Prevalence of Mycobacterium Tuberculosis Strains in both Respiratory and Non- Respiratory Clinical Specimens and their Resistance to Rifampicin at a Tertiary Care Teaching Hospital in Pakistan

Background: Tuberculosis (TB) is one of the diseases causing a high rate of morbidity and mortality worldwide. Amongst high TB burden countries, Pakistan ranks fifth, with an estimated new TB case of 510,000 emergings each year. Worldwide resistance to anti-tubercular drugs is a serious public health issue. Objective: This study was aimed to determine Mycobacterium tuberculosis (MTB) prevalence both in respiratory and non-respiratory clinical samples, their resistance to the first line Anti-tubercular drug especially to Rifampicin, hence to determine Multidrug-resistant Tuberculosis prevalence in the region. Method: This study was carried out to elucidate Mycobacterium tuberculosis (MTB) prevalence and their Rifampicin resistance among patients of Ayub teaching hospital and nearby districts in Hazara division of Pakistan from July 2017 to September 2019. Total 276 clinical samples were collected (both respiratory and non-respiratory) and screened by Zeihl-Neelsen (ZN) staining initially for the presence of Acid-Fast bacilli (AFB). Samples were further subjected to GeneXpert assay for detection of Mycobacterium Tuberculosis and Rifampicin resistance. Results: Out of 276 samples, 68 (24.64%) were AFB smear-positive while MTB was detected in 28 (20.29%) respiratory samples, and 9 (6.52%) in non-respiratory samples. Rifampicin resistance detected in 2 pulmonary samples (1.45%) and nil (0%) in non-respiratory samples . Conclusion: The possible reason for the low prevalence rate of resistance to Rifampicin in the current study is due to the small sample size and mixing of new and retreated cases. Still, the study could play its role to help government and health governing bodies in formulating sufficient plans regarding drug-resistant TB control.