A study of rifampicin resistance among new and retreatment cases of pulmonary tuberculosis using cartridge based nucleic acid amplification test (CBNAAT) in tertiary care hospital

Abstract

Background: Pulmonary tuberculosis is a common infection disease seen in India. Anti tubercular therapy is highly effective in treatment but prevalence of drug resistant cases is increasing, mostly due to inadequate doses and/or duration of treatment. Early detection of drug resistance case is vital for correct treatment. Materials and Methods: An observational study was done in patients of new and recurrent cases of pulmonary tuberculosis coming to OPD/IPD in Geetanjali Medical College and Hospital, Udaipur. After taking written consent, the detailed clinical history was obtained. Sputum sample were sent for AFF smear examination and CBNAAT testing. Bronchoscopy was done in patients whose chest x ray shadows were suggestive of pulmonary tuberculosis but sputum for AFB smear was negative or sputum was not produced. Results: A total of 200 patients were included in study out of which 107 were primary and 93 were recurrent cases of pulmonary tuberculosis. Most common symptom was fever (65%) followed by cough (55%) then weight loss (20%). Out of 200 cases, 65 patients underwent bronchoscopy. Rifampicin resistant was seen in 2.8 % patients of primary tuberculosis and 16.1% of recurrent pulmonary tuberculosis. Presence of pallor, bronchial breathing and higher AFB smear grading were predictive of rifampicin resistance tuberculosis. Conclusion: Rifampicin resistance was seen in 2.8% patients of primary tuberculosis and 16.1 % of recurrent tuberculosis. Since the drug resistance in tuberculosis is increasing, hence early detection and timely addition of sensitive drugs should be done in every case to improve outcome.