Background: The increasing number of tuberculosis cases and an alarming rate of MDR cases in the state of Sikkim has raised concerns calling for an effective awareness generation among the masses regarding MDR and XDR TB and for innovative ideas and dedicated service to tackle such challenges. Hence, the researcher aims to study MDR and XDR TB cases among the newly diagnosed cases of pulmonary tuberculosis.

Methods: A hospital based cross–sectional study was conducted from January 2016–May 2017 among 300 new clinical suspects of PTB. For all the clinical suspects, two sputum samples were collected and subjected to Auramine–o staining. Further, the samples diagnosed with tuberculosis were subjected to detection of MDR and XDR TB by real time PCR. We performed all the analysis using SPSS software (Statistical package, SPSS Inc., Chicago, IL, USA, version 13.0).

Result: A total of 300 clinical suspects enrolled for the study, of which 82(27.33%) were diagnosed of pulmonary tuberculosis by fluorescence microscopy. On further diagnosis for MDR and XDR TB cases; 1(7%) was mono resistant to rifampicin, 13(93%) showed point mutations in genes responsible for drug resistance to one or more drugs, 2(14%) cases showed resistance to both katG and inhA for isoniazid and 1(7%) case showed resistance to katG gene. All the diagnosed cases were resistant to rpoB gene for rifampicin resistance; further, only one case was found to be resistant to gyrA and eia–10 genes, thus determined to be an XDR TB case. Socio demographically, MDR TB cases were predominant in male and it was determined that the house–hold status, living condition, cross ventilation, overcrowding, history of contact were significantly correlated.

Conclusion: Detecting MDR and XDR TB in the initial stage helps in initiating the treatment quickly and effectively, further providing the benefit of better management of MDR and XDR TB cases in the diagnosed patients. The study also provides information on the socio demographic elements determining the burden of MDR and XDR TB among the suspected patients of Sikkim.