title: Resistance pattern in drug-resistant pulmonary tuberculosis.
abstract: BACKGROUND
  Drug-resistant tuberculosis is an important issue for public health. There is a rise in the trend of drug-resistant tuberculosis, especially multi drug resistance (MDR), in different parts of world, India being one of the high burden countries. This study is undertaken to assess the various patterns of resistance among confirmed drug resistant pulmonary tubercular patients and to initiate second line anti tubercular treatment.
  
  
  OBJECTIVE
  To assess various resistance patterns among confirmed drug resistant pulmonary tubercular patients and for the initiation of appropriate drug regimens in our setup.
  
  
  METHODS
  An observational prospective study.
  
  
  METHODS
  This study was conducted at Rajiv Gandhi Institute of Chest Diseases, Bangalore between January 2005 and November 2010. A total of 309 drug resistant tuberculosis cases were studied. Sputum culture and drug sensitivity were carried out at National Tuberculosis Institute. Drug sensitivity testing done for all first line drugs, except pyrazinamide, by using LJ media.
  
  
  RESULTS
  In this study, out of 309 patients, MDR pattern was observed in 224 (72%), of which 20 (6.47%) had resistance only to isoniazid (INH) and rifampicin (RMP), 58 (18.7%) had resistance to INH, RMP, and either of the other first line drugs streptomycinor ethambutol and 146 (47.25%) had resistance to all first line drugs. Poly drug resistance pattern was observed in 72 (23.3%) and Mono drug resistance in 13 (4.2%).
  
  
  CONCLUSIONS
  In the present study the most common pattern observed is MDR with predominant resistance to INH. There is a rise in the number of drug resistant tuberculosis cases, especially MDR. Hence close monitoring of drug resistant pattern is required to formulate designs of different regimens in the treatment of drug resistant tuberculosis; especially MDR-TB based on accredited laboratory reports, in a specialized center which is very much essential for the betterment of the patients and the community.
authors.affiliation: Department of Pulmonary Medicine, Rajiv Gandhi Institute of Chest Diseases, BMCRI, Bangalore, Karnataka, India. rgicdtrials@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Nagaraja
authors.forename: B L
authors.initials: BL
authors.lastname: Shashibhushan
authors.forename: C
authors.initials: C
authors.lastname: Sagar
authors.forename: M
authors.initials: M
authors.lastname: Asif
authors.forename: P H
authors.initials: PH
authors.lastname: Manjunath
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011446:Prospective Studies; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents