Multidrug Resistant Tuberculosis in a Northern District of Karnataka, South India

Background: Tuberculosis continues to be a major public health problem in most of the developing world. Further, emergence of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis has become a challenging problem in the management of the disease and tuberculosis control programmes. This study was undertaken to determine the prevalence rate of multi drug-resistance and analyze drug resistance pattern in new pulmonary tuberculosis cases. Methodology: A total of 631 clinically suspected new adult pulmonary tuberculosis cases were evaluated for microbiological evidence of tuberculosis. Two hundred and eighty three M. tuberculosis isolates were subjected to antimicrobial susceptibility to isoniazid (INH), streptomycin (SM), ethambutol (EMB) and rifampicin (RIF). Results: Amongst the 631 cases, direct microscopy was positive in 256 (40.57%) and M. tuberculosis was isolated in 283 cases (44.8%). Of the 283 isolates, 94 (33.21%) strains showed resistance to one or more drugs. Resistance to 1drug, 2 drugs, 3 drugs and all the 4 drugs was seen in 23.32%, 5.65%, 1.76 % and 2.47% of the isolates respectively. Multi drug resistance was seen in 12 (4.24%) cases. Maximum resistance was seen to streptomycin (28.97%). Conclusion: For a better management of drug resistant cases, early detection of resistance pattern is extremely important so that effective treatment can be prescribed and further dissemination of drug- resistant strains in the community can be prevented.