Extensively drug-resistant tuberculosis in Myanmar: burden and mutations causing second-line drug resistance
| Autor: | H. Y. Lee, Si Thu Aung, S. M. Win, T. L. Swe, W. W. Nyunt, J. S. Lee, W. W. Aung, Chulhun L. Chang, Phyu Win Ei, M. M. Htwe |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine Tuberculosis Genotype Extensively Drug-Resistant Tuberculosis 030106 microbiology Antitubercular Agents Drug resistance Microbial Sensitivity Tests Myanmar medicine.disease_cause Bacterial genetics Mycobacterium tuberculosis Second line drug 03 medical and health sciences Drug Resistance Multiple Bacterial Tuberculosis Multidrug-Resistant medicine Humans Retrospective Studies Mutation biology business.industry Extensively drug-resistant tuberculosis biology.organism_classification medicine.disease Virology Infectious Diseases Cross-Sectional Studies business |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 22(1) |
| ISSN: | 1815-7920 |
| Popis: | Setting Two tuberculosis (TB) reference laboratories in Myanmar. Objectives To determine the proportion of extensively drug-resistant TB (XDR-TB) cases among multidrug-resistant TB (MDR-TB) cases and the mutations that cause resistance to second-line drugs in Myanmar. Design This was a cross-sectional, retrospective study. Multidrug-resistant Mycobacterium tuberculosis isolates were collected during 2015-2016. Phenotypic drug susceptibility testing (DST) was performed and drug-resistant mutations identified by sequencing. Genotypes were determined to explain relationships between drug resistance patterns and genotypes. Results Of 89 MDR-TB isolates, 12 were XDR-TB and 24 were pre-XDR-TB, with 21 resistant to fluoroquinolones (FQs) and 3 to second-line injectable agents (SLIDs). High rates of cross-resistance among second-line drugs were observed. Correlations between phenotypic and molecular DST against FQs and SLIDs were 91% in both cases. The most frequent mutation in FQ-resistant isolates was D94G (8/21) in gyrA and A1401G (11/15) in rrs in those resistant to SLIDs. The dominant genotype was the Beijing type (76/89). Conclusion There were high proportions of XDR-TB and pre-XDR-TB among MDR-TB cases; cross-resistance among second-line drugs was high, with various types of genetic mutations. These data suggest that resistance to second-line anti-tuberculosis drugs should be monitored intensively, and molecular DST should be employed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|