Indian Journal of Microbiology Research 6 (2019) 237–240 Content available at: iponlinejournal.com Indian Journal of Microbiology Research Journal homepage: www.innovativepublication.com Original Research Article Prevalence of multi-drug resistant (MDR) pulmonary tuberculosis in a tertiary care rural hospital in Western Maharashtra, India Snehal Patil 1 , Prasanna Nakate 1, *, Suvarna Patil 1 , Yogendra Shelke 1 1 Dept. of Microbiology, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India ARTICLE INFO Article history: Received 02-06-2019 Accepted 07-08-2019 Available online 09-09-2019 Keywords: Tuberculosis (TB) Multidrug resistant tuberculosis (MDRTB) GeneXpert assay Rifampicin resistance M tuberculosis ABSTRACT Introduction: The emergence of Multi-Drug Resistant tuberculosis (MDR-TB) has become a big issue in tuberculosis (TB) control programs in recent times. It is seen more frequently in patients already treated for TB, but has been now diagnosed in new TB patients as a primary infection. Present study was carried out to find out the prevalence of MDR-TB in new and previously treated pulmonary TB patients attending a tertiary care rural hospital. Material and Methods: The study included a total of 1154 suspected MDR-TB patients out of which 1052 were new patients while 102 had received anti-TB drugs in past. Sputum samples of these patients were tested using GeneXpert MTB/RIF assay to detect Mycobacterium tuberculosis infection and Rifampicin resistance. Results: MDR-TB was detected in 5.55% of overall patients. In case of new TB suspects, MDR-TB was detected in 4.37%, while 17.65% of patients with past history of anti-TB treatment had MDR-TB. Conclusion: Improper management of drug sensitive TB has led to emergence of MDR-TB. Previous drug treatment seems to be the most important risk factor for acquiring resistance. It is important to strongly suspect and correctly diagnose MDR-TB at an early stage in all suspected patients of tuberculosis to control the spread of this disease and for improving the management of all TB cases. © 2019 Published by Innovative Publication. 1. Introduction Tuberculosis (TB) continues to be a major health issue worldwide even after great efforts being taken for its control and prevention. Although Lung is the commonest site affected in TB, it can also affect other organ systems presenting as an extra-pulmonary TB. In pulmonary TB, the patients often present with an insidious clinical onset with symptoms such as lack of appetite, low-grade evening fevers, and night sweats. Respiratory symptoms such as cough which is initially dry and later on productive with purulent or mucous expectoration also develop. Hemoptysis and chest pain can also occur. 1 Infection with TB bacillus is found in almost 1/3 rd of world’s population and every day nearly 5000 new cases are being added to this. 2 According to the 2017 Global TB report, in India the incidence of TB w as found to be * Corresponding author. E-mail address: prasannanakate@gmail.com (P. Nakate). approximately 28,00,000 cases which accounts for 1/4 th of total TB cases in the world. 3 India reports 1.9 million new cases of TB each year. Out of these, 0.8 million are open cases of TB with sputum smear positive for acid fast TB bacilli and have all the potential to infect their contacts. 4 As per the World Health Organisation (WHO), in India the death rate due to TB is nearly 28 per 100,000 population which is highest among all other communicable diseases and accounts for 26% of all avoidable adult deaths. 4 Although the WHO and governments across the world are taking great efforts for prevention and control of TB, the emergence and spread of Multi- drug resistant strains of TB bacillus has become a big hurdle in TB control programs. Presently MDR-TB is defined as resistance of TB bacilli to at least Rifampicin and Isoniazid (INH) which are the most important primary drugs used to treat TB, with or without resistance to other anti-tubercular drugs. 5 In 2016, multi-drug resistance was diagnosed in 3.9% of new patients of TB, whereas in patients who were treated https://doi.org/10.18231/j.ijmr.2019.052 2394-546X/© 2019 Published by Innovative Publication. 237