BIOMARKER-BASED ASSESSMENT OF DISEASE SEVERITY IN RIFAMPICIN-RESISTANT TUBERCULOSIS WITH DIABETES ANDCHRONIC KIDNEY DISEASE (CKD)

Abstract

Background: Tuberculosis (TB) caused by Mycobacterium tuberculosis is a global health issue, particularly with the emergence of MDR-TB. Rifampicin resistance is a sign of drug-resistant TB, although disease severity is difficult to assess. CRP, ESR, and D-dimer biomarkers elucidate inflammation and disease severity.Aim:The GeneXpert MTB/RIF test was used to detect rifampicin resistance in pulmonary tuberculosis patients and to correlate CRP, ESR, and D-dimer levels with disease severity.Materials and Methods: In all, 300 samples (150 sputum and 150 blood) were obtained from pulmonary TB patients. Sputum samples were stained with Ziehl-Neelsen and microscopically examined for acid-fast bacilli (AFB). M. tuberculosis and rifampicin resistance were detected using GeneXpert MTB/RIF. Blood samples were analysed for CRP, ESR and D-dimer levels.Results: All the 150 sputum samples were positive for M. tuberculosis by Ziehl–Neelsen staining and GeneXpert testing. Of them, 26 (13%) were found to be rifampicin-resistant and 124 (87%) rifampicin-sensitive. Biomarker study found that CRP was high in 143 (95.3%) patients, ESR was raised in 119 (79.3%) cases, and D-dimer was discovered in only 7 (4.7%) instances. The results show that CRP and ESR are more related to the severity of TB than D-dimer.Conclusion: GeneXpert MTB/RIF is a powerful tool for quick identification of rifampicin resistance. Elevated CRP and ESR levels were significantly correlated with the severity of pulmonary TB and might be helpful supporting biomarkers in the clinical evaluation of TB patients.