ORIGINAL ARTICLE: Resistance To Quinolones, Aminoglycosides And Capreomycin In Multi Drug Resistant M.Tuberculosis

Abstract

Background:

Tuberculosis is a major health issue of developing countries like Pakistan. Multi drug resistance (MDR) and Extensive drug resistance (XDR) in M. tuberculosis is on continuous rise in our region. Detection and prevalence of resistance in tuberculosis patients were discussed in few of the studies in Pakistan but pattern of resistance to second-line anti-tuberculosis drugs was still unknown and was a gap in the knowledge. This study was aimed to determine the pattern of resistance against Quinolones, Aminoglycosides and Capreomycin in Multi-drug resistant (MDR-TB) tuberculosis from a tertiary care hospital of Karachi.

Methods:

The cross-sectional study was carried out from January 2007 to October 2008 in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Sixty MDR-M.tuberculosis strains of two groups were collected. Group 1 consisting of 30 samples from stock cultures of MDR-TB collected during previous 5 years (Laboratory of Microbiology, BMSI) and Group 2 consisting of 30 culture positive specimens from JPMC and Ojha Institute of Chest diseases, Karachi. These samples were further analysed for anti-microbial sensitivity against Quinolones (Ofloxacin), Aminoglycosides (Amikacin and Kanamycin) and Capreomycin. Indirect Proportion Method is used for drug susceptibility test (DST) following WHO guidelines 2001. For calculations & results, Quantitative analysis was done and percentages were calculated.

Results:

From among 60 MDR-TB isolates, 3 (5%) were resistant to Ofloxacin; 1 (1.6%) resistant to Amikacin; 4 (6.6%) were resistant to Kanamycin and 60 (100%) were sensitive to Capreomycin. There was an increase in resistance in-group 2.

Conclusion:

Our study confirmed the resistance against second-line anti-tuberculous drugs. Overall resistance to second-line anti-tuberculous is at low percentage but results clearly show the marked increase in resistance in Group 2. Immediate measures are surely required to detect and control drug resistance in our country.