Multidrug-resistant and extensively drug resistant tuberculosis in Kashmir, India.
BACKGROUND
To study the profile of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in tertiary care hospital setting, representing almost the whole affected population in Kashmir valley of India.


METHODS
A total of 910 cases of pulmonary tuberculosis were enrolled over four years. Among these, cases of MDR-TB and XDR-TB were meticulously studied for drug susceptibility, treatment, adverse effects profile and overall survival.


RESULTS
Fifty-two (5.7%) cases of MDR-TB were identified, among which eight (15.3%) were diagnosed as XDR-TB on the basis of drug susceptibility testing, using the prescribed definition. The cases were sensitive to 2, 3, 4, 5 and more than 5 drugs in almost equal proportions. Thirty-seven (71.1%) cases were successfully cured; eleven (21.1%) patients died; and only four (7.6%) cases defaulted, indicating overall satisfactory adherence to treatment.


CONCLUSIONS
For effective treatment of MDR-TB and XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens, and financial assistance in resource-limited settings through effective political intervention are necessary for better patient adherence and overall cure.
Datta
Bikram Singh
BS
Government Medical College associated Chest Diseases Hospital, Srinagar, Kashmir, India. kadrism@gmail.com
Hassan
Ghulam
G
Kadri
Syed Manzoor
SM
Qureshi
Waseem
W
Kamili
Mustadiq Ahmad
MA
Singh
Hardeep
H
Manzoor
Ahmad
A
Wani
Mushtaq Ahmad
MA
Shamas-u-Din
Thakur
Natasha
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D015995:Prevalence; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
D000995:Antitubercular Agents