Background: The emergence of pre-extensively drug-resistant tuberculosis (Pre-XDR-TB) is the major hurdle for TB prevention and care programs especially in developing countries like Pakistan. This trend of drug-resistant mycobacterium increasing day by day, so we have discussed about emergence of pre-extensively drug resistant tuberculosis in this study, which help the peoples about awareness and through this, clinicians can reduce the emergence of drug resistant in future. Tuberculosis (TB) still remain a challenge to health authorities throughout the world. It is most dangerous in the form of drug resistant either multi-drug resistant or pre-extensively drug resistant.

Objective: We have conducted this study in order to determine pattern of pre-extensively drug resistance tuberculosis in MDR-TB patients Zero follow-up reports, pre XDR,

Materials and Methods:Study was conducted at the PMDT site Chandika Medical hospital, Larkano, Pakistan from Dec 2017 to 2020.All Zero month pulmonary samples of MDR and Pre-XDR DST patients of both genders having different ages were included in this research. Five to 10 ml of sputum samples were collected into a sterile 50 ml falcon tube at baseline and all specimens were stored at -20˚C until transported to Biosafety Level 03 laboratory Chandka Medical Hospital Larkano

The study protocol was approved by Additional Director of Tuberculosis program Sindh.

Results:Amongst 64 patients, 23 were females (35.94%) and rest 41 (64.06%) were males. Among 64 patients 15 (23.44%) were negative for microscopy and other 49 (76.56%) were positive. and 59.38% were between 10–40 years age group, rest of the participants ranged from 41 to 70 years. Mean age was 34.3±4.2. Moreover, 14 patients (21.88%) were pre-XDR, 45 patients (70.31%) were MDR and 5 sample (7.81%) were contaminated in DST.

Conclusion: Patients with resistance to isoniazid, rifampicin, Levofloxacin amikacin, and Moxifloxacin is called as  (Pre-XDR TB) were 22%, however, 70% had multi drug resistance. Isoniazid and Rifampicin were the most resistant drugs in the study.

Keywords: Tuberculosis, Pre XDR-TB,  MDR-TB, Larkano, Pakistan