{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T16:33:55Z","timestamp":1770914035577,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: To effectively manage tuberculosis (TB), it is essential to address the high incidence of the disease, as multidrug-resistant pulmonary TB (MDR-PTB) remains a significant concern to halt pre-extensive drug-resistant (pre-XDR) recrudescence. The objective of the current study was to examine and compare MDR-PTB patterns among adult PTB patients (&gt;12 years) in Bangladesh\u2019s urban and rural areas who had newly diagnosed and previously treated PTB. Methods: A total of 430 newly diagnosed and previously treated adult patients with PTB were randomly recruited during two study periods: the 1st period, from May 2010 to December 2010 (eight months), and the 2nd period, from January 2014 to January 2015 (thirteen months). Only the drug-resistant (DR) patients were included in the final analysis. Mycobacteriological tests, i.e., smear microscopy, culture, drug susceptibility testing (proportion method of Canetti), line-probe assay, and GeneXpert MTB\/RIF were performed. Logistic regression analysis was used to determine the strength of associations between treatment outcomes and predictor variables. Results: Of the newly diagnosed patients, 156 cases were negative and drug-sensitive (DS) at diagnosis, and 274 patients exhibited various DR patterns. During the 1st period, MDR-PTB was 26% among newly diagnosed patients, while the proportion was 31% among previously treated patients in the 2nd period. The majority of MDR-PTB belonged to the age group of \u226445 years. Male patients consistently revealed a higher proportion of MDR-PTB compared to females in both the newly diagnosed and previously treated groups. Conclusion: The proportion of MDR-PTB was higher among the previously treated patients than among newly diagnosed patients. Regardless of demographic characteristics, a significant proportion of patients showed DR, particularly in previously treated groups, indicating a substantial burden of MDR-PTB.<\/jats:p>","DOI":"10.3390\/pathogens15020208","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:28:11Z","timestamp":1770910091000},"page":"208","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Multidrug Resistance and Treatment Outcomes Among Pulmonary Tuberculosis Patients in Bangladesh"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6695-5294","authenticated-orcid":false,"given":"Naima","family":"Nur","sequence":"first","affiliation":[{"name":"Tuberculosis Reference Laboratory, Management Sciences for Health, Gulshan-1, Dhaka 1212, Bangladesh"},{"name":"Department of Public Health, North South University, Bashundhara R\/A, Dhaka 1229, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9929-1236","authenticated-orcid":false,"given":"Azaz Bin","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Public Health, North South University, Bashundhara R\/A, Dhaka 1229, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-3103","authenticated-orcid":false,"given":"Anish","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Chaudhary Ranbir Singh University, Jind 126102, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8950-4253","authenticated-orcid":false,"given":"Md Rashedul","family":"Islam","sequence":"additional","affiliation":[{"name":"National Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-6741","authenticated-orcid":false,"given":"Hafid","family":"Soualhine","sequence":"additional","affiliation":[{"name":"National Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada"},{"name":"Department of Medical Microbiology, University of Manitoba, Winnipeg, MB R3T 5V6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zubaida","family":"Nasreen","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Programme, Mycobacterial Disease Control, Directorate General of Health Services, Mohakhali, Dhaka 1212, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmadul Hasan","family":"Khan","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Programme, Mycobacterial Disease Control, Directorate General of Health Services, Mohakhali, Dhaka 1212, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pronab Kumar","family":"Modak","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Programme, Mycobacterial Disease Control, Directorate General of Health Services, Mohakhali, Dhaka 1212, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Faridul","family":"Alam","sequence":"additional","affiliation":[{"name":"Clinical Research, Sheridan College, Davis Campus 7899, McLaughlin Road, Brampton, ON L6Y 5H9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safa","family":"Islam","sequence":"additional","affiliation":[{"name":"School of Life and Medical Science, University of Hertfordshire, Hatfield, Hertfordshire AL10 9AB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeema","family":"Islam","sequence":"additional","affiliation":[{"name":"Pulse Specialized Hospital Limited, Dania, Kadamtoli, Jatrabari, Dhaka 1236, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, University Institute of Engineering & Technology, Maharshi Dayanand University, Rohtak 124001, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6020-9995","authenticated-orcid":false,"given":"Meenu Kaushal","family":"Sharma","sequence":"additional","affiliation":[{"name":"National Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada"},{"name":"Department of Medical Microbiology, University of Manitoba, Winnipeg, MB R3T 5V6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.5588\/ijtld.21.0624","article-title":"Finding gaps in routine TB surveillance activities in Bangladesh","volume":"26","author":"Allorant","year":"2022","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_2","unstructured":"World Health Organization (2020, October 14). Tuberculosis. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis."},{"key":"ref_3","unstructured":"World Health Organization (2021, January 27). WHO Announces Updated Definitions of Extensively Drug-Resistant Tuberculosis. Available online: https:\/\/www.who.int\/news\/item\/27-01-2021-who-announces-updated-definitions-of-extensively-drug-resistant-tuberculosis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4236\/jtr.2018.63018","article-title":"Pre-Extensively Drug Resistant Tuberculosis (Pre-XDR-TB) among Pulmonary Multidrug Resistant Tuberculosis (MDR-TB) Patients in Bangladesh","volume":"6","author":"Tasnim","year":"2018","journal-title":"J. Tuberc. Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rahman, S.M., Nasrin, R., Rahman, A., Ahmed, S., Khatun, R., Uddin, M.K.M., Rahman, M.M., and Banu, S. (2021). Performance of GenoType MTBDRsl assay for detection of second-line drugs and ethambutol resistance directly from sputum specimens of MDR-TB patients in Bangladesh. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0261329"},{"key":"ref_6","unstructured":"World Health Organization (2023). Global Tuberculosis Control. Global TB Programme, World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis."},{"key":"ref_7","unstructured":"Centers for Disease Control and Prevention (2024, November 18). The U.S. Government and Global Tuberculosis Efforts, Available online: https:\/\/www.kff.org\/global-health-policy\/fact-sheet\/the-u-s-government-and-global-tuberculosis-efforts\/#endnote_link_608351-7."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"551","DOI":"10.5588\/ijtld.22.0648","article-title":"Stress resilience in patients with drug-resistant TB","volume":"27","author":"Nur","year":"2023","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kuddus, M.A., Meehan, M.T., White, L.J., McBryde, E.S., and Adekunle, A.I. (2020). Modeling drug-resistant tuberculosis amplification rates and intervention strategies in Bangladesh. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236112"},{"key":"ref_10","unstructured":"(2024, October 29). Global Tuberculosis Report. Available online: https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2024."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5588\/ijtld.16.0384","article-title":"Multidrug-resistant tuberculosis in Bangladesh: Results from a sentinel surveillance system","volume":"21","author":"Banu","year":"2017","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_12","unstructured":"United Nations (2017). Global Indicator Framework for the Sustainable Development Goals and Targets of the 2030 Agenda for Sustainable Development, Springer."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Welekidan, L.N., Skjerve, E., Dejene, T.A., Gebremichael, M.W., Brynildsrud, O., Agdestein, A., Tessema, G.T., T\u00f8njum, T., and Yimer, S.A. (2020). Characteristics of pulmonary multidrugresistant tuberculosis patients in Tigray Region, Ethiopia: A cross-sectional study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236362"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Liebenberg, D., Gordhan, B.G., and Kana, B.D. (2022). Drug resistant tuberculosis: Implications for transmission, diagnosis, and disease management. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.943545"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Haq, K.A.T.M.E., Moriyama, M., Zaman, K., Chisti, M.J., Long, J., Islam, A., Hossain, S., Shirin, H., Raihan, M.J., and Chowdhury, S. (2018). Health seeking behaviour and delayed management of tuberculosis patients in rural Bangladesh. BMC Infes. Dis., 18.","DOI":"10.1186\/s12879-018-3430-0"},{"key":"ref_16","first-page":"427","article-title":"Recent nosocomial transmission and genotypes of multidrug-resistant Mycobacterium tuberculosis","volume":"14","author":"Nodieva","year":"2010","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"789","DOI":"10.2147\/IDR.S240408","article-title":"Distribution and Frequency of rpoB Mutations Detected by GeneXpert MTB\/RIFMTB\/RIF Assay Among Beijing and Non-Beijing Rifampicin Resistant Mycobacterium tuberculosis Isolates in Bangladesh","volume":"13","author":"Uddin","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4613","DOI":"10.21037\/jtd.2019.11.03","article-title":"Phenotypic and genotypic characterization of levofloxacin- and moxifloxacin-resistant Mycobacterium tuberculosis clinical isolates in southern China","volume":"11","author":"Hameed","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"5494","DOI":"10.21037\/jtd-23-138","article-title":"Distribution of common and rare drug resistance patterns in Mycobacterium tuberculosis clinical isolates revealed by GenoTypeMTBDRplus and MTBDRsl assay","volume":"15","author":"Khan","year":"2023","journal-title":"J. Thorac. Dis."},{"key":"ref_20","unstructured":"National Tuberculosis Control Programme (NTP) (2021, July 26). Tuberculosis Control in Bangladesh, Available online: https:\/\/www.ntp.gov.bd\/wp-content\/uploads\/2021\/07\/Annual-Report-2018.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1128\/JCM.00251-16","article-title":"Multicenter Noninferiority Evaluation of Hain GenoType MTBDRplus Version 2 and Nipro NTM+MDRTB Line Probe Assays for Detection of Rifampin and Isoniazid Resistance","volume":"54","author":"Nathavitharana","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1080\/17576180.2024.2349423","article-title":"Tuberculosis diagnosis versus GeneXpert\u00ae MTB\/RIF formats","volume":"16","author":"Khan","year":"2024","journal-title":"Bioanalysis"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100116","DOI":"10.1016\/j.medmic.2024.100116","article-title":"Diagnosis of tuberculous lymphadenitis by molecular and immunological tools","volume":"22","author":"Kumar","year":"2024","journal-title":"Med. Microecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1099\/jmm.0.000449","article-title":"Rapid detection of Mycobacterium tuberculosis and rifampicin resistance in extrapulmonary tuberculosis and sputum smear- negative pulmonary suspects using GeneXpert MTB\/RIFMTB\/RIF","volume":"66","author":"Ullah","year":"2017","journal-title":"J. Med. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1084\/jem.21.1.38","article-title":"A new and rapid method for isolation and culture of tubercle bacilli directly from the sputum and faece","volume":"21","author":"Petroff","year":"1915","journal-title":"J. Exp. Med."},{"key":"ref_26","unstructured":"Kentor, I.N.D., Kim, S.J., Friden, T., Lazlo, A., Norvel, P.Y., and Reider, H. (1998). Ziehl-Neelsen Staining, in Laboratory Services in Tuberculosis Control-Microscopy, World Health Organization. [2nd ed.]."},{"key":"ref_27","first-page":"485","article-title":"Yield of serial sputum specimen examinations in the diagnosis of pulmonary tuberculosis: A systematic review","volume":"11","author":"Mase","year":"2007","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_28","unstructured":"Kent, P.T., and Kubica, G.P. (1985). Public Health Mycobacteriology: A Guide for Level III Laboratory."},{"key":"ref_29","first-page":"21","article-title":"Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes","volume":"41","author":"Canetti","year":"1969","journal-title":"Bull. World Health Organ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e01227-24","DOI":"10.1128\/jcm.01227-24","article-title":"A Simplified pyrazinamidase test for Mycobacterium tuberculosis pyrazinamide antimicrobial susceptibility testing","volume":"62","author":"Chan","year":"2024","journal-title":"J. Clin. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Tenzin, C., Chansatitporn, N., Dendup, T., Dorji, T., Lhazeen, K., Tshering, D., and Pelzang, T. (2020). Factors associated with multidrug-resistant tuberculosis (MDR-TB) in Bhutan: A nationwide case-control study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236250"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"303","DOI":"10.5588\/ijtld.16.0444","article-title":"Pattern of first- and second-line drug resistance among pulmonary tuberculosis retreatment cases in Pakistan","volume":"21","author":"Javaid","year":"2017","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5588\/ijtld.14.0200","article-title":"Anti-tuberculosis drug resistance in Bangladesh: Reflections from the first nationwide survey","volume":"19","author":"Kamal","year":"2015","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Wu, X., Yang, J., Tan, G., Liu, H., Liu, Y., Guo, Y., Gao, R., Wan, B., and Yu, F. (2019). Drug Resistance Characteristics of Mycobacterium tuberculosis Isolates from Patients with Tuberculosis to 12 Antituberculous Drugs in China. Front. Cell. Infect. Microbiol., 9.","DOI":"10.3389\/fcimb.2019.00345"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kundu, S., Marzan, M., Gan, S.H., and Islam, M.A. (2020). Prevalence of Antibiotic-Resistant Pulmonary Tuberculosis in Bangladesh: A Systematic Review and Meta-Analysis. Antibiotics, 9.","DOI":"10.3390\/antibiotics9100710"},{"key":"ref_36","unstructured":"World Health Organization (2022, December 15). WHO Consolidated Guidelines on Tuberculosis, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK588564\/."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/2\/208\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:49:44Z","timestamp":1770911384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/15\/2\/208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["pathogens15020208"],"URL":"https:\/\/doi.org\/10.3390\/pathogens15020208","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}