{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:03:25Z","timestamp":1790157805574,"version":"4.1.0"},"reference-count":23,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Tuberculosis (TB) continues to be a major global health challenge, with India contributing a significant share of the burden. Drug-resistant TB (DR-TB) is additionally responsible for the huge numbers. Despite the magnitude of the problem, there is a relative paucity of data with respect to the different patterns of DR-TB from Northern India. A retrospective, observational study was undertaken at the Department of Pulmonary Medicine at Chest and TB Hospital, Government Medical College, Patiala, Punjab, India, to analyze the drug resistance profile of Mycobacterium tuberculosis\u00a0and associated risk factors, essential for aiding clinicians and evaluating evidence\u00a0to strengthen programmatic strategies, with an aim to ultimately reduce the overall burden of TB.\u00a0A total of 14,142 microbiologically confirmed M. tuberculosis\u00a0cases from 2022-2024 were reviewed. Resistance patterns were characterized according to national guidelines. The prevalence of resistance patterns and associations between drug resistance and demographic variables, treatment and contact history, and comorbidities (HIV co-infection, diabetes mellitus, alcohol, and smoking) were analyzed using chi-square tests and univariate and multivariate logistic regression.\u00a0In this cohort, the\u00a0median age of included patients was 37 years, with the majority from 21-40 years (41.01%) and predominantly male gender (60.72%). The overall prevalence of DR-TB was 8.6%. INH monoresistance accounted for 50.53% of DR-TB, with 35.99% harboring katG\u00a0and 14.54% inhA gene\u00a0mutations. katG\u00a0mutations were significantly higher in newly diagnosed patients (37.7%, p=0.006), those with a positive contact history (37.6%, p=0.027), diabetics (43.6%, p=0.038), and individuals with tobacco exposure (49.1%, p=0.034). inhA mutations were strongly associated with HIV co-infection (32.30%, p=0.005). Rifampicin resistance was more frequent among previously treated cases (15.3%, p&lt;0.001), patients with no contact history (13%, p=0.003), and those with HIV co-infection (19.40%, p=0.026). Multivariate analysis demonstrated that female gender [adjusted odds ratio (AOR) 1.15, p=0.030], previous treatment history (AOR 1.78, p&lt;0.001), and absence of contact history (AOR 1.74, p&lt;0.001) had higher odds of having DR-TB.\u00a0These findings, when interpreted in the context of existing literature, suggest that factors contributing to the development of resistance are either acquired through treatment failure or community transmission. Individual host factors, including gender and the presence of comorbidities such as HIV, diabetes, and tobacco exposure, further increase the risk. Understanding the epidemiology of drug resistance is crucial to improve patient outcomes, curb the burden of TB in our region, and eventually advance the nation's TB elimination goals.<\/jats:p>","DOI":"10.4081\/monaldi.2026.3932","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:18:33Z","timestamp":1790155113000},"source":"Crossref","is-referenced-by-count":0,"title":["Drug resistance in patients with\u00a0tuberculosis:\u00a0a study from a tertiary care center in northern India"],"prefix":"10.4081","author":[{"given":"Pranav","family":"Raj","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehar Kaur","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Chopra","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kranti","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"87158","unstructured":"WHO. Global tuberculosis report 2024. 1st ed. Available from: https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2024"},{"key":"87159","unstructured":"Ministry of Health and Family Welfare. National guidelines for management of drug resistant TB. Available from:https:\/\/tbcindia.mohfw.gov.in\/wp-content\/uploads\/2025\/01\/National-Guidelines-for-Management-of-DR-TB_Final.pdf"},{"key":"87160","doi-asserted-by":"crossref","unstructured":"Myneedu VP, Singhal R, Khayyam KU, et al. First and second line drug resistance among treatment na\u00efve pulmonary tuberculosis patients in a district under Revised National Tuberculosis Control Programme (RNTCP) in New Delhi. J Epidemiol Glob Health 2015;5:365-73.","DOI":"10.1016\/j.jegh.2015.04.002"},{"key":"87161","doi-asserted-by":"crossref","unstructured":"Sinha P, Srivastava GN, Gupta A, Anupurba S. Association of risk factors and drug resistance pattern in tuberculosis patients in north India. J Glob Infect Dis 2017;9:139-45.","DOI":"10.4103\/jgid.jgid_167_16"},{"key":"87162","doi-asserted-by":"crossref","unstructured":"Chawla GK, Garg K, Kaur K, et al. Pattern of drug resistance among patients of pulmonary tuberculosis. Indian J Tuberc 2022;69:669-74.","DOI":"10.1016\/j.ijtb.2021.10.003"},{"key":"87163","unstructured":"Ministry of Health and Family Welfare. India TB Report 2024 Available from: https:\/\/tbcindia.mohfw.gov.in\/wp-content\/uploads\/2024\/10\/TB-Report_for-Web_08_10-2024-1.pdf"},{"key":"87164","unstructured":"Ministry of Health and Family Welfare. National Tuberculosis Elimination Programme . Available from: https:\/\/dghs.mohfw.gov.in\/national-tuberculosis-elimination-programme.php"},{"key":"87165","doi-asserted-by":"crossref","unstructured":"Sharma P, Visnegarwala F, Tripathi V. Burgeoning double burden of tuberculosis and diabetes in India: magnitude of the problem \u2013 strategies and solutions. Clin Epidemiol Glob Health 2014;2:107-16.","DOI":"10.1016\/j.cegh.2013.03.002"},{"key":"87166","doi-asserted-by":"crossref","unstructured":"Debnath A, Nath R, Mondal A, et al. Prevalence of tobacco consumption among pulmonary tuberculosis patients and its correlation with tuberculosis incidence: a systematic review and meta-analysis in the Indian context. Monaldi Arch Chest Dis Arch 2026;96:3324.","DOI":"10.4081\/monaldi.2025.3324"},{"key":"87167","doi-asserted-by":"crossref","unstructured":"Mondal T, Sarkar A, Chaudhuri SJ, Rahaman J. Tuberculosis and HIV coinfection and rifampicin-resistant tuberculosis among patients living with HIV in Northern part of West Bengal, India. Asian J Med Sci 2023;14:81-7.","DOI":"10.3126\/ajms.v14i1.47930"},{"key":"87168","doi-asserted-by":"crossref","unstructured":"Salindri AD, Sales RMF, DiMiceli L, et al. Isoniazid monoresistance and rate of culture conversion among patients in the state of georgia with confirmed tuberculosis, 2009-2014. Ann Am Thorac Soc 2018;15:331-40.","DOI":"10.1513\/AnnalsATS.201702-147OC"},{"key":"87169","doi-asserted-by":"crossref","unstructured":"Baluku JB, Mugabe P, Mulwana R, et al. High prevalence of rifampicin resistance associated with rural residence and very low bacillary load among TB\/HIV-coinfected patients at the National Tuberculosis Treatment Center in Uganda. BioMed Res Int 2020;2020:2508283.","DOI":"10.1155\/2020\/2508283"},{"key":"87170","doi-asserted-by":"crossref","unstructured":"Sharling L, Marks SM, Goodman M, et al. Rifampin-resistant tuberculosis in the United States, 1998-2014. Clin Infect Dis 2020;70:1596-605.","DOI":"10.1093\/cid\/ciz491"},{"key":"87171","doi-asserted-by":"crossref","unstructured":"Rehman A ur, Khattak M, Mushtaq U, et al. The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis. Front Public Health 2023;11:1244450.","DOI":"10.3389\/fpubh.2023.1244450"},{"key":"87172","doi-asserted-by":"crossref","unstructured":"Hatiya M, Merid Y, Mola A, et al. Prevalence of drug-resistant Mycobacterium tuberculosis and its associated factors among tuberculosis patients attending Dilla university referral hospital, Ethiopia. BMC Infect Dis 2025;25:797.","DOI":"10.1186\/s12879-025-11191-z"},{"key":"87173","doi-asserted-by":"crossref","unstructured":"Singh N, Singh AK, Sarita S, et al. Prevalence and genetic analysis of isoniazid-resistant tuberculosis in eastern Uttar Pradesh, India. Cureus 2025;17:e80243.","DOI":"10.7759\/cureus.80243"},{"key":"87174","doi-asserted-by":"crossref","unstructured":"Alavi-Naini R, Sharifi-Mood B, Metanat M. Association between tuberculosis and smoking. Int J High Risk Behav Addict 2012;1:71-4.","DOI":"10.5812\/ijhrba.5215"},{"key":"87175","doi-asserted-by":"crossref","unstructured":"Zellweger JP. Tobacco and tuberculosis. Monaldi Arch Chest Dis 2008;69:403.","DOI":"10.4081\/monaldi.2008.403"},{"key":"87176","doi-asserted-by":"crossref","unstructured":"Prasanna MV, Muthuraj R, Raj RV, et al. Clinico-microbiological profile and treatment outcomes in patients with isoniazid monoresistant tuberculosis in South India. Eur Respir J 2023;62.","DOI":"10.1101\/2023.01.31.23285245"},{"key":"87177","doi-asserted-by":"crossref","unstructured":"Kendall EA, Fofana MO, Dowdy DW. The burden of transmitted multi-drug resistance among epidemics of tuberculosis: A transmission model. Lancet Respir Med 2015;3:963-72.","DOI":"10.1016\/S2213-2600(15)00458-0"},{"key":"87178","doi-asserted-by":"crossref","unstructured":"Garg K, Saini V, Dhillon R, Agarwal P. Isoniazid mono-resistant tuberculosis: time to take it seriously. Indian J Tuberc 2019;66:247-52.","DOI":"10.1016\/j.ijtb.2019.04.001"},{"key":"87179","doi-asserted-by":"crossref","unstructured":"Mishra GP, Mulani JD. First national anti-tuberculosis drug resistance survey (NDRS) from India - an eye opener. J Infect Epidemiol 2018;1:1117.","DOI":"10.29245\/2689-9981\/2018\/2.1117"},{"key":"87180","doi-asserted-by":"crossref","unstructured":"Goyal V, Kadam V, Narang P, Singh V. Prevalence of drug-resistant pulmonary tuberculosis in India: systematic review and meta-analysis. BMC Public Health 2017;17:817.","DOI":"10.1186\/s12889-017-4779-5"}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3932\/2278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3932\/2278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:18:49Z","timestamp":1790155129000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/3932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":23,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.3932","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}