The latest guidelines under Programmatic Management of Drug Resistant TB (PMDT) by the National TB Elimination Programme (NTEP) of India provide simplified regimens for various types of DR-TB including shorter oral Bedaquiline-containing regimen for Multi-drug resistant/ Rifampicin resistant TB (MDR/RR-TB) cases. However, baseline resistance to Fluoroquinolones (FQ) renders a patient ineligible for this shorter regimen. A retrospective record-based study was undertaken to determine the proportion of FQ resistance among MDR/RR- TB patients in the public sector in the state of Goa. Data of available baseline Second line- Line Probe Assay (SL-LPA) results of MDR/RR TB patients diagnosed in Goa from January 2018 to December 2021 was analyzed. Of a total of 213 MDR/RR- TB cases, SL-LPA results of 144 cases were available. Of these, 55 (38%), were resistant to FQ (with or without resistance to second-line injectable drugs). 26 (47%) of the FQ-resistant cases were among newly diagnosed MDR/RR -TB cases while 29(53%) were among previously treated TB cases. The high incidence of FQ resistance among MDR/RR -TB cases is a cause for concern and has many negative implications for their management and outcomes.

Keywords: MDR/RR -TB, SL-LPA, Fluoroquinolone (FQ), NTEP, PMDT

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Cigy C Borges,

Microbiologist- Intermediate Reference Laboratory,

Department of Microbiology, Goa Medical College, Bambolim, Goa