Indian Pediatr. 2011 Jun 10. pii: S097475591101060-2. [Epub ahead of print]
Clinical Profile of Drug Resistant Tuberculosis in Children.
Abstract
This Cross-sectional observational study was conducted at Pediatric Tuberculosis Clinic, BJ Wadia Hospital for Children, Mumbai from July 2007- August 2010 to determine the clinical profile of Drug resistant tuberculosis in children. All children with active or latent TB with culture and drug susceptibility test proven drug resistant TB or in contact with a patient who had drug resistant TB were enrolled in the study. Patients were classified as monoresistant TB, polyresistant TB, multidrug resistant (MDR)-TB and extensively drug resistant (XDR) - TB as per the World Health Organization (WHO) definition and contact with DR-TB. We coined a term called as Partial XDR-TB when isolates of Mycobacterium TB were confirmed to beresistant in vitro to be MDR along with either a fluoroquinolone or an aminoglycoside resistance (apart from streptomycin). Clinical and biochemical features associated with drug resistance TB were analysed. Of 500 children analysed, 34 (6.8%) had drug resistant TB. Mean age of presentation was 6.8±3.2 years (Male: Female ratio 13:21). Eighteen (52.9%) children had been treated for tuberculosis in the past (1 defaulted), seven patients had been in contact with an adult suffering from drug resistant TB and 3 patients (10.3%) were HIV co-infected. Fourteen children (41.2 %) had MDR TB,11 (32.4%) had Partial XDR, 1 each (2.9%) had Polyresistant TB and XDR TB. Clinical features of DRTB are similar in all age groups. Past history of TB with treatment with antitubercular agents, and contact with adults suffering with drug resistant (DR-TB) are important risk factors in development of drug-resistant -TB in children.
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