title: Multi-drug resistant tuberculosis among category I treatment failures--a retrospective study.
abstract: BACKGROUND
  Tuberculosis (TB) remains a major global health problem and ranks as the second leading cause of death worldwide. An important cause of TB epidemic is the emergence of multi drug resistant (MDR) strains of Mycobacterium tuberculosis. Despite the availability of treatment that is expected to cure most cases of TB, levels of MDR-TB remain worryingly high in India.
  
  
  OBJECTIVE
  This study was carried out to ascertain the prevalence of MDR-TB among category I pulmonary TB treatment failure patients.
  
  
  METHODS
  This was a retrospective study involving 750 pulmonary tuberculosis patients enrolled at six district centres of Delhi State under RNTCP who failed to respond to CAT I treatment and whose sputum samples were submitted for culture and drug sensitivity testing (DST) over a period of three years (2009-2012). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin.
  
  
  RESULTS
  Out of the total 750 patients included in the study, 470 (62.6 %) were culture positive. Of these, 377 (80.2%) were subjected to DST and rest 93 (19.7%) were excluded. Ultimately, DST result was available for 353 (93.6 %) cases. 239 (68%) cases were detected as multi drug resistant TB.
  
  
  CONCLUSIONS
  High proportion of MDR-TB (68%) among culture positive CAT I treatment failure cases highlights the need for rapid diagnostic tests which will enable the detection of MDR-TB at an early stage and will thus minimize the risk of transmission as well as the possible errors associated with the treatment.
authors.forename: Niti
authors.initials: N
authors.lastname: Singh
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Sidiq
authors.forename: Manpreet
authors.initials: M
authors.lastname: Bhalla
authors.forename: V P
authors.initials: VP
authors.lastname: Myneedu
authors.forename: Rohit
authors.initials: R
authors.lastname: Sarin
mesh_terms: D006801:Humans; D015995:Prevalence; D012189:Retrospective Studies; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology*