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Prospective study of isolation of Mycobacterium tuberculosis with its drug susceptibility: In a tertiary care hospital

Preet Priyadarshini, Dibya Prasana Mohanty, Pradipta Kishore Sahoo, Dharma Niranjan Mishra.

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Background: Multidrug resistant tuberculosis (MDR-TB) for Isoniazid and Rifampicin is a major threat to Antitubercular therapy. At present it is infecting approximately one third of the world population with 500 new cases annually. Hence this prospective study was carried out in the Department of Microbiology, M.K.C.G. Medical College Berhampur from November 2012 to October 2014.
Aim: To isolate Mycobacterium species from clinical samples and identify the drug susceptibility pattern for all mycobacterium species.
Methods: All the samples were collected aseptically in the appropriate sterile container and subjected to direct microscopy and culture. Direct microscopy smear was done by Zeihl – Neelsen and Fluorochrome stains. After digestion and decontamination the samples are subjected to appropriate culture medium for their growth and sensitivity to anti tubercular drugs.
Results: In the present study majority of cases were from the age group of 15-30 years (45.19%) with a male predominance and the M:F ratio was 3.3. Out of 208 cases, 19.23% were found to be HIV positive followed by association with Smoking (16.82%), Diabetes Mellitus (7.21%) and COPD (7.21%). Culture positivity was highest in persons having a history of smoking. Sputum was the most common sample received 157(75.5%) followed by pleural fluid. Out of 57 culture positives 9(15.78%) were resistant strains.
Discussion and conclusion: A total of 57 samples from 208 cases yielded Mycobacteria by culture on L-J Media. Culture positivity of sputum samples is considered to be the gold standard as it leads to access to the drug susceptibility of the grown mycobacterial culture. Mycobacterium tuberculosis was the major isolate (89.47%) and 6 cultures grew non tuberculous mycobacteria (10.52%) (NTM).

Key words: Multidrug resistant, Ziehl – Neelsen and Fluorochrome stains, Mycobacterium

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