Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India
Background & objectives: A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present st...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Medical Research |
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| Online Access: | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2023;volume=157;issue=2;spage=174;epage=182;aulast=Desikan |
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| author | Prabha Desikan Nikita Panwalkar Ram Prakash Punde Zeba Khan Ankur Pauranik Shaina Beg Mirza Manju Chourey Sridhar Anand K S Sachdeva |
| author_facet | Prabha Desikan Nikita Panwalkar Ram Prakash Punde Zeba Khan Ankur Pauranik Shaina Beg Mirza Manju Chourey Sridhar Anand K S Sachdeva |
| author_sort | Prabha Desikan |
| collection | DOAJ |
| description | Background & objectives: A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India.
Methods: A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip.
Results: Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively.
Interpretation & conclusions: Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients. |
| first_indexed | 2024-03-12T22:31:50Z |
| format | Article |
| id | doaj.art-a280b3a71c8e432abbcf7500205bcc64 |
| institution | Directory Open Access Journal |
| issn | 0971-5916 |
| language | English |
| last_indexed | 2024-03-12T22:31:50Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Medical Research |
| spelling | doaj.art-a280b3a71c8e432abbcf7500205bcc642023-07-21T14:56:36ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Research0971-59162023-01-01157217418210.4103/ijmr.ijmr_607_22Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central IndiaPrabha DesikanNikita PanwalkarRam Prakash PundeZeba KhanAnkur PauranikShaina Beg MirzaManju ChoureySridhar AnandK S SachdevaBackground & objectives: A combination of resistant and susceptible Mycobacterium tuberculosis (MTB) isolated from clinical specimens is referred to as heteroresistance. Heteroresistance leads to difficulties in drug resistance testing and may adversely affect treatment outcomes. The present study estimated the proportion of heteroresistance among MTB in clinical samples of presumptive drug-resistant tuberculosis (TB) patients in Central India. Methods: A retrospective analysis of data generated from line probe assay (LPA) at a tertiary care hospital in Central India between January 2013 and December 2018 was carried out. A heteroresistant MTB in a sample was indicated by the presence of both wild-type and mutant-type patterns on an LPA strip. Results: Data analysis was carried out on interpretable 11,788 LPA results. Heteroresistance in MTB was detected in 637 (5.4%) samples. Of these, heteroresistance in MTB was detected in 413 (64.8%), 163 (25.5%) and 61 (9.5%) samples with respect to rpoB, katG and inhA genes, respectively. Interpretation & conclusions: Heteroresistance is considered a preliminary step in the development of drug resistance. Delayed or suboptimal anti-tubercular therapy in patients with heteroresistance of MTB may elicit full clinical resistance and negatively impact the National TB Elimination Programme. Further studies are, however, needed to determine the impact of heteroresistance on treatment outcomes in individual patients.http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2023;volume=157;issue=2;spage=174;epage=182;aulast=Desikancentral india - heteroresistance - presumptive drug resistance - tuberculosis |
| spellingShingle | Prabha Desikan Nikita Panwalkar Ram Prakash Punde Zeba Khan Ankur Pauranik Shaina Beg Mirza Manju Chourey Sridhar Anand K S Sachdeva Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India Indian Journal of Medical Research central india - heteroresistance - presumptive drug resistance - tuberculosis |
| title | Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India |
| title_full | Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India |
| title_fullStr | Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India |
| title_full_unstemmed | Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India |
| title_short | Heteroresistance to rifampicin & isoniazid in clinical samples of patients with presumptive drug-resistant tuberculosis in Central India |
| title_sort | heteroresistance to rifampicin isoniazid in clinical samples of patients with presumptive drug resistant tuberculosis in central india |
| topic | central india - heteroresistance - presumptive drug resistance - tuberculosis |
| url | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2023;volume=157;issue=2;spage=174;epage=182;aulast=Desikan |
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