Drug Resistance Pattern and Changing Diagnostic Trends of Multidrug-Resistant Tuberculosis at Tertiary Care Centre in Western Rajasthan: A 5-Year Experience

Purpose Multidrug-resistant tuberculosis (MDR-TB) is a serious obstacle to successful TB control. India has a high burden of drug-resistant tuberculosis (TB). Microscopy is the most available diagnostic technique but drug resistance cannot be diagnosed by microscopy. As Culture method is the gold standard important in diagnosis and drug resistance testing, but it has the prolonged turnaround time, high costs and unavailability. The Gene Xpert method for XpertMTB/Rif assay, allows rapid diagnosis of tuberculosis/multiple drug resistance Mycobacterium tuberculosis (MTB/MDRTB). The aim of thisstudy is to evaluate the day by day increase role of the XpertMTB/Rifassay method in the diagnosis of MTB and drug resistance -tuberculosis (DR-MTB) after its installation inwestern Rajasthan. The objectives of this study were to determine the first-line drug resistance patterns and its changing diagnostic trends in western Rajasthan in the 5 years. In view of this, we reviewed our data over last five years. Materials and MethodsThis five year observational, retrospective, hospital base, study was carried out in tertiary center of western Rajasthan, Kamla Nehru chest hospital, Dr. S. N. medical college Jodhpur Rajasthan, India. During the period of March 2012 to December 2016, 1225 cases of multidrug resistant tuberculosis. ResultsIn our study we observed progressive increase in percentage of CBNAAT based diagnosis of MDR-TB in our study population as 9 % in 2012, 23 % in 2013, 29 % in 2014, 39 % in 2015 and 46.96 % in 2016.16.9 % patients were rifampicin mono-resistant and 53.6 % patients were both isoniazid and rifampicin resistant based on LPA.29.5 % patients on retreatment group were put on treatment on the basis of gene expert. Conclusion This study recommends that Xpert MTB/RIF should be incorporated in the diagnostic algorithm of pulmonary tuberculosis, which has been dealt in the latest tuberculosis guideline.