Redefining MDR-TB: Comparison of Mycobacterium tuberculosis clinical isolates from Russia and Taiwan.

Autor: Jou R; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan., Lee WT; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan., Kulagina EV; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia., Weng JY; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan., Isakova AI; The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department, Moscow, Russia., Lin WH; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan., Antonova OV; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia., Wu MH; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan., Arslanbaeva LR; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia., Tasi HY; Tuberculosis Research Center, Taiwan Centers for Disease Control, Taipei, Taiwan.; Diagnostics and Vaccine Center, Taiwan Centers for Disease Control, Taipei, Taiwan., Nosova EY; The Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department, Moscow, Russia., Zimenkov DV; Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia. Electronic address: z@biochip.ru.
Jazyk: angličtina
Zdroj: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases [Infect Genet Evol] 2019 Aug; Vol. 72, pp. 141-146. Date of Electronic Publication: 2018 Dec 26.
DOI: 10.1016/j.meegid.2018.12.031
Abstrakt: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis are global challenges due to the limited number of effective drugs for treatment. Treatment with less than 4-5 effective drugs might lead to the further emergence of drug resistance and poor clinical outcomes. For better prediction of treatment outcomes, we compared drug-resistance profiles of consecutive clinical MDR Mycobacterium tuberculosis isolates from high- and low-burden settings. This was a retrospective cohort study. We analysed 225 and 229 MDR isolates from Moscow (Russia) and Taiwan, respectively, obtained between 2014 and 2015. Drug susceptibility testing was performed by the Bactec MGIT 960 automated system and the agar proportion method. Detection of resistance-associated mutations in the M. tuberculosis genome was carried out by an array and/or sequencing of selected loci. The principal differences between resistance profiles of MDR isolates in the two countries were the percentages of pre-XDR (40.9% vs. 14.8%) and XDR (34.7% vs. 1.7%) isolates, both of which were significantly higher in Moscow isolates. Forty-eight (33%) of 147 MDR and pre-XDR Russian isolates fall into a group with less than four effective drugs, which accounts for 40% (N = 120) of these isolates. The other 60% in this group were XDR strains (N = 72). Consequently, the average number of effective anti-tuberculosis drugs for MDR-TB treatment was lower for Russian isolates (3 vs. 7). Furthermore, a notable percentage (9%) of isolates resistant to kanamycin harboured mutations in the whiB7 locus, which was not detected by molecular tests targeting common mutations in the rrs and eis loci. We found that 98.2% and 45.9% of MDR isolates from Moscow and Taiwan, respectively, were resistant to streptomycin. Molecular tests for detecting resistance to drugs other than rifampicin, isoniazid, fluoroquinolones, and second-line injectable drugs are needed for individualized therapy. The conventional MDR treatment schemes most probably fail in these cases due to the limited number of effective drugs.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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