Comparison of the characteristics of Mycobacterium tuberculosis isolates from sputum and lung lesions in chronic tuberculosis patients

Autor: H.-K. Kwak, J.-H. Kim, S.-Y. Eum, J.-S. Lee, Y.-I. Choi, M.-S. Hong, H. Lee, Yeon Sook Kim, E.-J. Cho, C.-T. Kim, J.-S. Cho, S.-K. Park, D. Jeon
Rok vydání: 2017
Předmět:
Adult
Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Tuberculosis
030106 microbiology
Antitubercular Agents
Microbial Sensitivity Tests
Drug resistance
Gastroenterology
Mycobacterium tuberculosis
Young Adult
03 medical and health sciences
0302 clinical medicine
Drug Resistance
Multiple
Bacterial
Internal medicine
Tuberculosis
Multidrug-Resistant
medicine
Humans
030212 general & internal medicine
Typing
Lung
Tuberculosis
Pulmonary
Genotyping
biology
business.industry
Sputum
General Medicine
Middle Aged
respiratory system
biology.organism_classification
medicine.disease
respiratory tract diseases
Infectious Diseases
medicine.anatomical_structure
Immunology
Female
medicine.symptom
Restriction fragment length polymorphism
business
Polymorphism
Restriction Fragment Length
Zdroj: European Journal of Clinical Microbiology & Infectious Diseases. 36:2063-2072
ISSN: 1435-4373
0934-9723
Popis: Mycobacterium tuberculosis (Mtb) in sputum originates from lung cavities in tuberculosis (TB) patients. But drug susceptibility testing (DST) of sputum Mtb can not be conducted the same as in the lung because mutagenesis of bacilli may be happening in the lung during treatment and result in the possibility of the presence of heterogeneous drug-resistant subpopulations in the different lung lesions. This could be one of the reasons for low cure rates for multi-drug resistant (MDR)-TB. We studied the resected lungs of nine surgery patients with chronic TB. The isolates isolated from the sputum and different lung lesions of each patient were tested for phenotypic DST and genotyped using restriction fragment length polymorphism (RFLP) typing method. Genetic analysis to resistance to first and second line drugs was also performed. Five of nine patients were MDR-TB and three XDR-TB. DST results for ten anti-TB drugs were in accordance among different lung lesions in eight patients. However, only three of these eight patients showed the concordance of DST with sputum. Even though the isolates were heteroresistant, genotyping them by RFLP showed the clonal population in each individual patient. Six of eight followed-up patients achieved successful cure. In conclusion, the heteroresistance between sputum and lung lesions and a clonal population without mixed infection might provide useful information in establishing treatment regimen and surgery decision for MDR- and XDR-TB.
Databáze: OpenAIRE
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