Survey of Drug-Resistant Tuberculosis Patients in a University Tertiary Hospital in Saudi Arabia
Objective: Drug-resistant tuberculosis is a major health problem worldwide. In Saudi Arabia, 16.4% of tuberculosis cases were found to be resistant to at least one first-line drug. This study aims to assess and determine patterns of tuberculosis drug resistance among patients with culture-positive tuberculosis in order to develop an appropriate treatment strategy.
Methods: Data for 51 patients with culture-proven drug-resistant tuberculosis from January 2006 to January 2017 seeking treatment at the King Abdulaziz University Hospital were retrospectively analyzed. World Health Organization criteria were used to classify cases according to type of resistance: monoresistant, polyresistant, and multidrug resistant.
Results: Of the 299 tuberculosis positive cases there were 51 cases of drug-resistant tuberculosis, of which 60.8% were monoresistant (isoniazid, 17.6%; rifampin, 5.88%; pyrazinamide, 11.76%; ethambutol, 3.92%; streptomycin, 21.57%), 25.49% were multidrug-resistant tuberculosis, and 13.73% were polyresistant. Moreover, 18% involved children, 37% adolescents, 17.6% early adults, 17.6% late adults, and 11.76% elderly. Two-thirds of the patients were non-Saudi (76.46%). We found that 5.8% of the patients were HIV positive and 50% of these patients demonstrated monoresistant tuberculosis. Moreover, 47.05% of patients had type 2 diabetes. A total of 45 (88%) patients had primary resistance and 6 had secondary resistance. Radiologically, 60.78% of the patients had cavitary tuberculosis and 64% had bilateral pulmonary disease.
Conclusions: Our results show that the pattern of tuberculosis drug resistance observed within King Abdulaziz University Hospital is similar to that observed globally.