Prevalence of primary anti-tuberculosis drug resistance at the tertiary center in Saudi Arabia and associated risk factors

Article Figures & Data

Table 1

- Comparison of tuberculosis patients according to various parameters.

Parameters	2000 - 2002	2003 - 2005	2006 - 2008	2009 - 2011	2012 - 2014	2015 - 2018	Total n (%)
Age (years)
0-20	0	5	16	14	11	15	61 (6.8)
21-40	28	42	55	58	37	44	264 (29.3)
41-60	41	50	45	39	18	22	215 (23.9)
61-80	42	62	57	42	21	20	244 (27.1)
>80	37	30	21	13	6	10	117 (13.0)
Total	148	189	194	166	93	111	901 (100)
Gender
Female	61	92	96	81	29	39	398 (44.2)
Male	87	97	98	85	64	72	503 (55.8)
Total	148	189	194	166	93	111	901 (100)
Nationality
Non-Saudi	7	5	8	7	3	5	35 (3.9)
Saudi	141	184	186	159	90	106	866 (96.1)
Total	148	189	194	166	93	111	901 (100)

Table 2

- Drugs sensitive/resistant tuberculosis with resistant pattern.

Drugs sensitive/resistant	2000 - 2002	2003 - 2005	2006 - 2008	2009 - 2011	2012 - 2014	2015 - 2018	Total n (%)
Drug susceptibility
Sensitive	134 (90.5)	162 (85.7)	148 (76.3)	110 (66.3)	74 (79.6)	80 (72.1)	708 (78.6)
Resistant	14 (9.5)	27 (14.3)	46 (23.7)	56 (33.7)	19 (20.4)	31 (27.9)	193 (21.4)
Total	148	189	194	166	93	111	901 (100)
Resistant pattern
Mono-resistant	12 (85.7)	27 (100)	43 (93.5)	55 (98.2)	19 (100)	21 (67.7)	177 (91.7)
Multi-resistant	2 (14.3)	0	3 (6.5)	1 (1.8)	0	10 (32.3)	16 (8.3)
Total	14	27	46	56	19	31	193 (100)

Table 3

- Prevalence of primary mono-drug resistant tuberculosis

Mono-drug resistant	2000 - 2002	2003 - 2005	2006 - 2008	2009 - 2011	2012 - 2014	2015 - 2018	Total n (%)
Ethambutol	5	3	3	3	1	6	21 (7.1)
Isoniazid	6	3	21	25	8	16	79 (26.7)
Pyrazinamide	0	4	27	32	16	20	99 (33.4)
Rifampicin	3	15	4	3	0	11	36 (12.2)
Streptomycin	4	5	18	18	0	16	61 (20.6)
Total	18	30	73	81	25	69	296 (100)

Table 4

- Possible risk factors associated with mono-drug, multi-drug resistant tuberculosis.

Variables	Mono-resistant	Multi-resistant	Odds ratio	95% confidence interval	P-value
Smoking
Yes	26	3	1.305	0.39-4.3	0.663
No	151	13	0.95	0.85-1.11	0.663
Gender
Female	77	8	1.5	0.69-1.93	0.616
Male	100	8	0.89	0.53-1.47	0.616
Nationality
Saudi	164	16	1.1	1.05-1.15	0.262
Non-Saudi	13	0	1.1	1.05-1.15	0.262
Creatinine
Normal	83	3	0.96	0.93-1.01	0.421
High	18	0	0.96	0.93-1.01	0.421
Alanine aminotransferase
Normal	124	5	0.96	0.93-0.99
High	26	0	0.96	0.93-0.99
AST
Normal	51	1	0.98	0.94-1.02	0.643
High	11	0	0.98	0.94-1.02	0.643
Total bilirubin
Normal	111	3	0.4	0.13-1.25	0.157
High	21	2	1.4	0.7-.9	0.157
Diabetes mellitus
Normal	91	3	0.65	0.21-1.99	0.488
High	32	2	1.23	0.6-2.5	0.488
HIV
Negative	177	15	12.8	7.87-20.8	0.001
Positive	0	1	0.078	0.05-0.13	0.001

* p-value is considered significant for <0.05. AST: aspartate aminotransferase, HIV: human immune deficiency virus

Table 5

- Correlation of tested factors with patients showed resistance to TB treatment either (multi and/or mono) compared to non-resistant patients.

Variables	Age	Gender	Creatinine	ALT	AST		Total bilirubin		Diabetes mellitus	SMOK	HIV
Spearman’s rho resistance (mono & multi)
Correlation coefficient	-0.145^**	-0.001	-0.024	-0.025		-0.062	-0.009		-0.011	0.054	0.064
Sig. (2-tailed)	0.000	0.483	0.272	0.247		0.117	0.398		0.383	0.053	0.055
N	901	901	647	800		370	752		713	901	901
Correlation of tested factors with patients showed multi-resistance to TB treatment compared to mono-resistant patients.
Spearman’s rho multi- resistance
Correlation coefficient	0.020	0.036	-0.079	-0.082		-0.058		0.121	0.061	-0.031	0.24^**
Sig. (2-tailed)	0.780	0 6.618	0.426	0.311	0.649			0.159	0.492	0.665	0.001
N	193	193	104	153	63			137	128	193	193
Correlation of tested factors with patients showed Mono-resistance to TB treatment compared to Multi-resistant patients.
Spearman’s rho mono-resistance
Correlation coefficient	-0.020	-0.036	0.079	0.082	0.058			-0.121	-0.061	0.031	-0.24^**
Sig. (2-tailed)	0.780	0 6.618	0.426	0.311	0.649			0.159	0.492	0.665	0.001
N	193	193	104	153	63			137	128	193	193

* Correlation is significant at the 0.05 level (2-tailed).
↵** Correlation is significant at the 0.01 level (2-tailed). ALT: alanine aminotransferase, AST: aspartate aminotransferase, HIV: human immune deficiency virus, SMOK: smoking