J Arockiaraj1, G S Balaji2, V M Cherian3, Jepegnanam T S3, B P Thomas4, Joy S Michael5, P M Poonnoose3. 1. Spinal Disorder Surgery Unit, Department of Orthopaedics, Christian Medical College & Hospital, Vellore, Tamil Nadu, 632004, India. 2. Department of Orthopaedics, JIPMER, Puducherry, India. 3. Department of Orthopaedics, Christian Medical College & Hospital, Vellore, Tamil Nadu, 632004, India. 4. Department of Hand and Leprosy Reconstructive and Peripheral Nerve Surgery, Christian Medical College & Hospital, Vellore, Tamil Nadu, 632004, India. 5. Department of Microbiology, Christian Medical College & Hospital, Vellore, Tamil Nadu, 632004, India.
Abstract
BACK GROUND: Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. RESULTS: A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically.898 patients were treated for skeletal tuberculosis during the period of 2006-2013 (96 months). 478 (53.2%) patients were treated for tubercular spondylitis and 420 (46.8%) for extra-spinal skeletal tuberculosis. Ninety two patients (10.2%) had documented resistance to the anti-tubercular drugs. There were 42 mono resistant tuberculosis cases (4.7%), 13 poly resistant cases (1.4%), 33 multi-drug resistant cases (MDR TB) (3.7%) and 4 (0.4%) extremely drug resistant tuberculosis cases (XDR). All the patients were treated medically as per drug susceptibility patterns and protocols. Surgery was performed when indicated in 59 (66%) cases. 85% completed their course of treatment and were successfully healed as per pre-set clinical, biochemical and radiological criteria. The remaining were lost to follow up. One patient died as a result of post op respiratory infection. CONCLUSIONS: The prevalence of Multi-drug resistant tuberculosis patients in our centre was 3.7% and that of Extremely drug resistant tuberculosis cases was 0.4%. A Multi-disciplinary approach with drug susceptibility tests, sensitive drugs, and surgery if required is essential. Health education is essential to improve awareness among health care professionals about the danger of drug resistance in tuberculosis.
BACK GROUND: Drug resistant tuberculosis is alarmingly on the rise especially in developing countries. Skeletal tuberculosis accounts up to 10% of all extra pulmonary tuberculosis. World Health Organisation (WHO) has not formulated guidelines for the management of Multi-drug resistant skeletal tuberculosis. RESULTS: A retrospective analysis of patients treated for musculoskeletal tuberculosis was done, to study drug resistance patterns. The outcome was assessed both clinically and radiologically.898 patients were treated for skeletal tuberculosis during the period of 2006-2013 (96 months). 478 (53.2%) patients were treated for tubercular spondylitis and 420 (46.8%) for extra-spinal skeletal tuberculosis. Ninety two patients (10.2%) had documented resistance to the anti-tubercular drugs. There were 42 mono resistant tuberculosis cases (4.7%), 13 poly resistant cases (1.4%), 33 multi-drug resistant cases (MDR TB) (3.7%) and 4 (0.4%) extremely drug resistant tuberculosis cases (XDR). All the patients were treated medically as per drug susceptibility patterns and protocols. Surgery was performed when indicated in 59 (66%) cases. 85% completed their course of treatment and were successfully healed as per pre-set clinical, biochemical and radiological criteria. The remaining were lost to follow up. One patient died as a result of post op respiratory infection. CONCLUSIONS: The prevalence of Multi-drug resistant tuberculosis patients in our centre was 3.7% and that of Extremely drug resistant tuberculosis cases was 0.4%. A Multi-disciplinary approach with drug susceptibility tests, sensitive drugs, and surgery if required is essential. Health education is essential to improve awareness among health care professionals about the danger of drug resistance in tuberculosis.
Authors: Ali Akbar Velayati; Mohammad Reza Masjedi; Parissa Farnia; Payam Tabarsi; Jalladein Ghanavi; Abol Hassan ZiaZarifi; Sven Eric Hoffner Journal: Chest Date: 2009-04-06 Impact factor: 9.410
Authors: M A Espinal; K Laserson; M Camacho; Z Fusheng; S J Kim; R E Tlali; I Smith; P Suarez; M L Antunes; A G George; N Martin-Casabona; P Simelane; K Weyer; N Binkin; M C Raviglione Journal: Int J Tuberc Lung Dis Date: 2001-10 Impact factor: 2.373