Evaluation of Drug Susceptibility Profile Among  Category Ii Pulmonary Tuberculosis Patients  (Relapse, Failure, Defaulter) at Tirunelveli

Amudha VP; Ramnath R; Palaniappan N

Volume : II, Issue : XI, November - 2013

Evaluation of Drug Susceptibility Profile Among Category Ii Pulmonary Tuberculosis Patients (Relapse, Failure, Defaulter) at Tirunelveli

Amudha Vp, Ramnath R, Palaniappan N

Abstract :

The present study was undertaken at Tirunelveli Medical College aiming to find the drug susceptibility profile among previously treated pulmonary tuberculosis cases and identify the risk factors of acquiring drug resistant TB. Early morning sputum specimens were collected, cultured and drug sensitivity testing was performed. Of the 108 samples processed, 78.7% showed a positive growth for M. tuberculosis, 13.9% were culture negative, 3.7% were contaminated and 3.7% had a growth of non tuberculous mycobacteria. Among the 85 culture positive cases, 50 (58.8%) were sensitive to the first line drugs and 35 (41.2%) were resistant to one or more drugs. Resistance to one drug was noted in 14 (16.6%), to two drugs in 9 (10.6%), to three drugs in 10 (11.8 %) and to all four drugs in 2 (2.4%) cases. Monodrug resistance was most commonly seen with Isoniazid and Streptomycin (6 patients each, 7.1%), followed by Rifampicin and Ethambutol (1 patient each, 1.2%). Among the 35 drug resistant cases, cumulative resistance was highest to Isoniazid (27 patients 31.7%) followed by Streptomycin (21 patients, 24.7%), Rifampicin (19 patients, 22.3%) and Ethambutol (3 patients, 3.5%). 18 were MDR TB (21.2%) among the culture positive cases. No XDR TB cases were present. Age, sex, residence, education, income, diabetes were not risk factors for multidrug resistant tuberculosis. Smoking and taking irregular and interrupted treatment was a significant risk factor among MDR cases.