Clinical profile and risk stratification in multidrug-resistant tuberculosis (MDR-TB) and non-MDR-TB patients: A prospective study in a tertiary care hospital

Abstract

Background: Multidrug resistant tuberculosis (MDR-TB) is a major threat for successful control of TB. Early diagnosis and drug sensitivity testing helps in improving disease prevalence. This study was undertaken to determine clinical profile and risk factors for MDR-TB and factors differentiating it from non MDR-TB. Materials and methods: This is a prospective study conducted at a TB hospital attached to Vijayanagara institute of medical sciences, Bellary, Karnataka in South India over a period of 2 years. All patients diagnosed with MDR-TB were studied for clinical parameters and another cohort of non MDR-TB in same study period were included for comparison. Clinical and radiological characteristics, and risk factors were compared between two groups. Results: A total of 59 MDR-TB and 72 non MDR-TB patients were studied in this period. Males were predominant in both groups. Body mass index (BMI) was significantly low in MDR-TB group (18.5 vs 20.3 kg/m2). Among clinical symptoms, breathlessness was significantly seen in MDR-TB group. Defaulter, failure and relapse were seen in 6.8%, 54.3% and 37.3% respectively. Cavitary lesions and reticulonodular patterns in imaging were significantly seen in MDR group. Eight patients in non MDR group had human immunodeficiency virus (HIV) infection compared to one patient in MDR. Conclusion: Presence of cavity and reticulonodular patterns in imaging, significant breathlessness and lower BMI are significantly common in MDR TB patients. These parameters maybe considered for early suspicion and monitoring for drug resistance in index presentation.

Keywords

• multidrug resistant tb
• breathlessness
• human immunodeficiency virus
• cavity lesion
• reticulonodular patterns