Extensively drug-resistant tuberculosis (XXDR-TB), which created chaos in Mumbai after discovery of 12 cases at a private hospital, might be prevalent in Pune too, with chest physicians and microbiologists stating having examined patients who may have been suffering from XXDR-TB. While laboratory reports too have confirmed the view in a few cases, the physicians and microbiologists are cautious enough not to label it as of one of their clinical observations.
India grabbed international attention after Mumbai-based PD Hinduja Hospital announced that 12 patients taking tuberculosis treatment have developed totally drug resistant (TDR) strain of the disease. Later, these patients were said to be suffering from XXDR-TB.
However, Pune doctors said that while the focus has been on Mumbai — which reported the first such cases, the drug-resistant strain was not new to Pune either. Currently, the disease is receiving attention across the country, especially across the state as it is a highly infectious ailment and the possibility of the spread of a highly drug resistant strain is worrisome.
TB consultant Dr Mahavir Modi at Ruby Hall Clinic claims a 15-year-old girl, whom he was treating last year, was suspected to be a case of XXDR-TB. “She first came to me when she was in Standard IX but she discontinued treatment after four months as she was getting better. A year later, she came again for treatment after a relapse. Even after following proper regime, her weight wasn’t improving and her X-ray report was not showing good resolution. We started her on the third-line drugs and sent the samples for culture report,” recalled Modi. However, it took a month for reports to arrive and the girl succumbed a day after.
While confirming that the reports indicated the girl to be suffering from an infection beyond extremely drug resistant (XDR)TB, Modi said, “Even now I am treating few patients of XDR-TB. These patients too show resistance to third-line drugs, but we cannot declare anything beyond that as it needs careful scrutiny.” At the Sassoon General Hospital too, chest physician Dr Sanjay Gaikwad is handling a case of XDR-TB. Confirming treating cases of drug-resistant TB and a select number of XDR TB cases, Gaikwad said they “lacked a laboratory that can say with conviction the stage of resistance of the illness”.
Stating there was a huge difference in laboratory test findings and real-life cases, chest physician Dr Nitin Abhyankar said, “We have had patients whose lab tests showed no sensitivity to any known drugs, but clinically that is not true as they do respond to certain drugs. While we don’t deny XXDR-TB cases, a few hundred patients would have it,” he said.
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