DIAGNOSIS OF RIFAMPICIN-RESISTANT TUBERCULOSIS AND BIOMARKER-BASED ASSESSMENT OF DISEASE SEVERITY WITH DENTAL AND PHYSICAL THERAPY FINDINGS IN DISTRICT PESHAWAR

Abstract

Tuberculosis remains a leading global cause of infectious mortality, with multidrug-resistant tuberculosis (MDR-TB), particularly rifampicin resistance, posing a major therapeutic challenge. Despite the widespread use of molecular diagnostics, the relationship between rifampicin resistance and inflammatory biomarkers remains underexplored. This study assessed rifampicin resistance using the GeneXpert assay and evaluated its association with selected inflammatory markers in pulmonary tuberculosis.A total of 150 sputum and 150 blood samples were collected from patients with confirmed pulmonary Mycobacterium tuberculosis infection. Sputum samples were examined by Ziehl–Neelsen staining and analyzed using GeneXpert for rifampicin resistance. Blood samples were evaluated for C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and D-dimer levels.GeneXpert analysis identified 87% non-MDR and 13% MDR cases, with rifampicin resistance detected in 26 samples. Elevated CRP levels were observed in 143 (95.3%) patients, while ESR was increased in 119 (79.3%) cases. In contrast, D-dimer positivity was detected in only 7 (4.7%) patients.In conclusion, CRP and ESR were markedly elevated in GeneXpert-confirmed tuberculosis cases, whereas D-dimer showed limited diagnostic or prognostic relevance. These findings suggest that CRP and ESR may serve as valuable adjunct biomarkers for assessing disease severity in pulmonary tuberculosis, complementing molecular diagnostic approaches in clinical practice.