IMC Journal of Medical Science https://www.imcjms.com/ Ibrahim Medical College Journal of Medical Science <![CDATA[First Line Anti-Tubercular Drug Resistance Pattern of Mycobacterium Tuberculosis Isolated From Specialized Hospitals of Dhaka City]]> Md. MohiuddinJ. Ashraful Haq https://www.imcjms.com/registration/journal_full_text/69 2016-08-02 12:06:05 Original Article Ibrahim Med. Coll. J. 2014; 8(2): 41-46 0.05). Table-7: Rate of isolation of MDR-TB from untreated and treated pulmonary tuberculosis cases      Table-9: Rate of concomitant resistance of RIF / INH / ETH /SM sensitive M. tuberculosis to corresponding drugs Table-9 shows the concomitant resistance rate of M. tuberculosis to any three first line anti-TB drugs which were sensitive to RIF, INH, ETH or SM. Rate of resistance to three other drugs ranged from 34.78% to 43.21% among RIF, INH, ETH or SM sensitive isolates. Discussion Monitoring of drug resistance pattern, early diagnosis and initiating prompt treatment has been the mainstay to interrupt the transmission of tuberculosis. In this context, the present study was designed to determine the drug resistance pattern of mycobacterium. In the present study, about 70.0% sputum samples yielded positive culture results on L-J media. Various authors have reported similar culture positivity rate in L-J media which ranged from 59.72 to 87.2%.8-11 However, the culture positivity rate was only 44.0% in lymph node aspirate samples. The failure to isolate mycobacteria in about 30-56% sputum and lymph node aspirates was due to contamination of media or damage to organisms during decontamination process. Previous studies reported the contamination rate from 1.2% to 27.2%.9-13 Therefore, the isolation rate of mycobacteria can be increased if contamination is prevented and sample processing procedure is further improved. Out of the 200 isolates of mycobacteria, 96.0% were M. tuberculosis and 4.0% were MOTT. Earlier, a study in Dhaka by Miah et al. reported 95.3% isolates as M. tuberculosis and 4.7% as MOTT.3 The resistance pattern of first line anti-tubercular drugs observed in the present study among untreated cases was almost similar to the resistance pattern reported previously in 2000 and 2007.3,4 Almost similar rate of resistance was observed in other neighboring countries.14,15 In the present study, out of 30 RIF resistant M. tuberculosis, 83.3% were also concomitantly or cross resistant to other three first line anti-tubercular drugs (p<0.05; Table-8). On the other hand, of the 50 INH resistant M. tuberculosis, 64.0% were concomitantly or cross resistant to other three first line anti tubercular drugs (p>0.05) while for ETH and SM the rate was 74.3% and 55.5% respectively. Resistance to RIF in M. tuberculosis occurs in a high frequency and mono resistance to RIF is rare, whereas mono resistance to INH is common.17 It has been proposed that resistance to RIF can be used as a surrogate marker for MDR-TB as nearly 90% of the RIF resistant strains are also INH resistant.17,18 It is to be noted that only 43.21% M. tuberculosis isolates which were sensitive to RIF, was concomitantly resistant to other 3 drugs (Table-9). This indicates that a sensitive M. tuberculosis isolates (sensitive to RIF, INH, ETH and SM) could be resistant to any of the three other first line anti-TB drugs and it could not therefore, predict that if an isolate sensitive to any single first line drug would simultaneously be sensitive to other three drugs.   1.    World Health Organization Report 2010: Global tuberculosis control. World Health Organization, 1211 Geneva 27, Switzerland. 2010; 5-7. 3.    Miah MR, Ali MS, Saleh AA, Sattar H. Primary drug resistance pattern of mycobacterium tuberculosis in Dhaka, Bangladesh. Bangladesh Med Res Council Bull 2000; 26: 33-40. 5.    World Health Organization: Global tuberculosis control: surveillance, planning and financing. World Health Organization, 1211 Geneva 27, Switzerland 2006a; 362. 7.    Velayati AA, Masjedi MR, Farnia P, Tabarsi P, Ghanavi J, Ziazarifi AH, et al. Emergence of new forms extensively drug-resistant tuberculosis bacilli: super resistant strains in Iran. Chest 2009; 136: 420-25. 9.    Hanna BA, Ebrahimzadeh A, Elliot LB, Morgan MA, Novak SM, Rusch-Gerdes S, et al. Multicentre evaluation of BACTEC MGIT 960 system for recovery of mycobacteria. J Clin Microbiol 1999; 37: 748-52. 11.  Uddin MN, UddinMJ, Mondol MEA, Islam SMJ, Wadud ABM. Comparison of conventional and automated culture system for isolation of Mycobacterium tuberculosis. JAFMC Bangladesh 2009; 5: 14-17. 13.  Chien HP, Yu MC, WU MH, Lin TP, Luh KT. Comparison of the BACTEC MGIT 960 with Lowenstein Jensen media for recovery of mycobacteria from clinical specimens. Int J Tuberc Lung DIS 2000; 4: 866-70. 15.  Iqbal R, Shabbir I, Khan SU, Saleem S, Munir K. Multidrug resistance tuberculosis in Lahore. Pak J Med Res 2008: 47: 22-25. 17.  Somoskovi A, Parsons LM and Salfinger M. The molecular basis of resistance to isoniazid, rifampicin and pyrazinanide in Mycobacterium tuberculosis. Respir Res 2001; 2: 164-68. ]]> 2024 Ibrahim Medical College. All rights reserved.