Rising Menace of Multidrug Resistant Mycobacteria in Pulmonary Tuberculosis

OBJECTIVE: The study was conducted to determine the rising menace of multidrug resistant mycobacteria in Pulmonary tuberculosis. SUBJECTS & METHODS: This prospective study was conducted in the Department of Medicine, Muhammad Medical College Mirpurkhas, from May 2007 to July 2008. Sixty cases of pulmonary tuberculosis were selected for multidrug resistant tuberculosis (MDR-TB) study that fulfilled the inclusion criteria. Pulmonary specimens consisted of 2-5 ml, early morning sputa and bronchial washings were sent for the ZN staining (AFB) and culture and drug sensitivity on culture-media. MDR-TB was defined as simultaneous resistance of an isolate to isoniazid and rifampicin. RESULTS: Drug culture and sensitivity revealed that 22 (36.66%) were sensitive to all the five first-line drugs, while 38 (63.33%) showed one or other type of drug resistance, including 7 (11.66%) resistant to single drug, 15 (25%) resistant to two drugs, 10 (16.66%) resistant to three drugs, while 6 (10%) were resistant to all the first-line drugs. Primary drug resistance was noted in 3 (5%). Resistance to isoniazid, rifampicin, streptomycin, ethambutol and pyrazinamide was seen in 32 (53.33%), 28 (46.66%), 24(40%), 20 (33.33%), and 18 (30%) respectively. CONCLUSIONS: In view of this increasing level of drug resistance, more organized national strategy against tuberculosis is needed. MDR-TB was most commonly seen in chronic cases/ drug defaulters, and it is a major threat to the tuberculosis control measures.