High prevalence of primary drug resistance in children with intrathoracic tuberculosis in India.

Abstract

BACKGROUND:

Drug susceptibility testing (DST) of Mycobacterium tuberculosis (Mtb) isolates is crucial for the effective treatment of tuberculosis. Data on DST patterns in Mtb isolates in childhood tuberculosis are scanty.

AIMS:

To determine drug resistance patterns in Mtb isolates from a paediatric TB cohort in North India.

METHODS:

403 children aged 6 months to14 year with probable intrathoracic tuberculosis were enrolled prospectively. All were treatment-naïve. 802 ambulatory-induced sputa (IS) and 787 gastric aspirate (GA) samples were cultured in BACTEC-MGIT960 system, and DST of the Mtb isolates was undertaken using the automated BACTEC-MGIT960 SIRE kit.

RESULTS:

Of the 403 children, 147 (36.4%) were culture-confirmed: 132 (89.8%) isolates were Mtb and 15 (10.2%) non-tuberculous mycobacteria (NTM). Five Mtb isolates were contaminated and the remaining 127 were subjected to in-vitro drug susceptibility testing against streptomycin, isoniazid, rifampicin and ethambutol. Twenty-six (20.47%) isolates were resistant to one or more drugs, seven (5.5%) were resistant to rifampicin singly or in combination, and 11 (8.7%) were resistant to isoniazid singly or in combination. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol was detected in four (3.1%), one (0.8%), four (3.1%) and two (1.6%), respectively. Five children (3.9%) had MDR-TB; 101 (79.9%) children had Mtb isolates which were sensitive to all four drugs.

CONCLUSIONS:

The rifampicin and isoniazid resistance rates were much higher than those in the adult TB population in India.

• Authors: Suneel Prajapati, Kriti Upadhyay, Aparna Mukherjee, S K Kabra, Rakesh Lodha, Varinder Singh, Harleen M S Grewal, Sarman Singh, Delhi Pediatric TB Study Group
• Journal: Paediatrics and international child health (Paediatr Int Child Health) Vol. 36 Issue 3 Pg. 214-8 (Aug 2016) ISSN: 2046-9055 [Electronic] England
• PMID: 26052730 (Publication Type: Journal Article)

Chemical References

• Antitubercular Agents

Topics

• Adolescent
• Antitubercular Agents (therapeutic use)
• Child
• Child, Preschool
• Drug Resistance, Bacterial
• Female
• Humans
• India (epidemiology)
• Infant
• Male
• Microbial Sensitivity Tests
• Mycobacterium tuberculosis (drug effects, isolation & purification)
• Prevalence
• Prospective Studies
• Tuberculosis, Pulmonary (drug therapy, epidemiology, microbiology)