Prevalence of rifampicin and isoniazid mono-resistance among cases of pulmonary tuberculosis from Western Uttar Pradesh, North India

Mol Biol Rep. 2024 Oct 24;51(1):1091. doi: 10.1007/s11033-024-10014-9.

Abstract

Background: Mono-resistance to rifampicin/isoniazid increases poor treatment outcomes and the risk of multi-drug resistance (MDR) in tuberculosis (TB) patients. Limited information exists about mono-resistance status of TB patients in Uttar Pradesh, North India. This study aimed to estimate the burden of rifampicin and isoniazid mono-resistance in Western Uttar Pradesh.

Methods and results: 153 sputum samples of suspected pulmonary tuberculosis patients were processed to isolate Mycobacterium tuberculosis using the Lowenstein-Jensen (L-J) culture medium. The isolates were identified using an immuno-chromatographic test and IS6110 PCR. The confirmed Mycobacterium tuberculosis isolates were tested for drug susceptibility testing against rifampicin and isoniazid anti-tuberculosis drugs. The results of the drug susceptibility testing were compared with demographic information and analyzed statistically. Out of 153 sputum samples, 83 (54.24%) samples were positive for growth on L-J medium, including 82 (98.79%) Mycobacterium tuberculosis isolates. Of the 82 Mycobacterium tuberculosis isolates, 16 (19.51%), 7 (8.54%), and 5 (6.10%) isolates were MDR, mono-resistant to rifampicin and isoniazid, respectively. The occurrence of RIF/INH mono-resistant-TB was higher in patients of male gender, age above 45 years, living in rural conditions, history of weight loss, and previous anti-TB treatment, but the effect was not statistically significant.

Conclusions: The study reported the status of rifampicin and isoniazid mono-resistance among TB patients and highlighted the need for continuous monitoring and improved intervention for the initial detection of mono-drug-resistant cases. This will improve clinical treatment outcomes and decrease the rate of drug-resistant TB in Uttar Pradesh, North India.

Keywords: Mycobacterium tuberculosis; Drug susceptibility testing; Isoniazid mono-resistance; Multi-drug resistant tuberculosis; Pulmonary tuberculosis; Rifampicin mono-resistance.

MeSH terms

  • Adult
  • Aged
  • Antitubercular Agents* / pharmacology
  • Antitubercular Agents* / therapeutic use
  • Drug Resistance, Bacterial / genetics
  • Female
  • Humans
  • India / epidemiology
  • Isoniazid* / pharmacology
  • Isoniazid* / therapeutic use
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Mycobacterium tuberculosis* / drug effects
  • Mycobacterium tuberculosis* / genetics
  • Mycobacterium tuberculosis* / isolation & purification
  • Prevalence
  • Rifampin* / pharmacology
  • Rifampin* / therapeutic use
  • Sputum / microbiology
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / epidemiology
  • Tuberculosis, Multidrug-Resistant* / microbiology
  • Tuberculosis, Pulmonary* / drug therapy
  • Tuberculosis, Pulmonary* / epidemiology
  • Tuberculosis, Pulmonary* / microbiology
  • Young Adult

Substances

  • Rifampin
  • Isoniazid
  • Antitubercular Agents