Sohail Akhtar, Fakhir Raza Haidri, Abdul Majeed Memon.
Drug resistance to tuberculosis in a tertiary care setting in Karachi.
J Pak Med Assoc Jan ;57(6):282-4.

Objective: To evaluate the resistance pattern of tuberculosis cases. Methods: A descriptive study was done in two out patient referral clinics from January 1999 to March 2003. All TB cases that had cultures positive for mycobacterium tuberculosis were evaluated. Results: Data from 71 proven culture positive patients was available. Resistance to at least one antituberculous drug was found in 44 (60.5%) cases. Primary, Initial and Secondary Resistance to at least one drug was 7.0%, 21.1% and 32.3% respectively. Out of 7.0% primary resistance cases, there were 5.6% of single drug resistance, 1.4% Multiple Drugs and zero percent of Multi drug Resistance (MDR). Initial resistance cases (out of 21.1%) included 12.6% to single drug, 7% to multiple drugs and 1.4% MDR. Acquired Resistance Cases (out of 32.3%) included 5.6% each to single and multiple drugs and 21% MDR. Single drug resistance (for primary, initial and acquired) showed 14% resistance for Isoniazid, 4.2% for Rifampicin, 2.8% each for Ethambutol and Streptomycin and 1.4% to Pyrazinamide. Conclusion: In this cohort of patients, Primary resistance to at least one drug was 7.0% and no MDR. Among individual drugs, resistance to Isoniazid was highest (14%) and lowest for Pyrazinamide (1.4%) (JPMA 57:282;2007).

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