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The XDR-TF surveillance system is a lab based surveillance system designed to collect data on TF drug resistance across Karachi

The XDR-TF surveillance system is a lab based surveillance system designed to collect data on TF drug resistance across Karachi. Drug resistance pattern is identified through susceptibility testing of biological specimens (isolates) collected from culture-positive TF cases.
From the labs of tertiary hospitals and laboratory network, each week drug susceptibility test results for isolates tested in the previous week were obtained using passive and active approach by RDSRU-FELTP for inclusion in the XDR-TF surveillance system. Not all hospital have the capacity to perform drug susceptibility testing, these hospitals forward the isolates to other laboratories of tertiary hospitals for detection of resistance pattern.
In the hospitals, data were compiled either using a software or through the manual completion on a standard reporting. The proforma contains following information
1. Lab/Medical number
2. Demographic data (age, gender, address and contact number)
3. The Districts of the individual from which the isolate originated
4. Admission status (in or out patient)
5. Date of Request and detection
6. The name(s) of the drug(s) tested
7. Drug susceptibility result (sensitive/resistant)

For the identification of resistance pattern all laboratories used to test resistance initially against the first line antibiotics (Chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole), followed by fluoroquinolones, third-generation cephalosporins and Meropenem. Table 1 describes TF drug resistance patterns are defined as

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