Pattern of Drug Resistance in Primary Spinal Tuberculosis: A Single-Center Study From India. Issue 7 (September 2021)

• Record Type: Journal Article
• Authors: Bhosale, Sunil; Prabhakar, Akil; Srivastava, Sudhir; Raj, Aditya; Purohit, Shaligram; Marathe, Nandan
• Is Part Of: Global spine journal. Volume 11:Issue 7(2021)
• Page Start: 1070
• Page End: 1075
• Publication Date: 2021-09
• Subjects: spinal tuberculosis -- drug-resistant tuberculosis -- MDR-TB -- XDR-TB; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/2192568220941445
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Retrospective observational analysis. Objectives: Spinal tuberculosis accounts for about 50% of cases among extra pulmonary osteoarticular tuberculosis. Resistance to drugs in spinal tuberculosis patients is on a rise and there is inadequate literature concentrating on the precise pattern of resistance in Indian subcontinent which harbors 24% of global prevalence. The aim was to study the pattern of drug resistance in spinal tuberculosis among first- and second-line drugs. Drug resistance is common in spinal tuberculosis and we intended to find the prevalence of various drug resistance patterns. Methods: Patients with spinal tuberculosis visiting a tertiary center were assessed. Samples were taken from the affected vertebrae and sent for BACTEC mycobacterium growth indicator tube (MGIT) 960 culture. Patients with a positive growth in MGIT were included in the study. All previously treated patients (relapse, treatment after failure, treatment after loss to follow-up and other previously treated patients) were excluded. Results: A total of 150 patients with a positive growth in MGIT report were included in the study, of whom 43 patients had some kind of drug resistance. Seven were multidrug resistant (MDR), 9 had preextensive drug resistance (pre-XDR), and 4 had extensive drug resistance (XDR). Seventeen patients had mono-drug resistance, which was most frequently for isoniazid. Resistance among second-line drugs was common in the fluoroquinolone group. Conclusion: Drug resistance in spinal tuberculosis was found to be 28.6%. Of these, MDR was in 16.2%, pre-XDR in 20.9%, and XDR in 9.3% patients.