Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Analysis of molecular mechanisms of drug resistance of Mycobacterium tuberculosis in patients with pulmonary tuberculosis and its pharmacoeconomics

Zeqing Bao¹, Yingyi Bao², Xiaocui Qin³, Weibin Wu⁴, Xia Zhang⁵

¹Department of Basic Medicine, Foshan University Medical School, Foshan, Guangdong, China; ²Department of Nursing, Foshan University Medical School, Foshan, Guangdong, China; ³Department of Physiology, Zhaoqing Medical College, Zhaoqing, China; ⁴The First Affiliated Hospital of Zhaoqing Medical College, Zhaoqing, China; ⁵Department of Pathology, he First Affiliated Hospital of Zhaoqing Medical College, Zhaoqing, China.

For correspondence:- Xia Zhang Email: xiazhangzhao558df@163.com Tel:+8613413830667

Accepted: 26 September 2022 Published: 28 October 2022

Citation: Bao Z, Bao Y, Qin X, Wu W, Zhang X. Analysis of molecular mechanisms of drug resistance of Mycobacterium tuberculosis in patients with pulmonary tuberculosis and its pharmacoeconomics. Trop J Pharm Res 2022; 21(10):2211-2218 doi: 10.4314/tjpr.v21i10.23

© 2022 The authors.
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Abstract

Purpose: To investigate the molecular mechanisms of drug resistance of Mycobacterium tuberculosis in patients with pulmonary tuberculosis and its pharmacoeconomics.

Methods: Data pertaining to patients with primary tuberculosis treated in the First Affiliated Hospital of Zhaoqing Medical College, Zhaoqing, China from January 2020 to June 2021 were retrospectively analyzed. Sputum specimens were collected from all eligible patients, and 151 uncontaminated specimens with good bacteriophage activity were screened.

Results: A total of 107 Mycobacterium tuberculosis strains were isolated from the 151 specimens, 31 of which strains were resistant to varying degrees to rifampicin, isoniazid, streptomycin, and ethambutol with an overall resistance of 28.97 %. There were 16 strains with rpoB mutation, 22 strains with katG mutation, and 8 strains with inhA mutation. The difference in the sputum negative rate, lesion absorption rate, and tuberculosis cavity closure rate, and total medical cost between the two group were not statistically significant (p > 0.05). The incidence of adverse reactions in the FDC group was significantly lower than that in the blister pack group (p < 0.05).

Conclusion: The total resistance of Mycobacterium tuberculosis in primary tuberculosis patients remains at a high level, and the development of resistance is associated with mutations in rpoB, katG, and inhA genes. FDC regimen provides more pharmacoeconomic and therapeutic benefits than blister pack regimen.

Keywords: Tuberculosis, Molecular mechanism of drug resistance, Fixed-dose combination, Cost-effectiveness analysis