Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan
OBJECTIVE: To obtain population-based data on Mycobacterium tuberculosis drug resistance in Pakistan.
METHODS: To obtain drug resistance data, we conducted a population-based study of TB cases in all provinces of Pakistan. We performed culture and drug susceptibility testing on M. tuberculosis isolates from patients with a prior history of anti-tuberculosis treatment (retreatment cases) from all over the country.
RESULTS: Of 544 isolates from previously treated cases, 289 (53.1%) were susceptible to all first-line drugs, 255 (46.9%) were resistant to at least one anti-tuberculosis drug and 132 (24.3%) were MDR-TB. Among MDR-TB isolates, 47.0% were ofloxacin (OFX) resistant. Extensively drug-resistant TB was found in two (0.4%) isolates.
CONCLUSION: Prevalence of drug resistance in retreatment isolates was high. The alarmingly high prevalence of OFX resistance among MDR-TB isolates may threaten the success of efforts to control and treat MDR-TB.
Keywords: Pakistan; drug resistance; retreatment cases
Document Type: Research Article
Affiliations: 1: Department of Pulmonology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar 2: Department of Microbiology, Agha Khan University, Karachi 3: Gulab Devi Chest Hospital, Lahore 4: Ojha Institute of Chest Disease, Karachi 5: National TB Control Programme, Islamabad 6: Department of Pulmonology, Nishtar Medical College, Multan 7: Fatima Jinnah Chest Hospital, Quetta 8: Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi 9: Khyber Medical College, Peshawar 10: Department of Pulmonology, Services Hospital, Lahore 11: Department of Pulmonology, Ayub Medical College, Abbottabad 12: Health Department, Peshawar 13: Department of Chest Medicine, Lahore General Hospital, Lahore 14: Itefaq Medical College, Lahore 15: Department of Medicine, Ziauddin University, Karachi 16: Department of Pulmonology, King Edward Medical University, Lahore 17: Department of Pulmonology, Allama Iqbal Medical College, Lahore 18: Orthopaedic and Medical Institute, Karachi, Pakistan 19: Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
Publication date: 01 March 2017
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