Drug-resistant Mycobacterium tuberculosis among Nepalese patients at a tuberculosis referral center.

Autor: Chand AB; Department of Microbiology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.; Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Kathmandu, Nepal.; German Nepal Tuberculosis Project, Kathmandu, Nepal., Basnet A; Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Kathmandu, Nepal., Maharjan B; German Nepal Tuberculosis Project, Kathmandu, Nepal., Rai G; Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Kathmandu, Nepal., Joshi YP; Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal., Bhatt LR; Department of Microbiology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal., Sen B; Department of Dentistry, KIST Medical College and Teaching Hospital, Lalitpur, Nepal., Rai SK; Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Kathmandu, Nepal.; Department of Microbiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 May 06; Vol. 19 (5), pp. e0301210. Date of Electronic Publication: 2024 May 06 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0301210
Abstrakt: Background: Multidrug-resistant tuberculosis (MDR-TB), characterized by isoniazid and rifampicin resistance, is caused by chromosomal mutations that restrict treatment options and complicate tuberculosis management. This study sought to investigate the prevalence of pre-extensively drug-resistant (pre-XDR) and extensively drug-resistant (XDR) tuberculosis, as well as mutation pattern, in Nepalese patients with MDR/rifampicin-resistant (RR)-TB strains.
Methods: A cross-sectional study was conducted on MDR/RR-TB patients at the German Nepal Tuberculosis Project from June 2017 to June 2018. The MTBDRsl line probe assay identified pre-XDR-TB and XDR-TB. Pre-XDR-TB included MDR/RR-TB with resistance to any fluoroquinolone (FLQ), while XDR-TB included MDR/RR-TB with resistance to any FLQ and at least one additional group A drug. Mutation status was determined by comparing bands on reaction zones [gyrA and gyrB for FLQ resistance, rrs for SILD resistance, and eis for low-level kanamycin resistance, according to the GenoType MTBDRsl VER 2.0, Hain Lifescience GmbH, Nehren, Germany definition of pre-XDR and XDR] to the evaluation sheet. SPSS version 17.0 was used for data analysis.
Results: Out of a total of 171 patients with MDR/RR-TB, 160 had (93.57%) had MTBC, of whom 57 (35.63%) had pre-XDR-TB and 10 (6.25%) had XDR-TB. Among the pre-XDR-TB strains, 56 (98.25%) were FLQ resistant, while 1 (1.75%) was SLID resistant. The most frequent mutations were found at codons MUT3C (57.14%, 32/56) and MUT1 (23.21%, 13/56) of the gyrA gene. One patient had SLID resistant genotype at the MUT1 codon of the rrs gene (100%, 1/1). XDR-TB mutation bands were mostly detected on MUT1 (30%, 3/10) of the gyrA and rrs, MUT3C (30%, 3/10) of the gyrA, and MUT1 (30%, 3/10) of the rrs.
Conclusions: Pre-XDR-TB had a significantly higher likelihood than XDR-TB, with different specific mutation bands present in gyrA and rrs genes.
Competing Interests: The authors have declared that no competing interests exist
(Copyright: © 2024 Chand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje