Misra Richa, Kesarwani Vasudha, Nath Alok
MD, Department of Microbiology, Division Mycobacteriology, SGPGIMS, Lucknow, India.
MD, DM, Department of Pulmonary Medicine, SGPGIMS, Lucknow, India
BMJ Open. 2021 Apr 15;11(4):e044096. doi: 10.1136/bmjopen-2020-044096.
We aim to define the burden of rifampicin monoresistant tuberculosis (TB) at a tertiary care centre in northern India as well as determine the second-line drug susceptibilities (SL-DST) in a subset of patients.
A total of 3045 pulmonary (n=1883) and extrapulmonary (n=1162) samples from likely patients with TB were subjected to microscopy, culture and the Xpert MTB/RIF assay from March 2017 to June 2019. SL-DST testing by line probe assay version 2 for fluoroquinolones (FQs) and second-line injectable drugs were performed on 62 samples.
Out of 3045 samples processed in our laboratory during the study period, 36.1% (1101/3045) were positive for Mycobacterium tuberculosis complex (MTBC) and 21.6% were rifampicin monoresistant (223/1032). The rate of rifampicin resistance in pulmonary samples was 23.5% (166/706) and in extrapulmonary cases, it was 17.4% (57/326). Out of 62 cases included for second-line testing, 48 were resistant to FQs (77.4%) while 11 were extensively drug resistant.
India urgently needs to arrest an emerging multidrug-resistant TB epidemic with associated resistance to FQs. A robust surveillance system is needed to execute the National Strategic Plan for 2017-2025.
我们旨在确定印度北部一家三级医疗中心耐利福平肺结核（TB）的负担，并确定部分患者的二线药物敏感性（SL-DST）。
2017年3月至2019年6月，对3045份来自疑似结核病患者的肺部（n = 1883）和肺外（n = 1162）样本进行显微镜检查、培养和Xpert MTB/RIF检测。对62份样本进行了二线药物敏感性检测，采用线探针检测版本2检测氟喹诺酮类（FQs）和二线注射用药物。
在研究期间，我们实验室处理的3045份样本中，36.1%（1101/3045）结核分枝杆菌复合群（MTBC）呈阳性，21.6%为耐利福平单耐药（223/1032）。肺部样本中利福平耐药率为23.5%（166/706），肺外病例中为17.4%（57/326）。在纳入二线检测的62例病例中，48例对FQs耐药（77.4%），11例为广泛耐药。
印度迫切需要遏制新兴的耐多药结核病疫情以及相关的对FQs的耐药性。需要一个强大的监测系统来执行2017 - 2025年国家战略计划。
