Prevalence of Mono Rifampicin and Isonizaid Resistance Among Pulmonary Tuberculosis Patients in Agra Region of Uttar Pradesh, North India
Rifampicin and isoniazid are the two most important anti-tuberculosis drugs that shorten the duration of treatment and reduce the relapse rate of tuberculosis (TB). The emergence of rifampicin and isoniazid mono-resistance in Mycobacterium tuberculosis stains may results in treatment failure and hamper the effectiveness of tuberculosis control programs worldwide. Present study was aimed to estimate the burden of rifampicin and isoniazid mono-resistance among pulmonary TB patients of Agra region (Agra, Firozabad, Mathura and Manipuri districts)in Uttar Pradesh, north India. A total of 877 sputum samples were collected from suspected cases of pulmonary tuberculosis and screened for the presence of Mycobacterium tuberculosis using Ziehl-Neelsen (ZN) and culture on Lowenstein-Jensen (LJ) medium by NALC-NaOH method. Species level identification of the growth recovered on LJ medium was done using biochemical tests. The isolates of M.tuberculosiswere subjected to first line (rifampicin, isoniazid, ethambutol and streptomycin) drug susceptibility testing. Of the 877 sputum samples, 450 (51.31%) and 399 (45.49%) samples were found positive for the presence of acid fast bacilli and Mycobacterium tuberculosis using ZN stating and LJ culture method, respectively. Out of 399 isolates, 394 (98.7%) and 5 (1.25%) were identified as M.tuberculosis and non-tuberculous mycobacteria, respectively. Of the 394 M.tuberculosis isolates, 40 (10.15%) and (0.25%)isolates were mono- resistant to rifampicin and isoniazid, respectively. In conclusion, present study reported moderate prevalence of rifampicin mono-resistance and highlights thatisoniazid resistance should be confirmed phenoltypically if genotypic rifampicinresistant-TB is detectedin TB patientsof Agra regions of Uttar Pradesh, North India.
Keywords - Pulmonary Tuberculosis, Mycobacterium Tuberculosis, Mono-resistance, Rifampicin, Isoniazid