Molecular Epidemiology of Mycobacterium tuberculosis in Division Mirpur, Azad Jammu & Kashmir

Abstract

: The causative agent for TB is Mycobacterium tuberculosis which is member of MTC. Mycobacterium tuberculosis is non-motile, rate of growth is very slow, acid fast and rod in shape (bacilli) belongs to the Mycobacterium genus and differs substantially from other bacteria due to the exceptionally thick cell wall and high genomic guaninecytosine content. In 2013, 9 million people contracted while 1.5 million died due to this disease, 550,000 children got TB while 80,000 were died who were HIV-negative this estimation was done by World Health Organization (WHO). Furthermore, approximately 0.5 million people developed multidrug resistant TB (MDR-TB) and they needed comparatively long and costly treatment. With high occurrence of TB and perhaps getting high number of MDR and XDR, Pakistan is among the top five in the world. 85–100 individuals out one hundred thousand gets TB and 120,000 new cases are adding single year but in Northern area of Pakistan, scenario is totally different where 554 out of one hundred thousand individuals were get TB. M. tuberculosis produces their colonies in 21–28 days and takes 24 hours to extend generation on cultivated artificial medium. TB can be transmitted by inhaling droplets having nuclei of size 1–5 micron produced by infected individuals thus persons having TB of lungs are the major source of contagion. The total 580 patients were examined during the study out of 332 were male while 248 were female (Figure 4.1). Only 17 percent were admitted (indoor patient department) in different hospitals of the division while 83 percent were from outdoor patient department of various settings. Pulmonary tuberculosis was detected in 97 patients while extra pulmonary tuberculosis was noticed in 5 individuals. All samples examined by Direct Microscopy (88) followed by Fluorescent Microscopy and found presence of Acid Fast Bacilli in 91 cases which means Light microscopy missed 3 positive cases. Of the 109 specimens 68 grew during seven weeks of incubation while 20 grew in four week and 21 grew in second week of incubation. GeneXpert detected 102 samples as positive for Mycobacterium tuberculosis. Rifampicin (RIF) which is one of the drugs from first line treatment was detected as resistant in 2 (1.96%) patients so, multi-drug resistant (MDR) was found in two cases. The mutation was noticed in Pro-E gene which was responsible for Rifampicin resistance.

Keywords

• tuberculosis (tb), genexpert, fluorescent microscopy, mirpur