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Olabiyi OE, Okiki PA, Adarabioyo MI, Adebiyi OE, Adegoke OE, Esan OE, Idris OO, Agunbiade TB. Distribution of multi-drug resistant tuberculosis in Ekiti and Ondo states, Nigeria. New Microbes New Infect 2023; 55:101192. [PMID: 38046896 PMCID: PMC10690628 DOI: 10.1016/j.nmni.2023.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Background Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is one of the top infectious killer diseases in the world. The emergence of drug-resistant MTB strains has thrown challenges in controlling TB worldwide. This study investigated the prevalence of drug-resistant tuberculosis in the states of Nigeria and the risk factors that can increase the incidence of tuberculosis. Methods The study is a cross-sectional epidemiological research carried out in the six senatorial districts of Ekiti and Ondo states, Nigeria, between February 2019 and January 2020. A structured questionnaire was administered to 1203 respondents for socio-demographic information, and sputum samples were collected from them for TB investigation. GeneXpert technique was used to diagnose TB from the sputum samples, followed by bacterial isolation using Löweinstein-Jensen medium and antibiotic susceptibility testing. Results Prevalence of TB in the two states combined was 15 %; with 13.8 % for Ekiti state and 16.1 % for Ondo State. The distribution of TB in the senatorial districts was such that: Ondo South > Ekiti Central > Ekiti South > Ondo North > Ekiti North > Ondo Central. The risk factors identified for TB prevalence in two states were gender, male > female (OR = 0.548, p = 0.004); overcrowding (OR = 0.733, p = 0.026); room size (OR = 0.580, p = 0.002); smoking (OR = 0.682, p = 0.019) and dry and dusty season (OR = 0.468, p = 0.005). The prevalence of MDR-TB in Ekiti and Ondo States were 1.2 % and 1.3 % respectively. The identified risk factors for MDR were education (OR = 0.739, p = 0.017), age (OR = 0.846, p = 0.048), religion (OR = 1.95, p = 0.0003), family income (OR = 1.76, p = 0.008), previous TB treatment (OR = 3.64, p = 0.004), smoking (OR = 1.33, p = 0.035) and HIV status (OR = 1.85, p = 0.006). Rifampicin monoresistant was reported in 6.7 % of the rifampicin-resistant strains, while 93.3 % were rifampicin polyresistant strains. Two (13.3 %) of the MDR-TB strains were resistant to all the 3 first-line antimycobacterial agents. All the Rifampicin-resistant TB strains were susceptible to the aminoglycosides (Amikacin, Capreomycin and Kanamycin), also with high susceptibility to the fluoroquinilones: Moxifloxacin (100 %) and Levofloxacin (86.7 %). Sixteen (94.1 %) of the 17 Rifampicin-susceptible strains were susceptible to all the eight antibiotics tested, while one (5.9 %) was susceptible to Rifampicin and Isoniazid but resistant to the rest antibiotics. Conclusion: The study showed that there is high prevalence of TB and MDR-TB in Ekiti and Ondo States Nigeria, hence, to meet the SDG Target 3.3 of ending TB epidemic by 2030, culturing and antibiotic susceptibility testing should be carried out on every TB-positive sputum and the patients treated accordingly.
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Affiliation(s)
- Olugbenga Enoch Olabiyi
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Medical Microbiology and Parasitology, Ekiti State Teaching Hospital, Ado-Ekiti, Nigeria
| | - Pius Abimbola Okiki
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Institute of One-Health, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Mumuni Idowu Adarabioyo
- Department of Mathematical & Physical Sciences (Statistics Unit), Afe Babalola University, Ado-Ekiti, Nigeria
| | - Oludele Emmanuel Adebiyi
- South-West Zonal Tuberculosis Reference Laboratory, Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - Olusola Emannuel Adegoke
- South-West Zonal Tuberculosis Reference Laboratory, Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria
| | - Olubunmi Ebenezer Esan
- Department of Medical Microbiology and Parasitology, Ondo State Specialist Hospital, Akure, Nigeria
| | - Olayinka O. Idris
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Toluwani Bosede Agunbiade
- Department of Biological Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Integrated General Medical Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
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2
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Tahseen S, Khanzada FM, Rizvi AH, Qadir M, Ghazal A, Baloch AQ, Mustafa T. Isoniazid resistance profile and associated levofloxacin and pyrazinamide resistance in rifampicin resistant and sensitive isolates/from pulmonary and extrapulmonary tuberculosis patients in Pakistan: A laboratory based surveillance study 2015-19. PLoS One 2020; 15:e0239328. [PMID: 32966321 PMCID: PMC7511002 DOI: 10.1371/journal.pone.0239328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022] Open
Abstract
Background Pakistan is among top five high burden countries for tuberculosis and drug resistant TB. Among rifampicin sensitive new pulmonary TB (PTB), prevalence of isoniazid resistance is 8.3% (95%CI: 7.0–10.7) and resistance to fluoroquinolone is higher (11·1%, 95%CI: 7·8–14·3) than isoniazid resistance. Method Five year retrospective data (2015–2019) of drug susceptibility testing (DST) for Mycobacterium tuberculosis isolates, performed using recommended phenotypic (pDST) and/or genotypic (gDST) methods was analyzed stratified by rifampicin results for isoniazid resistance profiles and associated levofloxacin and pyrazinamide resistance. Findings DST data was analyzed from 11045 TB patients. Isolates were tested using pDST (87%), gDST (92%) and both methods (79.5%). For both rifampicin and isoniazid, a significant difference (P < .001) was noted between resistance detected by pDST and gDST. Among isolates, tested by both methods (8787), 49% were resistant to rifampicin and 51.7% to isoniazid with discordance in resistant results of 15.8% for each, with 13.2% (570) of rifampicin resistance reported sensitive by pDST and 14.2% (660) of isoniazid resistance missed by gDST. Estimated isoniazid resistance among rifampicin sensitive new PTB, extrapulmonary TB and previously treated PTB was 9.8% (95%CI: 8.7–11.1), 6.8% (95%CI: 5.4–8.5) and 14.6% (95%CI: 11.8–17.9) respectively. Significant differences were reported between the genotypic profile of isoniazid resistance associated with rifampicin-resistant and sensitive isolates including detectable mutations (87% vs 71.6%), frequency of inhA (7.6% and 30.2%) and katG mutations (76.1% vs 41.2%) respectively. Among rifampicin resistant and sensitive isolates, a significantly higher level of resistance to levofloxacin and pyrazinamide was seen associated with isoniazid resistance. Conclusion There are risks and many challenges in implementing WHO recommended treatment for isoniazid resistant tuberculosis. The laboratory based surveillance can complement random surveys in country specific planning for TB diagnostics and appropriate treatment regimens.
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Affiliation(s)
- Sabira Tahseen
- National TB Reference Laboratory, National TB Control Program, Islamabad, Pakistan
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- * E-mail:
| | | | | | - Mahmood Qadir
- National TB Reference Laboratory, National TB Control Program, Islamabad, Pakistan
| | - Aisha Ghazal
- National TB Reference Laboratory, National TB Control Program, Islamabad, Pakistan
| | - Aurangzaib Quadir Baloch
- National TB Control Program, Ministry of National Health Services Regulation and Coordination, Islamabad, Pakistan
| | - Tehmina Mustafa
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
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Acharya B, Acharya A, Gautam S, Ghimire SP, Mishra G, Parajuli N, Sapkota B. Advances in diagnosis of Tuberculosis: an update into molecular diagnosis of Mycobacterium tuberculosis. Mol Biol Rep 2020; 47:4065-4075. [DOI: 10.1007/s11033-020-05413-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 03/28/2020] [Indexed: 01/02/2023]
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Dookie N, Rambaran S, Padayatchi N, Mahomed S, Naidoo K. Evolution of drug resistance in Mycobacterium tuberculosis: a review on the molecular determinants of resistance and implications for personalized care. J Antimicrob Chemother 2018; 73:1138-1151. [PMID: 29360989 PMCID: PMC5909630 DOI: 10.1093/jac/dkx506] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Drug-resistant TB (DR-TB) remains a significant challenge in TB treatment and control programmes worldwide. Advances in sequencing technology have significantly increased our understanding of the mechanisms of resistance to anti-TB drugs. This review provides an update on advances in our understanding of drug resistance mechanisms to new, existing drugs and repurposed agents. Recent advances in WGS technology hold promise as a tool for rapid diagnosis and clinical management of TB. Although the standard approach to WGS of Mycobacterium tuberculosis is slow due to the requirement for organism culture, recent attempts to sequence directly from clinical specimens have improved the potential to diagnose and detect resistance within days. The introduction of new databases may be helpful, such as the Relational Sequencing TB Data Platform, which contains a collection of whole-genome sequences highlighting key drug resistance mutations and clinical outcomes. Taken together, these advances will help devise better molecular diagnostics for more effective DR-TB management enabling personalized treatment, and will facilitate the development of new drugs aimed at improving outcomes of patients with this disease.
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Affiliation(s)
- Navisha Dookie
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Santhuri Rambaran
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Nesri Padayatchi
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
- South African Medical Research Council (SAMRC) - CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Durban, South Africa
| | - Sharana Mahomed
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
| | - Kogieleum Naidoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa
- South African Medical Research Council (SAMRC) - CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Durban, South Africa
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Manson AL, Cohen KA, Abeel T, Desjardins CA, Armstrong DT, Barry CE, Brand J, Chapman SB, Cho SN, Gabrielian A, Gomez J, Jodals AM, Joloba M, Jureen P, Lee JS, Malinga L, Maiga M, Nordenberg D, Noroc E, Romancenco E, Salazar A, Ssengooba W, Velayati AA, Winglee K, Zalutskaya A, Via LE, Cassell GH, Dorman SE, Ellner J, Farnia P, Galagan JE, Rosenthal A, Crudu V, Homorodean D, Hsueh PR, Narayanan S, Pym AS, Skrahina A, Swaminathan S, Van der Walt M, Alland D, Bishai WR, Cohen T, Hoffner S, Birren BW, Earl AM. Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance. Nat Genet 2017; 49:395-402. [PMID: 28092681 PMCID: PMC5402762 DOI: 10.1038/ng.3767] [Citation(s) in RCA: 169] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 12/14/2016] [Indexed: 11/09/2022]
Abstract
Multidrug-resistant tuberculosis (MDR-TB), caused by drug resistant strains of Mycobacterium tuberculosis, is an increasingly serious problem worldwide. In this study, we examined a dataset of 5,310 M. tuberculosis whole genome sequences from five continents. Despite great diversity with respect to geographic point of isolation, genetic background and drug resistance, patterns of drug resistance emergence were conserved globally. We have identified harbinger mutations that often precede MDR. In particular, the katG S315T mutation, conferring resistance to isoniazid, overwhelmingly arose before rifampicin resistance across all lineages, geographic regions, and time periods. Molecular diagnostics that include markers for rifampicin resistance alone will be insufficient to identify pre-MDR strains. Incorporating knowledge of pre-MDR polymorphisms, particularly katG S315, into molecular diagnostics will enable targeted treatment of patients with pre-MDR-TB to prevent further development of MDR-TB.
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Affiliation(s)
- Abigail L Manson
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Keira A Cohen
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,KwaZulu-Natal Research Institute for TB and HIV (K-RITH), Durban, South Africa.,Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas Abeel
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | | | - Derek T Armstrong
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Clifton E Barry
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeannette Brand
- Medical Research Council, TB Platform, Pretoria, South Africa
| | | | - Sinéad B Chapman
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Sang-Nae Cho
- International Tuberculosis Research Center, Changwon and Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Andrei Gabrielian
- Office of Cyber Infrastructure and Computational Biology, National Institutes of Health, Rockville, Maryland, USA
| | - James Gomez
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Andreea M Jodals
- Clinical Hospital of Pneumology Leon Daniello, Cluj Napoca, Romania
| | - Moses Joloba
- Department of Medical Microbiology, Mycobacteriology Laboratory, Makerere University, Kampala, Uganda
| | | | - Jong Seok Lee
- International Tuberculosis Research Center, Changwon and Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Mamoudou Maiga
- University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | | | - Ecaterina Noroc
- Microbiology and Morphology Laboratory, Phthisiopneumology Institute, Chisinau, Moldova
| | - Elena Romancenco
- Microbiology and Morphology Laboratory, Phthisiopneumology Institute, Chisinau, Moldova
| | - Alex Salazar
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands
| | - Willy Ssengooba
- Department of Medical Microbiology, Mycobacteriology Laboratory, Makerere University, Kampala, Uganda
| | - A A Velayati
- Mycobacteriology Research Centre, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kathryn Winglee
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Aksana Zalutskaya
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Laura E Via
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Gail H Cassell
- Department of Global Health and Social Medicine, Harvard Medical School, Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Susan E Dorman
- Center for Tuberculosis Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jerrold Ellner
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Parissa Farnia
- Mycobacteriology Research Centre, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - James E Galagan
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.,Department of Biomedical Engineering and Microbiology, Boston University, Boston, Massachusetts, USA
| | - Alex Rosenthal
- Office of Cyber Infrastructure and Computational Biology, National Institutes of Health, Rockville, Maryland, USA
| | - Valeriu Crudu
- Microbiology and Morphology Laboratory, Phthisiopneumology Institute, Chisinau, Moldova
| | | | - Po-Ren Hsueh
- National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Alexander S Pym
- KwaZulu-Natal Research Institute for TB and HIV (K-RITH), Durban, South Africa
| | - Alena Skrahina
- Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | | | | | - David Alland
- Rutgers-New Jersey Medical School, Newark, New Jersey, USA
| | - William R Bishai
- KwaZulu-Natal Research Institute for TB and HIV (K-RITH), Durban, South Africa.,Center for Tuberculosis Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ted Cohen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Bruce W Birren
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ashlee M Earl
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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Báez-Saldaña R, Delgado-Sánchez G, García-García L, Cruz-Hervert LP, Montesinos-Castillo M, Ferreyra-Reyes L, Bobadilla-del-Valle M, Canizales-Quintero S, Ferreira-Guerrero E, Téllez-Vázquez N, Montero-Campos R, Yanes-Lane M, Mongua-Rodriguez N, Martínez-Gamboa RA, Sifuentes-Osornio J, Ponce-de-León A. Isoniazid Mono-Resistant Tuberculosis: Impact on Treatment Outcome and Survival of Pulmonary Tuberculosis Patients in Southern Mexico 1995-2010. PLoS One 2016; 11:e0168955. [PMID: 28030600 PMCID: PMC5193431 DOI: 10.1371/journal.pone.0168955] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/08/2016] [Indexed: 11/25/2022] Open
Abstract
Background Isoniazid mono-resistance (IMR) is the most common form of mono-resistance; its world prevalence is estimated to range between 0.0 to 9.5% globally. There is no consensus on how these patients should be treated. Objective To describe the impact of IMR tuberculosis (TB) on treatment outcome and survival among pulmonary TB patients treated under programmatic conditions in Orizaba, Veracruz, Mexico. Materials and Methods We conducted a prospective cohort study of pulmonary TB patients in Southern Mexico. From 1995 to 2010 patients with acid-fast bacilli or culture proven Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and microbiological evaluation. We included patients who harbored isoniazid mono-resistant (IMR) strains and patients with strains susceptible to isoniazid, rifampicin, ethambutol and streptomycin. All patients were treated following Mexican TB Program guidelines. We performed annual follow-up to ascertain treatment outcome, recurrence, relapse and mortality. Results Between 1995 and 2010 1,243 patients with pulmonary TB were recruited; 902/1,243 (72.57%) had drug susceptibility testing; 716 (79.38%) harbored pan-susceptible and 88 (9.75%) IMR strains. Having any contact with a person with TB (adjusted odds ratio (aOR)) 1.85, 95% Confidence interval (CI) 1.15–2.96) and homelessness (adjusted odds ratio (aOR) 2.76, 95% CI 1.08–6.99) were associated with IMR. IMR patients had a higher probability of failure (adjusted hazard ratio (HR) 12.35, 95% CI 3.38–45.15) and death due to TB among HIV negative patients (aHR 3.30. 95% CI 1.00–10.84). All the models were adjusted for socio-demographic and clinical variables. Conclusions The results from our study provide evidence that the standardized treatment schedule with first line drugs in new and previously treated cases with pulmonary TB and IMR produces a high frequency of treatment failure and death due to tuberculosis. We recommend re-evaluating the optimal schedule for patients harboring IMR. It is necessary to strengthen scientific research for the evaluation of alternative treatment schedules in similar settings.
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Affiliation(s)
- Renata Báez-Saldaña
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Guadalupe Delgado-Sánchez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Lourdes García-García
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- * E-mail:
| | - Luis Pablo Cruz-Hervert
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Marlene Montesinos-Castillo
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Leticia Ferreyra-Reyes
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Miriam Bobadilla-del-Valle
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y de Nutrición Salvador Zubirán, Ciudad de México, México
| | - Sergio Canizales-Quintero
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Elizabeth Ferreira-Guerrero
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Norma Téllez-Vázquez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Rogelio Montero-Campos
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Mercedes Yanes-Lane
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, San Luis Potosí, México
| | - Norma Mongua-Rodriguez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Rosa Areli Martínez-Gamboa
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y de Nutrición Salvador Zubirán, Ciudad de México, México
| | - José Sifuentes-Osornio
- Dirección Médica, Instituto Nacional de Ciencias Médicas y de Nutrición Salvador Zubirán, Ciudad de México. México
| | - Alfredo Ponce-de-León
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y de Nutrición Salvador Zubirán, Ciudad de México, México
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Kostera J, Leckie G, Tang N, Lampinen J, Szostak M, Abravaya K, Wang H. Analytical and clinical performance characteristics of the Abbott RealTime MTB RIF/INH Resistance, an assay for the detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis in pulmonary specimens. Tuberculosis (Edinb) 2016; 101:137-143. [DOI: 10.1016/j.tube.2016.09.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/15/2016] [Indexed: 10/21/2022]
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Rapid Molecular Detection of Multidrug-Resistant Tuberculosis by PCR-Nucleic Acid Lateral Flow Immunoassay. PLoS One 2015; 10:e0137791. [PMID: 26355296 PMCID: PMC4565584 DOI: 10.1371/journal.pone.0137791] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/21/2015] [Indexed: 01/18/2023] Open
Abstract
Several existing molecular tests for multidrug-resistant tuberculosis (MDR-TB) are limited by complexity and cost, hindering their widespread application. The objective of this proof of concept study was to develop a simple Nucleic Acid Lateral Flow (NALF) immunoassay as a potential diagnostic alternative, to complement conventional PCR, for the rapid molecular detection of MDR-TB. The NALF device was designed using antibodies for the indirect detection of labeled PCR amplification products. Multiplex PCR was optimized to permit the simultaneous detection of the drug resistant determining mutations in the 81-bp hot spot region of the rpoB gene (rifampicin resistance), while semi-nested PCR was optimized for the S315T mutation detection in the katG gene (isoniazid resistance). The amplification process additionally targeted a conserved region of the genes as Mycobacterium tuberculosis (Mtb) DNA control. The optimized conditions were validated with the H37Rv wild-type (WT) Mtb isolate and Mtb isolates with known mutations (MT) within the rpoB and katG genes. Results indicate the correct identification of WT (drug susceptible) and MT (drug resistant) Mtb isolates, with the least limit of detection (LOD) being 104 genomic copies per PCR reaction. NALF is a simple, rapid and low-cost device suitable for low resource settings where conventional PCR is already employed on a regular basis. Moreover, the use of antibody-based NALF to target primer-labels, without the requirement for DNA hybridization, renders the device generic, which could easily be adapted for the molecular diagnosis of other infectious and non-infectious diseases requiring nucleic acid detection.
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9
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Tavanaee Sani A, Shakiba A, Salehi M, Bahrami Taghanaki HR, Ayati Fard SF, Ghazvini K. Epidemiological Characterization of Drug Resistance among Mycobacterium tuberculosis Isolated from Patients in Northeast of Iran during 2012-2013. BIOMED RESEARCH INTERNATIONAL 2015; 2015:747085. [PMID: 26064950 PMCID: PMC4433661 DOI: 10.1155/2015/747085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/01/2014] [Accepted: 12/03/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Tuberculosis is still one of the most important health problems in developing countries and increasing drug resistance is the main concern for its treatment. This study was designed to characterize the drug resistant Mycobacterium tuberculosis isolated from patients suffering from pulmonary tuberculosis in northeast of Iran. METHOD In this cross-sectional study during 2012-2013, drug susceptibility testing was performed on Mycobacterium tuberculosis isolated in northeast of Iran using proportional method. Epidemiological data concerning these strains were also analyzed. RESULTS Among 125 studied isolates, 25 mycobacteria (20%) were diagnosed as nontuberculosis mycobacteria. Among the remaining 100 Mycobacterium tuberculosis isolates, the resistance rates were 7%, 7%, 3%, and 9% against isoniazid, rifampin, ethambutol, and streptomycin, respectively. Four isolates were resistant against both isoniazid and rifampin (MDR tuberculosis). The highest resistance rate was observed among 15-45-year-old patients. The MDR tuberculosis was much more prevalent among those who had previous history of treatment. CONCLUSION Considering these findings, DOTS strategy should be emphasized and promptly used in order to prevent further resistance. Regarding the high rate of nontuberculosis mycobacteria, it is recommended that confirmatory tests were performed before any therapeutic decision.
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Affiliation(s)
- Ashraf Tavanaee Sani
- Department of Infectious Diseases, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Shakiba
- Department of Infectious Diseases, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Salehi
- Departments of Community Medicine, School of Medicine and Research Center for Patient Safety, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Kiarash Ghazvini
- Antimicrobial Resistance Research Center, Buali Research Institute and Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Abstract
INTRODUCTION Drug-resistant tuberculosis (DR-TB) is associated with increased mortality and morbidity. This is at least partly due to late diagnosis and ineffective treatment of drug-resistant status. SOURCES OF DATA Selective search of the literature on DR-TB supplemented by recent guidelines from the World Health Organization. AREAS OF AGREEMENT Better and more rapid diagnosis of DR-TB by new techniques such as Xpert Mtb/RIF are likely to make a substantial impact on the disease. New therapeutics for DR-TB are entering, or about to enter the market for the first time in decades. AREAS OF CONTROVERSY It is not clear whether new treatments should be restricted for DR-TB or also used for drug-susceptible tuberculosis. GROWING POINTS With several new agents on the horizon, there is the real possibility of an entirely new regimen for tuberculosis. AREAS TIMELY FOR DEVELOPING RESEARCH An inexpensive 'near-patient' diagnostic test is still needed. Optimizing new drug combination regimens in a timely manner is urgently required.
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Affiliation(s)
- Melody Toosky
- Centre for Infectious Diseases Research, Tsinghua University School of Medicine, Beijing, China
| | - Babak Javid
- Centre for Infectious Diseases Research, Tsinghua University School of Medicine, Beijing, China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Hangzhou, China Department of Medicine, University of Cambridge, Cambridge, UK
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