Acid-fast bacilli culture positivity and drug resistance in abdominal tuberculosis in Mumbai, India

• Published in: Indian journal of gastroenterology Vol. 33; no. 5; pp. 414 - 419
• Main Authors: Samant, Hrishikesh, Desai, Devendra, Abraham, Philip, Joshi, Anand, Gupta, Tarun, Rodrigues, Camilla, George, Siji
• Format: Journal Article
• Language: English
• Published: India Springer India 01.09.2014
• Subjects: Adolescent; Adult; Aged; Antitubercular Agents - pharmacology; Drug Resistance, Bacterial; Female; Gastroenterology; Hepatology; Humans; India - epidemiology; Male; Medicine; Medicine & Public Health; Microbial Sensitivity Tests - methods; Middle Aged; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - isolation & purification; Original Article; Prevalence; Retrospective Studies; Tuberculosis, Gastrointestinal - epidemiology; Tuberculosis, Gastrointestinal - microbiology; Young Adult; India; MGIT; Bactec; Multidrug resistance; Granulomatous bowel disease
• ISSN: 0254-8860; 0975-0711; 0975-0711
• DOI: 10.1007/s12664-014-0467-x

Background and Aim Culture positivity for Mycobacterium tuberculosis complex (MTB) in abdominal tuberculosis (TB) using Lowenstein Jensen medium and Bactec system varies from 25 % to 36 %. Data on the prevalence of drug resistance in primary abdominal TB is scant. Our aim was to study the acid-fast bacilli (AFB) culture positivity rate in primary abdominal TB using Bactec Mycobacterial Growth Indicator Tubes (MGIT) system and the prevalence of drug resistance in these patients. Method Records of patients with abdominal TB (diagnosed on clinical features, endoscopy, histology, microbiology) seen during the period 2008 to 2013 were retrieved from the Gastroenterology and Microbiology departments. Patients with extra-abdominal TB (five pulmonary, two nodal), adnexal (one), and HIV (one) were excluded from analysis. Results Of 61 patients, 31 (50.8 %) had a positive AFB culture. In the 30 culture-negative patients, histology showed non-caseating granulomas in 25 patients. Drug sensitivity pattern was analyzed in 18 patients; resistance was detected in eight (14.3 % of all patients and 44.4 % of patients in whom drug sensitivity was done) including three (5.4 % of all subjects and 16.6 % in whom drug sensitivity was available) who were multidrug-resistant. Conclusions The rate of AFB culture positivity in primary abdominal TB was 50.8 % using Bactec MGIT. Likelihood of drug resistance was seen in 14.3 %, of whom 5.4 % were multidrug-resistant.