Risk Factors for Primary Drug Resistance among Newly Detected Pulmonary Tuberculosis Patients Presenting to a Tertiary Care Teaching Hospital in South India

Abstract Introduction: Knowledge of local disease burden, drug resistance, and risk factors for drug resistance are essential for the implementation of effective interventions for the control of tuberculosis (TB). Methodology: Single-center cross-sectional observational study was conducted on newly detected sputum-positive pulmonary TB (PTB) patients. Sputum samples were sent for Xpert- Mycobacterium TB (MTB)/Rif assay and Acid-fast Bacillus culture. Patient characteristics and comorbidities were compared between drug-sensitive and resistant groups and analyzed statistically. Results: Rifampicin resistance was 4.4%. About 13.3% of subjects with drug-sensitive TB and 55.56% of subjects with drug-resistant TB (DRTB) had a positive contact history with an odds ratio (OR) of 8.125 (95% confidence interval [CI] 2.04–32.23) to develop DRTB. Heavy alcohol consumption was found to have an OR of 9.25 (95% CI 2–42.5) for DRTB, which was statistically significant. Moderate underweight patients were found to have an OR of 9.25 [95% CI 2–42.5] for DRTB compared to the rest of the subjects (body mass index [BMI] >17) and this was statistically significant ( P = 0.013). Patients with poorly controlled diabetes had OR of 11.6 for DRTB. Conclusions: Rifampicin resistant, multidrug-resistant TB (MDR-TB) among new treatment-naïve, sputum-positive PTB cases was 4.4%. Positive contact history, poorly controlled diabetes mellitus, heavy alcohol consumption, and BMI <17 were found to be significant risk factors for primary MDR-TB in our study population.