Molecular Detection of Rifampicin and Isoniazid Resistant Mycobacterium Tuberculosis and Their Associated Mutation Pattern From Smear Positive Sputum Samples From a Tertiary Care Centre of West U.P.

Abstract

Background: Delayed diagnosis and treatment done on its basis has been proven to be a factor causing increase in rate of MDR TB. So we used GenoType MTBDR plus assay® in order to determine rate of MDR-TB, Isoniazid and Rifampicin mono resistance and common mutation pattern associated with them from our area in order to provide better patient care and reduce rate of MDR-TB. Subjects and Methods: This was a cross sectional prospective study comprising of 150 smear positive sputum samples collected during period of 1½ years from January 2018 to April 2019. Results: Out of total 150 smear positive samples 97 were from male patients and 53 from female patients. Rate of MDR TB found was 18/150 (12%), rifampicin mono resistance and isoniazid mono resistance was 10/150 (6.6%) and 13/150 (8.6%) respectively. Highest percentage of MDR TB was seen among defaulter cases (27.3%) followed by failure cases (25%) and relapse cases (12.5%). Mutation pattern most commonly reported for rifampicin is S531L in rpoB gene at codon 530-533 and for isoniazid was S315T1 in katG gene at codon 315. Conclusion: Problem of MDR-TB is continuously rising, so rapid detection of TB along with drug sensitivity is the need of hour and should be given utmost priority for END TB strategy. The GenoType MTBDR plus (LPAs) assay approved by world health organization is highly specific (≥99%) and sensitive (≥97%) diagnostic test for the detection of first line drugs resistance and is a rapid and reliable diagnostic tool.