Resistance to Antituberculosis Drugs in Pulmonary Tuberculosis.
BACKGROUND
Incidence of drug resistance and pattern of susceptibility to antitubercular drugs in pulmonary tuberculosis amongst soldiers and their families was studied for four years at a military hospital in northwest India.


METHODS
Identification and susceptibility tests were carried out as per procedures laid out in laboratory manual of Tuberculosis Research Centre (TRC), Chennai.


RESULTS
Of the 172 strains of Mycobacterium tuberculosis (MTB) isolated from sputum samples, 150 (87.21%) were sensitive and 22 (12.79%) showed resistance to one or more antitubercular drugs. Acquired drug resistance was observed in 7 (31.82%) and primary drug resistance in 15 (68.18%) cases. Among 22 drug resistant cases, who were on short course chemotherapy (SCC), resistance to single drug was observed in 12 (54.54%), two drugs in 7 (31.82%) and to three or more drugs in 3 (13.64%) isolates. Fourteen (18.14%) strains were resistant to Streptomycin, 8 (4.65%) to Rifampicin, 11 (6.40%) to Isoniazid, 1 (0.58%) to Pyrazinamide and 2 (1.16%) to Ethambutol. Multidrug resistance was observed in 5 (2.91%) cases, of which resistance to Isoniazid and Rifampicin was present in 2 (1.16%) and their combination with other drugs in other 3 (1.74%) isolates.


CONCLUSIONS
Drug susceptibility pattern to antitubercular drugs is discussed and compared with studies from other centres.
ADMS, HQ 5 Mountain Division, C/o 99 APO.
K
K
Chand
Classified Specialist (Pathology), Military Hospital, Kirkee.
R
R
Khandelwal
Classified Specialist (Medicine & Respiratory diseases), Military Hospital (CTC), Pune-40.
V
V
Vardhan
Antitubercular drugs; Drug resistance; Mycobacterium tuberculosis
J Clin Microbiol. 1999 Nov;37(11):3528-32
10523547
JAMA. 1992 Sep 9;268(10):1280-6
1507374
Indian J Med Microbiol. 2002 Apr-Jun;20(2):61-8
17657033
Indian J Med Microbiol. 2002 Apr-Jun;20(2):76-8
17657036
Med J Armed Forces India. 2004 Apr;60(2):134-6
27407606
Med J Armed Forces India. 2000 Apr;56(2):130-134
28790676
N Engl J Med. 1993 Apr 22;328(16):1137-44
8096066
N Engl J Med. 1993 Feb 25;328(8):521-6
8381207
Indian J Med Res. 1993 May;97:102-3
8406629
Tuber Lung Dis. 1993 Feb;74(1):23-7
8495016
JAMA. 1996 Dec 25;276(24):1980-3
8971069
Clin Infect Dis. 1997 Jan;24 Suppl 1:S121-30
8994791