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Incidence of various clinico-morphological variants of cutaneous tuberculosis and its drug susceptibility pattern-Delhi based study

Hemlata Lall, N P Singh, Meenakshi Chaudhary, I R Kaur.

Abstract
Background: Tuberculosis was declared global emergency in year 1993. The global spread of the disease is complicated by the ubiquitous appearance of drug-resistant strains, and particularly multidrug-resistant (MDR) strains. MDR is defined as resistant to isoniazid (INH) and rifampicin4.

Objective: To identify Mycobacterium in patients of cutaneous tuberculosis, to study clinical variants of cutaneous tuberculosis and to determine the pattern of anti mycobacterial drug susceptibility in these isolates.

Materials and Methods: The present study was performed on 30 consecutive patients of cutaneous tuberculosis attended skin OPD at UCMS and GTB Hospital, Delhi. Biopsy samples were taken from Dermatology department in 0.85% NACL. Samples were processed in Microbiology department for microscopy, LJ culture, and drug susceptibility methods.

Result: Out of 31 specimens, only 6 (19.3) were culture positives. Out of 6 isolates, only 4 isolates were positive for niacin and nitrate. Indirect proportion method was done on the 6 isolates of tuberculosis for susceptibility against isoniazid, rifampicin, ethambutol, and streptomycin. 16.6% (1) of the M. tuberculosis isolates showed resistance to isonazid and streptomycin by IPM. Interpretation was made by 28 days. Rest 4 isolates were sensitive. No multidrug resistant isolate was reported in the present study .

Conclusion: Cutaneous tuberculosis is increasing rapidly in era of HIV. However, there have been studies on the pattern of anti mycobacterial drug susceptibility but this can change with time and with particular geographical area. Although the drug-resistant strains causing cutaneous tuberculosis is not yet a significant issue but this situation may change. So, cutaneous tuberculosis should be diagnosed early and accurately.

Key words: TB (Tuberculosis), LJ (Lowenstein Jensen), MDR, indirect proportion method


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