Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan

Javaid A 1 , Hasan R 2 , Zafar A 2 , Chaudry MA 3 , Qayyum S 4 , Qadeer E 5 Show all authors , Shaheen Z 6 , Agha N 7 , Rizvi N 8 , Afridi MZ 9 , Chima MK 10 , Khan AR 11 , Ghafoor A 12 , Khan S 13 , Awan SR 14 , Akhtar S 15 , Choudry K 16 , Iqbal ZH 17 , Ansarie M 18 , Ahmad N 19

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
Int J Tuberc Lung Dis, 2017 03 01;21(3):303-308.
PMID: 28225340 DOI: 10.5588/ijtld.16.0444

Abstract

BACKGROUND: Drug resistance in general, and multidrug-resistant tuberculosis (MDR-TB) in particular, threatens global tuberculosis (TB) control efforts. Population-based estimates of drug resistance are needed to develop strategies for controlling drug-resistant TB 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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