RESUMO
Drug resistance is a threat to TB control program worldwide. Patient infected with multiple drug resistant strains are less likely to become cured. Management of resistant cases is complex and presents therapeutic limitations. Patients with multidrug resistant strains are more prone to treatment failure, progresses to more chronic forms of the disease and death. In most areas of the world, the routine use of drug susceptibility tests, let alone cultures to diagnose tuberculosis or multidrug resistant tuberculosis is beyond the scope of health care resources. According to Global Tuberculosis Report 2015, about 3.3% of newly diagnosed patients had multidrug resistant tuberculosis and 20% of previously treated Tuberculosis cases were estimated to have Multidrug resistant Tuberculosis (MDR-TB). This present study was conducted in the department of chest and TB, Government medical college, Amritsar, with an aim to study the clinico-radiological profile of patients with multidrug resistant tuberculosis. Methods: A prospective study was conducted at the Chest and TB hospital, Amritsar which included 100 diagnosed patients of Multidrug Resistant Tuberculosis. Clinicoradiological profile of these patients was determined. Results: Out of 100 study population, maximum number of patients belonged to the age group of 21-30 years i.e. 26% followed by 22% in the age group of <20 years. Most common symptom was cough with expectoration which was present in 94 (94%) patients. 97 (97%) patients were having previous history of ATT, 3 (3%) patients were not having any previous history of ATT. On radiology unilateral disease was present in 48 (48%) patients, bilateral disease present in 52 (52%) patients. Parenchymal infiltration was present in 79 (79%) patients. Cavitation was present in 23 (23%), Fibrocavitary disease was present in 37 (37%) study subjects. Previous history of ATT had significant association with extent of lesion on chest x- ray (p < 0.05). Conclusion: clinico-radiological characteristics should always be determined where appropriately administered drugs have not achieved necessary drug levels to deal with all the population of mycobacteria, to timely modify and strengthen the national programs, and evaluation of trends in drug resistance pattern.
RESUMO
Drug resistance is a threat to TB control program worldwide. Patient infected with multiple drug resistant strains are less likely to become cured. Multidrug – resistant and extensively drug -resistant tuberculosis continues to emerge in high HIV prevalence settings, and their mortality in HIV co-infected patients remain high. Methods: This retrospective study was carried out at DR-TB centre, Amritsar. This study included drug resistant TB cases registered over the period of 2012 to 2018 at DR-TB centre, Amritsar. Results: A total of 1163 patients of Drug resistant tuberculosis were registered during the period of 7 years , among these 1027, 39 and 97 patients were of MDR, XDR and isoniazid monoresistance respectively. The prevalence of HIV seropositivity was 2.7%, 2.9% and 2.6% in total drug resistant cases, MDR and XDR cases respectively. No case of isoniazid mono-resistance was found positive for HIV. And only one case with primary MDR tuberculosis was HIV positive. Conclusion: In this high drug-resistant TB settings, previous TB treatment failure was strong risk factor for both MDR and XDR-TB in HIV seropositive patients. And HIV seropositivity was more prevalent in MDR-TB cases.