Research Article
Volume 17 Issue 9 - 2021
Antimicrobial Susceptibility Profile of Mycobacterium tuberculosis among Patients with Pulmonary Tuberculosis in Anambra State, Southeast Nigeria
Ngozichukwu Gertrude Uzoewulu1*, Wilson Chukwuneke Igwe2, Chika Florence Ubajaka3 and Goyal Madhu4
1Department of Medical Microbiology/Parasitology, Faculty of Medicine, Nnamdi Azikiwe University Nnewi, Nigeria
2Department of Pediatrics, Faculty of Medicine, Nnamdi Azikiwe University Nnewi, Nigeria
3Department of community Medicine, Faculty of Medicine ,Nnamdi Azikiwe University Nnewi
4Department of Microbiology, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, England, United K
*Corresponding Author: Ngozichukwu Gertrude Uzoewulu, Department of Medical Microbiology/Parasitology, Faculty of Medicine, Nnamdi Azikiwe University Nnewi, Anambra State, Nigeria.
Received: May 05, 2021; Published: August 30, 2021




Abstract

Background: Mycobacterium tuberculosis drug resistance is a threat to global control of tuberculosis especially in resource limited settings. This study evaluated the anti-tuberculosis drug susceptibility pattern of Mycobacterium tuberculosis, strains isolated from patients with pulmonary tuberculosis in Anambra state, southeast Nigeria.

Methods: This was a cross-sectional study that involved the analysis of sputum samples of tuberculosis patients seen from 2010- 2012 in randomly selected public hospitals in Anambra state, southeast Nigeria. All the sputum samples were processed according to standard operating procedure and cultured using Lowenstein Jensen medium (LJ). One hundred and eighty colonies of Mycobacterium tuberculosis strains grown were identified on the basis of morphology, pigment production and biochemical characteristics. Drug susceptibility testing of each isolate to the first line anti-TB drugs (Streptomycin, Isoniazid, Rifampicin and Ethambutol) was performed by proportional method on LJ medium.

Results: Of the 180 M. tuberculosis isolates, 143 (79.4%) were from new TB cases and 37 (20.6%) from retreatment TB cases. A total of 95 (52.8%) {95% CL: 45.34 - 59.76} strains were susceptible to either one or more Tb drugs, of which 86 (47.8%) were from new TB cases while 9 (5%) were from retreatment TB cases. A total of 85 (47.2%) {95% CI: 22.68 - 69.32. P = 0.0001} were drug resistant strains. Of these resistant strains, 57 (31.7%) {95% CI: 23.59 - 39.40} were from new TB cases, while 28 (15.6%) {95% CI: 7.58 - 22.42} were retreatment TB cases. The rates of the sensitivity to a single first line anti-TB drug were: Streptomycin 78%, Isoniazid 68%, Rifampicin 85% and Ethambutol 75%. The rates of resistance to a single anti-TB drug were: Streptomycin 22%, Isoniazid 32%, Rifampicin 15% and Ethambutol 25%). Resistance to drugs were higher with Isoniazid compared to other drugs while Rifampicin was more susceptible than other anti-TB drugs. Among the total of 180 culture positive TB cases, 34(18.9%) were found to be monoresistance {95% CI: 10.45-26.58}. The prevalence rate 23(12.8%) among new TB cases was significantly higher than the retreatment 11(6.1%) diagnosed TB cases. About 16(8.9%) were MDR-TB [95%CI:2.34-15.55} with 7 (3.9%) new TB cases and 9(5%) retreatment TB cases . There was an association between retreatment TB cases and MDR-TB (P=0.0001). Of the total culture positive TB cases 35(19.4%) were Poly-resistant [ 95% CI: 11.66-27.34} of which the prevalence rate 27(15%) among new TB cases was significantly higher than 8(4.4%) retreatment TB cases and the difference was statistically significant. Drug resistance increased in both the new and retreatment TB cases. Also, of the 85 (47.2%) drug resistant TB, 14 (7.8%) (95% CL: 3.037: P = .386} were HIV positive while 71 (39.4%) were HIV negative. Those older than 21 years were most likely to have drug resistant TB (95% CI: 27.449: P = .156).

Conclusion: Retreatment cases of Pulmonary TB is significantly associated with drug resistance and patients who were treated at NAUTH Nnewi site had significantly higher rate of Multi-drug resistant TB compared to other hospitals investigated..

Keywords: Drug Resistance; Mycobacterium tuberculosis; Pulmonary Tuberculosis; Anambra State

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Citation: Ngozichukwu Gertrude Uzoewulu., et al. “Antimicrobial Susceptibility Profile of Mycobacterium tuberculosis among Patients with Pulmonary Tuberculosis in Anambra State, Southeast Nigeria”. EC Microbiology 17.9 (2021): 21-31.

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