title: Drug resistance patterns in 111 cases of drug-resistant tuberculosis spine.
abstract: OBJECTIVE
  We report the largest study conducted till date of drug resistant tuberculosis in spine analyzing the drug susceptibility patterns in 111 cases of proven drug resistance.
  
  
  METHODS
  An observed cross-sectional study was conducted. Six-hundred and eighty-six patients with positive cultures underwent sensitivity testing to 13 commonly used anti-tubercular drugs using BACTEC MGIT-960 system.
  
  
  RESULTS
  Females (60.3%) outnumbered males (39.6%). Only three patients (2.7%) were found HIV positive, and none of these had AIDS. Forty-four (39.6%) patients had taken AKT in the past for some form of tuberculosis. Eight (7.2%) patients had history of treatment default. The drug sensitivity testing revealed 87 (78.3%) cases of multi drug resistance (resistance to both isoniazid and rifampicin) and 3 (2.7%) cases of XDR-TB spine. Of the individual drugs, widespread resistance was present to both isoniazid (92.7%) and rifampicin (81.9%), followed by streptomycin (69.3%). Least resistance was found to kanamycin, amikacin and capreomycin.
  
  
  CONCLUSIONS
  It is recommended to do routine biopsy, culture and drug sensitivity testing in all patients of tuberculosis spine to guide selection of appropriate second-line drugs when required. In cases of non availability of drug susceptibility testing despite repeated attempts, it is suggested to use data from large series such as this to plan best empirical chemotherapy protocol.
authors.affiliation: Hinduja Hospital, Mahim, Mumbai, India. kapilmohan80@gmail.com
authors.forename: Kapil
authors.initials: K
authors.lastname: Mohan
authors.forename: Saurabh
authors.initials: S
authors.lastname: Rawall
authors.forename: Uday M
authors.initials: UM
authors.lastname: Pawar
authors.forename: Meeta
authors.initials: M
authors.lastname: Sadani
authors.forename: Premik
authors.initials: P
authors.lastname: Nagad
authors.forename: Amita
authors.initials: A
authors.lastname: Nene
authors.forename: Abhay
authors.initials: A
authors.lastname: Nene
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents