Publication:

Study of rifampicin resistance among newly diagnosed pulmonary tuberculosis patients with type 2 diabetes mellitus: a prospective observational study

Background Rifampicin (RIF) resistance in new cases of pulmonary tuberculosis is a matter of concern. Diabetes Mellitus triples the risk of developing tuberculosis. Early detection of TB and its resistance status in diabetics can help in improving the care and treatment outcomes of both diseases.

Methods It was a prospective study conducted from February 2019 to March 2020 in PGIMS, Rohtak on 50 patients of DM with newly diagnosed Pulmonary TB. Rifampicin resistance was detected by CBNAAT on sputum, induced sputum and BAL samples.

Results Mean age of study subjects was 51.24±10.421 (in years) with M: F ratio of 3:1 and maximum patients in 50-59 age group. The average BMI in patients was 22.49±2.42 kg/m2. The most common presenting complaint was cough (92%) followed by fever (68%). Mean serum HBA1c was 9.66±2.24 and mean FBS and PPBS was 195.81±59.08 and 302.02±99.01 mg/dl respectively. Out of 36 cases who gave sputum, 29 (80.55%) were detected rifampicin sensitive and 7 (19.44%) were rifampicin resistant whereas out of 11 who were induced, 9 (81.8%) were rifampicin sensitive and 2(18.18%) were rifampicin resistant. Out of 3 cases detected by BAL CBNAAT, 2 (66.6%) were rifampicin sensitive and 1 (33.33%) was rifampicin resistant. Overall, 10(20%) patients were detected Rifampicin resistant by CBNAAT.

Conclusions We found that TB-DM patients had a higher proportion of drug resistance (20%), so DM should be considered as an independent risk factor for MDR-TB and effective measures are required for early diagnosis of MDR-TB.