High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.

Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patien...

Full description

Bibliographic Details
Main Authors: N Selvakumar, Vanaja Kumar, S Balaji, S Prabuseenivasan, R Radhakrishnan, Gomathi Sekar, V Chandrasekaran, T Kannan, Aleyamma Thomas, S Arunagiri, Puneet Dewan, Soumya Swaminathan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4349813?pdf=render
_version_ 1811220514750857216
author N Selvakumar
Vanaja Kumar
S Balaji
S Prabuseenivasan
R Radhakrishnan
Gomathi Sekar
V Chandrasekaran
T Kannan
Aleyamma Thomas
S Arunagiri
Puneet Dewan
Soumya Swaminathan
author_facet N Selvakumar
Vanaja Kumar
S Balaji
S Prabuseenivasan
R Radhakrishnan
Gomathi Sekar
V Chandrasekaran
T Kannan
Aleyamma Thomas
S Arunagiri
Puneet Dewan
Soumya Swaminathan
author_sort N Selvakumar
collection DOAJ
description Periodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.
first_indexed 2024-04-12T07:43:11Z
format Article
id doaj.art-31e211c02c9f45a583a0c47e67d1e30e
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-12T07:43:11Z
publishDate 2015-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-31e211c02c9f45a583a0c47e67d1e30e2022-12-22T03:41:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e011742110.1371/journal.pone.0117421High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.N SelvakumarVanaja KumarS BalajiS PrabuseenivasanR RadhakrishnanGomathi SekarV ChandrasekaranT KannanAleyamma ThomasS ArunagiriPuneet DewanSoumya SwaminathanPeriodic drug resistance surveillance provides useful information on trends of drug resistance and effectiveness of tuberculosis (TB) control measures. The present study determines the prevalence of drug resistance among new sputum smear positive (NSP) and previously treated (PT) pulmonary TB patients, diagnosed at public sector designated microscopy centers (DMCs) in the state of Tamil Nadu, India. In this single-stage cluster-sampling prevalence survey, 70 of 700 DMCs were randomly selected using a probability-proportional to size method. A cluster size of 24 for NSP and a varying size of 0 to 99 for PT cases were fixed for each selected DMC. Culture and drug susceptibility testing was done on Lowenstein-Jensen medium using the economic variant of proportion sensitivity test for isoniazid (INH), rifampicin (RMP), ofloxacin (OFX) and kanamycin (KAN). Human Immunodeficiency Virus (HIV) status was collected from patient records. From June 2011 to August 2012, 1524 NSP and 901 PT patients were enrolled. Any RMP resistance and any INH resistance were observed in 2.6% and 15.1%, and in 10.4% and 30% respectively in NSP and PT cases. Among PT patients, multi drug resistant TB (MDR-TB) was highest in the treatment failure (35%) group, followed by relapse (13%) and treatment after default (10%) groups. Extensively drug resistant TB (XDRTB) was seen in 4.3% of MDR-TB cases. Any OFX resistance was seen in 10.4% of NSP, 13.9% of PT and 29% of PT MDR-TB patients. The HIV status of the patient had no impact on drug resistance levels. RMP resistance was present in 2.6% of new and 15.1% of previously treated patients in Tamil Nadu. Rates of OFX resistance were high among NSP and PT patients, especially among those with MDR-TB, a matter of concern for development of new treatment regimens for TB.http://europepmc.org/articles/PMC4349813?pdf=render
spellingShingle N Selvakumar
Vanaja Kumar
S Balaji
S Prabuseenivasan
R Radhakrishnan
Gomathi Sekar
V Chandrasekaran
T Kannan
Aleyamma Thomas
S Arunagiri
Puneet Dewan
Soumya Swaminathan
High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
PLoS ONE
title High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
title_full High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
title_fullStr High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
title_full_unstemmed High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
title_short High rates of ofloxacin resistance in Mycobacterium tuberculosis among both new and previously treated patients in Tamil Nadu, South India.
title_sort high rates of ofloxacin resistance in mycobacterium tuberculosis among both new and previously treated patients in tamil nadu south india
url http://europepmc.org/articles/PMC4349813?pdf=render
work_keys_str_mv AT nselvakumar highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT vanajakumar highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT sbalaji highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT sprabuseenivasan highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT rradhakrishnan highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT gomathisekar highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT vchandrasekaran highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT tkannan highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT aleyammathomas highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT sarunagiri highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT puneetdewan highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia
AT soumyaswaminathan highratesofofloxacinresistanceinmycobacteriumtuberculosisamongbothnewandpreviouslytreatedpatientsintamilnadusouthindia