A Five-Year Analysis of Secondary Infections and Antimicrobial Resistance in Post-Tuberculosis Patients at a Tertiary Care Hospital in Bangladesh

Abstract

Background: Pulmonary tuberculosis (PTB) remains a major public health concern in Bangladesh, with post-treatment complications and antimicrobial resistance posing significant challenges for patient management. This study aimed to investigate the microbial infection patterns, demographic characteristics, and antimicrobial resistance trends in post-PTB patients over a five-year period in Cumilla, Bangladesh. Methods: This observational study was conducted from January 2010 to December 2014 at the Department of Internal Medicine, BSMMU. A total of 166 post-PTB patients aged 20 years and older were enrolled. Data on demographics, clinical characteristics, and comorbidities were collected using a structured questionnaire. Standard Culture and Sensitivity (C&S) tests were performed on sputum samples using the Kirby-Bauer disk diffusion method. Data were analyzed using SPSS version 25, applying descriptive statistics and chi-square tests to evaluate associations between demographic variables and microbial patterns. Results: The majority of participants were male (66.27%) and aged between 51-70 years (60.25%). Most participants were farmers (40.96%) with a monthly income between 5000 and 10000 BDT (51.81%). Comorbid conditions included COPD (36.14%), diabetes (25.30%), and hypertension (20.48%). Elevated inflammatory markers were evident with a mean WBC count of 11036.34±4770.48 and ESR of 31.42±12.15. The highest antimicrobial sensitivity was observed for Levofloxacin (33.73%) and Ciprofloxacin (26.51%), while significant resistance was noted against Cefixime (48.19%), Cefuroxime (46.99%), and Azithromycin (42.17%). Conclusion: This study underscores the high burden of comorbidities and significant antimicrobial resistance among post-PTB patients. There is a pressing need for integrated care strategies and continuous surveillance of antimicrobial susceptibility to inform tailored treatment protocols. Effective management of multidrug-resistant TB requires localized epidemiological data and comprehensive healthcare approaches.