Tripathy Sunita, Kumar Rajesh, Singh Surya Deo
Professor, Department of Biochemistry, Darbhanga Medical College , Darbhanga, India .
Senior, Medical Officer, DRTB Centre , DMCH, Darbhanga, India .
J Clin Diagn Res. 2015 Nov;9(11):LC09-12. doi: 10.7860/JCDR/2015/14024.6793. Epub 2015 Nov 1.
Multidrug resistant tuberculosis (MDR-TB) is caused by Infection with Mycobacterium tuberculosis which is resistant to both isoniazid (INH) and rifampicin (RIF), with or without any other anti tubercular drug. It is caused by resistant mutant strains due to inadequate treatment and poor compliance. Due to time taking conventional diagnostic methods, drug resistant strains continue to spread. Therefore rapid diagnosis and treatment of MDR-TB strains are prerequisites for the worldwide fight against TB.
To determine the prevalence of MDR TB in North Bihar by molecular diagnostic method and to facilitate early diagnosis and treatment. Also, to find out the number of those diagnosed cases who were successfully initiated the treatment in MDR TB Centre of DMCH.
This six month observational study was carried out in IRL Darbhanga, Damien TB research Centre of the Darbhanga Medical College and Hospital, Bihar, India. During the period of February-July 2014, 256 sputum samples were collected from suspected cases of multidrug resistant tuberculosis, from 6 districts of North Bihar around Darbhanga. These samples were subjected to routine microscopy and culture to detect Mycobacterium tuberculosis. Positive cases were subjected to drug sensitivity test by a molecular diagnostic method, Using Genotype MTBDR plus kit.
Out of 256 sputum samples from suspected cases of MDR TB, 122 cases were microscopy positive for tuberculosis. Among these 122 cases, tuberculosis was confirmed by PCR in 114 cases. Finally with the help of Line Probe Assay (LPA), 39(15%) samples were found to have resistance to both INH and Rifampicin. Male female ratio was 4:1.
The Prevalence of Multi drug resistant pulmonary tuberculosis in North Bihar is 15%. It needs early diagnosis by molecular diagnostic method and prompt treatment to reduce the spread of MDR TB cases.
耐多药结核病(MDR-TB)是由感染结核分枝杆菌引起的,该菌对异烟肼(INH)和利福平(RIF)均耐药,无论是否对其他任何抗结核药物耐药。它是由于治疗不充分和依从性差导致的耐药突变菌株引起的。由于传统诊断方法耗时,耐药菌株持续传播。因此,快速诊断和治疗耐多药结核菌株是全球抗击结核病的先决条件。
通过分子诊断方法确定北比哈尔邦耐多药结核病的患病率,并促进早期诊断和治疗。此外,找出在达班加医学院医院耐多药结核病中心成功开始治疗的确诊病例数。
这项为期六个月的观察性研究在印度比哈尔邦达班加的达米恩结核病研究中心——国际防痨和肺部疾病联合会(IRL)达班加进行。在2014年2月至7月期间,从达班加周围北比哈尔邦的6个区疑似耐多药结核病病例中收集了256份痰标本。这些标本进行常规显微镜检查和培养以检测结核分枝杆菌。阳性病例通过分子诊断方法使用Genotype MTBDR plus试剂盒进行药敏试验。
在256份疑似耐多药结核病病例的痰标本中,122例显微镜检查结核阳性。在这122例中,114例通过PCR确诊为结核病。最后借助线性探针分析(LPA),发现39份(15%)标本对异烟肼和利福平均耐药。男女比例为4:1。
北比哈尔邦耐多药肺结核的患病率为15%。需要通过分子诊断方法进行早期诊断并及时治疗,以减少耐多药结核病例的传播。