Phenotypic drug resistance confirmation of additional second line drugs in extra-pulmonary multi drug resistant tb patient

Srashty Sharma., Mahmud Hanif., Kamal Kishore Chopra., Ashwani Khanna and Sunil Kumar Chauhan

Introduction: Rapid phenotypic Drug Susceptibility testing (DST) on liquid media BACTEC MGIT 960 system had been applied for additional newer Second line drugs currently being used in Indian TB programme known as extended second line drugs on confirmed multi drug resistant (MDR TB) patients with extra pulmonary (EP)TB.

Material & Methods: A total of 334 different types of EP specimens were collected from MDR-TB suspects. M. tuberculosis was recovered from such EP specimens using rapid liquid culture. All Mycobacterium tuberculosis complex (MTBC) positive isolates were subjected to line probe assay (LPA) for confirmation of MDR. Confirmed MDR isolates were subjected to MGIT DST for extended second line drugs.

Result: Total culture positivity was found 17 %. Out of these 58 MTBC positive culture isolates, 15% were MDR. Second line DST was performed for Kanamycin, Capreomycin, Levofloxacin, Moxifloxacin low, Moxifloxacin high, Linezolid, and Clofazimine. Different combinations of drug resistance were observed among these isolates.

Conclusion: Significant frequency of extensively drug resistant (XDR) and pre XDR strains in the cohort of EPTB MDR cases shows that there is a certain probability of more unreported XDR cases which can be left untreated otherwise.

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