan Medical Association, 61, 229-232.
[28]  Pradhan, P., et al. (2014) Drug Resistance Pattern of Mycobacteria Isolated from Smear Positive Cases of Pulmonary Tuberculosis in Eastern Part of Nepal. Journal of General Practice Emergency Medical Nepal, 8-11.
[29]  Lukoye, D., et al. (2011) Rates of Anti-Tuberculosis Drug Resistance in Kampala- Uganda Are Low and Not Associated with HIV Infection. PLoS ONE, 6, e16130.
https://doi.org/10.1371/journal.pone.0016130
[30]  Johnston, J.C., Shahidi, N.C., Sadatsafavi, M. and Fitzgerald, J.M. (2009) Treatment Outcomes of Multidrug-Resistant Tuberculosis: A Systematic Review and Meta- Analysis. PLoS ONE, 4, e6914.
https://doi.org/10.1371/journal.pone.0006914

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133