Abstract
The control of tuberculosis (TB) has become a global health challenge due to the emergence of multidrug-resistant tuberculosis (MDR-TB) in Mycobacterium tuberculosis (MTB). This highlights the need for faster and more accurate detection of tuberculosis cases. The study aims to detect MDR-TB strains of pulmonary tuberculosis using resistance ratio method and to compare the diagnostic value of drug susceptibility testing (DST) with line probe assay (LPA) using Genotype MTBDRplus. All the sputum samples were tested for Acid Fast Bacilli (AFB) by Ziehl-Neelsen’s staining method and were cultured on Lowenstein-Jensen (L-J) media. The identification and confirmation of M. tuberculosis were done using various biochemical tests. DST was carried against the first line of anti-TB drugs. MTB positive samples were subjected to LPA. A total of 57 samples were subjected to DST and LPA for the detection of drug resistance of MTB to RIF and INH after conventional detection methods were applied to all the samples. Among these 57 MTB samples, 11 (19.29%) were resistant to INH, 4 (7.14%) were resistant to RIF; eleven (19.29%) isolates were identified as MDR-TB. LPA revealed 54 MTB positive among 57 MTB culture-positive samples and 3 showed invalid results. In LPA, MDR-TB was found in10 samples (17.54%) in which one was RIF-resistant. The study concludes risk factors that resulted in the development of TB are biomedical, socio-cultural, and behavioral interactions. LPA can be used as a rapid diagnostic technique for the detection of MDR-TB. Key words: Tuberculosis (TB), multidrug resistance (MDR-TB), drug susceptibility testing (DST), line probe assay (LPA).  
Highlights
Tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) is one of the leading causes of deaths due to infectious diseases in developing nations, including India
Six countries had accounted for about 60% of the global total, with India leading the burden of tuberculosis in the world (WHO, 2016)
The present study was undertaken to study the drug resistance pattern, the risk factor associated with TB, and recommending the use of the resistance ratio method for drug susceptibility testing (DST)
Summary
Tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) is one of the leading causes of deaths due to infectious diseases in developing nations, including India. According to the World Health Organization (WHO), 1.8 million people died due to TB, and 10.4 million people were infected with TB in 2015. 95% of the total TB deaths occurred in low- and middle-income countries. Six countries had accounted for about 60% of the global total, with India leading the burden of tuberculosis in the world (WHO, 2016). In 2015, around 280, 00, 00 TB cases occurred in India, and 48, 0000 people had died due to this disease. The global emergence of Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem as it causes a major challenge to control the disease and the mortality rates associated with it. According to India reports, 130,000MDR-TB cases among which 79,000 MDR-TB cases are pulmonary TB (TB Statistics for India; WHO, 2008)
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