Butt T, Ahmad R N, Kazmi S Y, Rafi N.
Multi-drug resistant Tuberculosis in Northern Pakistan.
J Pak Med Assoc Jan ;54(9):469-72.

Objective: To determine the resistance pattern of Mycobacterium tuberculosis isolates in Rawalpindi-Islamabad. Methods: The study was carried out at the Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi between September 2000 and August 2002. We examined 1359 pulmonary and extra-pulmonary specimens from suspected cases of tuberculosis. The radiometric Bactec 460 TB system was used for culture and antimicrobial susceptibility testing. Results: Mycobacterium tuberculosis was isolated from 325 clinical specimens. Antimicrobial susceptibility of the isolates was tested against the four first-line anti-tuberculous drugs (rifampicin, isoniazid, streptomycin and ethambutol). Fifteen percent of the isolates were resistant to a single drug, 28% were multi-drug resistant including 7% which were resistant to all the four drugs. The overall resistance against individual drugs was rifampicin 32%, isoniazid 37%, streptomycin 19% and ethambutol 17%. Conclusions: The increasing level of drug resistance among mycobacterial isolates in our population is most alarming. Strict implementation of control measures is required to combat this unfolding crisis (JPMA 54:469;2004).

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