2017•The International Journal of Tuberculosis and Lung DiseaseRequires access
Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan
Anadil Javaid, Ragheb I. Hasan, Afia Zafar, Muhammad Ashraf Chaudry, Sadaf Qayyum, Ehteshaam Qadeer, Zunaira Shaheen, Nizam Agha, Narjis Rizvi, Mashal Afridi, Margot Chima, A. R. Khan, Abdul Ghafoor, Suhail Ahmad Khan, S. R. Awan, Saeed Akhtar, K. Choudry, Zafar Iqbal, Mosavir Ansarie, Nafees Ahmad
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Abstract
BACKGROUND: Drug resistance in general, and multidrug-resistant tuberculosis (MDR-TB) in particular, threatens global tuberculosis (TB) control efforts. Population-based estimates of drug resistance are needed to develop strategies for controlling drug-resistant TB in Pakistan. OBJECTIVE: To obtain population-based data on Mycobacterium tuberculosis drug resistance in Pakistan. METHODS: To obtain drug resistance data, we conducted a population-based study of TB cases in all provinces of Pakistan. We performed culture and drug susceptibility testing on M. tuberculosis isolates from patients with a prior history of anti-tuberculosis treatment (retreatment cases) from all over the country. RESULTS: Of 544 isolates from previously treated cases, 289 (53.1%) were susceptible to all first-line drugs, 255 (46.9%) were resistant to at least one anti-tuberculosis drug and 132 (24.3%) were MDR-TB. Among MDR-TB isolates, 47.0% were ofloxacin (OFX) resistant. Extensively drug-resistant TB was found in two (0.4%) isolates. CONCLUSION: Prevalence of drug resistance in retreatment isolates was high. The alarmingly high prevalence of OFX resistance among MDR-TB isolates may threaten the success of efforts to control and treat MDR-TB.