Prevalence of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: a retrospective hospital-based study.
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Date
2009-10
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Abstract
Background & objective: Extensively drug-resistant tuberculosis (XDR-TB) is a difficult-to-treat form of
multidrug-resistant tuberculosis (MDR-TB). High rates of XDR-TB have been reported from India. We
sought to ascertain the prevalence of XDR-TB among patients with MDR-TB treated at a tertiary care
centre in New Delhi, India.
Methods: Case records of patients treated for MDR-TB at the All India Institute of Medical Sciences
hospital, New Delhi, between 1997 and 2003 were retrospectively reviewed. All patients underwent a pretreatment
drug-susceptibility testing (DST) to first- as well as second-line drugs. XDR-TB was defined as
TB caused by bacilli showing resistance to rifampicin and isoniazid in addition to any fluoroquinolone
and to at least one of the three following injectable drugs: capreomycin, kanamycin, and amikacin.
Results: A total of 211 laboratory-confirmed cases of MDR-TB were reviewed. The mean age of the
patients was 33 ± 12 yr. Fifty one (24%) patients were females. All patients were sero-negative for human
immunodeficiency virus infection. Five of the 211 MDR-TB patients had XDR-TB. The prevalence of
XDR-TB was 2.4 per cent among MDR-TB patients.
Interpretation & conclusion: Our results showed that XDR-TB was rare among patients with MDR-TB
treated between 1997 and 2003 at our centre. Unreported selection bias might have been responsible for the high prevalence of XDR-TB reported in previous hospital-based studies from India.
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Keywords
Drug resistance, extensively drug-resistant tuberculosis (XDR-TB), India, multidrug-resistant tuberculosis (MDR-TB), tuberculosis
Citation
Sharma Surendra K, George Ninoo, Kadhiravan Tamilarasu, Saha Pradip K, Mishra Hemant K, Hanif Mahmud. Prevalence of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: a retrospective hospital-based study. Indian Journal of Medical Research. 2009 Oct; 130(4): 392-395.