Laboratory-based study of drug resistance and genotypic profile of multidrug-resistant tuberculosis isolates in Salvador, Bahia, Brazil.

Autor:	Sousa EO; Laboratório Central de Saúde Pública Professor Gonçalo Moniz (LACEN-BA), Salvador, BA, Brasil.; Fundação Oswaldo Cruz, Instituto de Pesquisa Gonçalo Moniz, Salvador, BA, Brasil., Carneiro RTO; Fundação Oswaldo Cruz, Instituto de Pesquisa Gonçalo Moniz, Salvador, BA, Brasil., Montes FCOF; Fundação Oswaldo Cruz, Centro de Referência Professor Hélio Fraga, Laboratório de Bacteriologia da Tuberculose, Rio de Janeiro, RJ, Brasil., Conceição EC; Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo de Góes, Rio de Janeiro, RJ, Brasil., Bartholomay P; Universidade de Brasília, Brasília, DF, Brasil., Marinho JM; Escola Baiana de Medicina e Saúde Pública, Faculdade de Medicina, Salvador, Bahia, Brasil., Lima KVB; Instituto Evandro Chagas, Seção de Bacteriologia e Micologia, Ananindeua, Pará, Brasil., Natividade MSD; Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, Bahia, Brasil., Araújo WN; Universidade de Brasília, Brasília, DF, Brasil., Matos ED; Escola Baiana de Medicina e Saúde Pública, Faculdade de Medicina, Salvador, Bahia, Brasil., Barbosa T; Fundação Oswaldo Cruz, Instituto de Pesquisa Gonçalo Moniz, Salvador, BA, Brasil.; Rede Brasileira de Pesquisa em Tuberculose, Rio de Janeiro, RJ, Brasil.
Jazyk:	angličtina
Zdroj:	Revista da Sociedade Brasileira de Medicina Tropical [Rev Soc Bras Med Trop] 2022 Jul 25; Vol. 55, pp. e00132022. Date of Electronic Publication: 2022 Jul 25 (Print Publication: 2022).
DOI:	10.1590/0037-8682-0013-2022
Abstrakt:	Background: Surveillance of multidrug resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) is essential to guide disease dissemination control measures. Brazil contributes to a significant fraction of tuberculosis (TB) cases worldwide, but only few reports addressed MDR/XDR-TB in the country. Methods: This cross-sectional, laboratory-based study describes the phenotypic resistance profiles of isolates obtained between January 2008 and December 2011 in Bahia, Brazil, and sociodemographic, epidemiological, and clinical characteristics (obtained from mandatory national registries) of the corresponding 204 MDR/XDR-TB patients. We analyzed the mycobacterial spoligotyping and variable number of tandem repeats of mycobacterial interspersed repetitive units in 12-loci profiles obtained from Salvador. Results: MDR/XDR-TB patients were predominantly male, had a median age of 43 years, belonged to black ethnicity, and failed treatment before MDR-TB diagnosis. Nearly one-third of the isolates had phenotypic resistance (evaluated by mycobacteria growth indicator tube assay) to second-line anti-TB drugs (64/204, 31%), of which 22% cases (14/64) were diagnosed as XDR-TB. Death was a frequent outcome among these individuals and was associated with resistance to second-line anti-TB drugs. Most isolates successfully genotyped belonged to the Latin-American Mediterranean (LAM) Family, with an unprecedented high proportion of LAM10-Cameroon subfamily bacilli. More than half of these isolates were assigned to a unique cluster by the genotyping methods performed. Large clusters of identical genotypes were also observed among LAM SIT42 and SIT376 strains. Conclusions: We highlight the need for strengthening local and national efforts to perform early detection of TB drug resistance and to prevent treatment discontinuation to limit the emergence of drug-resistant strains.
Databáze:	MEDLINE
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