Patterns and trends in first-line anti-tuberculosis drug resistance in a major Malaysian tertiary teaching hospital over a 4-year period (2017-2020)

• Main Author: Atiya, Nadia
• Format: Conference or Workshop Item
• Language: English
• Subjects: R Medicine
• Online Access: http://eprints.um.edu.my/45069/1/Profesor%20Madya%20Dr.%20Nadia%20Atiya_ISID%202022%20POSTER.pdf; http://eprints.um.edu.my/45069/
• Institution: Universiti Malaya

Drug-resistant tuberculosis is a significant contributor to antimicrobial resistance globally. Despite tuberculosis (TB) being endemic in Malaysia, there is limited published data from Malaysia on anti-TB drug resistance. This study aims to determine the patterns and trends in first-line anti-TB drug resistance in a major Malaysian tertiary teaching hospital. A retrospective observational study was conducted on all patients who were diagnosed with culture-confirmed tuberculosis at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia, between 1 January 2017 – 31 December 2020. Patients were identified from the microbiology laboratory database. The medical records of the patients were reviewed, and the following data were collected using a standardised data collection form: demographic data and first-line anti-TB drug resistance patterns. Over the 4-year study period, a total of 675 non-duplicate Mycobacterium tuberculosis isolates were identified from the clinical specimens of 675 patients, of whom the majority were men (64.3%) and between 18-40 years of age (39.9%). Only 8.3% of the isolates were resistant to at least one of the first-line anti-TB drugs tested. The most common form of first-line anti-TB drug resistance was resistance to streptomycin (4.0%), followed by resistance to isoniazid (3.6%), resistance to ethambutol (2.7%) and resistance to rifampicin (1.5%). Multidrugresistant TB (MDR-TB) accounted for only 0.9% of the isolates. Between 2017 and 2020, there was an overall increase in the prevalence of resistance to at least one of the first-line anti-TB drugs (7.4% to 12.0%), rifampicin-resistant TB (RR-TB) (1.3% to 3.3%) and isoniazid-resistant TB (Hr-TB) (3.9% to 4.3%). However, there was no increase in the prevalence of MDR-TB (1.3%).