title: Drug resistance detection and mutation patterns of multidrug resistant tuberculosis strains from children in Delhi.
abstract: A total of 312 sputum samples from pediatric patients presumptive of multidrug resistant tuberculosis were tested for the detection of drug resistance using the GenoTypeMTBDRplus assay. A total of 193 (61.8%) patients were smear positive and 119 (38.1%) were smear negative by Ziehl-Neelsen staining. Line probe assay (LPA) was performed for 208 samples/cultures (193 smear positive samples and 15 cultures from smear negative samples). Valid results were obtained from 198 tests. Of these, 125/198 (63.1%) were sensitive to both rifampicin (RIF) and isoniazid (INH). 73/198 (36.9%) were resistant to at least INH/RIF, out of which 49 (24.7%) were resistant to both INH and RIF (multidrug resistant). Children with tuberculosis are often infected by someone close to them, so strengthening of contact tracing in the program may help in early diagnosis to identify additional cases within the household. There is a need to evaluate newer diagnostic assays which have a high sensitivity in the case of smear negative samples, additional samples other than sputum among young children not able to expectorate, and also to fill the gap between estimated and reported cases under the program.
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Arora
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Ritu
authors.initials: R
authors.lastname: Singhal
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Manpreet
authors.initials: M
authors.lastname: Bhalla
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Ajoy
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Niti
authors.initials: N
authors.lastname: Singh
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Digamber
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of TB and Chest, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Sarin
authors.affiliation: Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India. Electronic address: tbmicro@gmail.com.
authors.forename: Vithal Prasad
authors.initials: VP
authors.lastname: Myneedu
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009154:Mutation; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics
keywords: Drug resistance; Line probe assay; Retreatment cases; Smear positive; Tuberculosis