A study on prevalence of drug resistance and genetic mutation pattern among suspected Drug resistant pulmonary tuberculosis cases in Jamnagar district

study on prevalence of drug resistance and genetic mutation pattern among suspected Drug resistant pulmonary tuberculosis cases

Abstract

Background: Drug resistant tuberculosis is a growing public health problem. Diagnosis of drug resistant tuberculosis is challenging due to equivocal disease presentation of drug sensitive and drug resistant tuberculosis. Isoniazide is one of the oldest and most potent anti- tuberculosis drugs and consistent component of time treated Standard Short Course Chemotherapy. Resistance to first line drugs can pose a significant challenge to efforts of TB control especially in developing countries like India. Objective: The present study aims to determine prevalence of isoniazid and rifampicin mono resistance and multidrug resistance among suspected pulmonary tuberculosis cases and study pattern of their genotypic mutation. Methods: We screened 1332 suspected drug resistant pulmonary tuberculosis patients registered from January 1st, 2013 to December 31st, 2014 under Revised National TB Control Program in Jamnagar district. Their sputum samples were subjected drug sensitivity for isoniazid and rifampicin. Out of 1332 patients, valid reports were obtained for 1005 patients. Results: We observed that the prevalence of isoniazid mono resistance, rifampicin mono resistance and multi-drug resistance was 9.25%, 2.29% and 5.57% respectively. Proportion of mono or multi-drug resistance was as high as 85% among category-II patients. Kat-G gene mutation (bad mutation) was found in three fourth of total patients studied. Conclusion: The prevalence of isoniazid mono resistance was higher, followed by multi-drug resistance and least for rifampicin mono resistance. Drug resistance was observed to be higher in retreatment cases than new cases. The prevalence of Kat-G mutation was also very high compared to Inh-A mutation with about three fourth of isoniazid mono resistant cases having Kat-G genotypic pattern.[Rami K Natl J Integr Res Med, 2019; 10(4):6-9]