Drug Resistance Patterns and Associated Factors Among Patients with Pulmonary Tuberculosis: A Hospital-Based Cross-Sectional Study

Background: Determination of the pattern and prevalence of drug resistance among patients with Mycobacterium tuberculosis and its associated clinical factors. To determine the prevalence and pattern of first-line drug resistance among patients with pulmonary tuberculosis and identify demographic and clinical factors associated with drug resistance. Material and Methods: A cross-sectional study from February 2023 to February 2024 was conducted on 85 adults with Mycobacterium tuberculosis confirmed by sputum or bronchoalveolar lavage smear positivity and CBNAAT detection of Mycobacterium tuberculosis were enrolled. Drug susceptibility testing was performed using the BACTEC MGIT 960 system. Demographic, clinical, comorbidity, tobacco-use, and radiological data were recorded and associated with drug resistance. Results: The study cohort mean age was 35.27 ± 8.9 years, with 45 (52.94%) males and 40 (47.06%) females. Drug resistance to at least one anti-tubercular drug was detected in 15/85 (17.65%) patients, while 70 (82.35%) were pan-susceptible. Isoniazid monoresistance was observed in 6 (7.06%) patients and rifampicin monoresistance in 1 (1.18%). MDR-TB was identified in 8 (9.41%) patients. Previous tuberculosis history was significantly more frequent among drug-resistant patients than pan-susceptible patients (73.33% vs. 11.43%; p<0.0001). Diabetes mellitus was also significantly associated with drug resistance (40.00% vs. 11.43%; p=0.007). Conclusion: Drug resistance was found in 17.65% cases of Mycobacterium tuberculosis patients, with MDR-TB present in 9.41%. Significant associated factors were a history of previous Mycobacterium tuberculosis and diabetes mellitus as a comorbidity. Early drug-susceptibility testing and close monitoring of previously treated and diabetic patients may facilitate timely identification and management of drug-resistant tuberculosis.

Keywords: Antitubercular Agents, Diabetes Mellitus, Drug Resistance, Microbial, Multidrug-Resistant Tuberculosis, Tuberculosis, Pulmonary.