MDR- and XDR-TB among suspected drug-resistant TB patients in a tertiary care hospital in India

Aim: To study the anti-tubercular drug resistance pattern among suspected cases of drug-resistant TB.

Materials and methods: First and second line drug susceptibility data were retrospectively analysed for all suspected cases of drug-resistant tuberculosis (TB), presenting to the Pulmonary Medicine department of tertiary care hospital in South India from 2003 to 2007.

Results and discussion: Out of 177 cases of suspected drug-resistant TB, 103 (58.2%) cases were multi-drug-resistant tuberculosis (MDR-TB). Out of 75 cases of MDR-TB for whom second-line drug susceptibility test was performed, 45 (60.0%) cases met the criteria of extensively drug-resistant (XDR) TB, which is very high when compared with existing worldwide data on XDR-TB (6.6% cases of MDR-TB). In comparison with non-MDR-TB cases, MDR and XDR-TB cases had a history of significantly higher duration of anti-TB treatment (ATT) and significantly higher exposure to multiple ATT regimens. Past exposure to second-line anti-TB drugs was significantly high in XDR-TB cases than in MDR-TB and non MDR-TB cases.

Conclusion: This study highlights the high burden of XDR- and MDR-TB among TB patients coming to tertiary care hospitals in India.