Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland.
BMC Microbiol. 2012 Sep 4;12:191. doi: 10.1186/1471-2180-12-191.
Monitoring drug resistance in Mycobacterium tuberculosis is essential to curb the spread of tuberculosis (TB). Unfortunately, drug susceptibility testing is currently not available in Papua New Guinea (PNG) and that impairs TB control in this country. We report for the first time M. tuberculosis mutations associated with resistance to first and second-line anti-TB drugs in Madang, PNG. A molecular cluster analysis was performed to identify M. tuberculosis transmission in that region.
Phenotypic drug susceptibility tests showed 15.7% resistance to at least one drug and 5.2% multidrug resistant (MDR) TB. Rifampicin resistant strains had the rpoB mutations D516F, D516Y or S531L; Isoniazid resistant strains had the mutations katG S315T or inhA promoter C15T; Streptomycin resistant strains had the mutations rpsL K43R, K88Q, K88R), rrs A514C or gidB V77G. The molecular cluster analysis indicated evidence for transmission of resistant strain.
We observed a substantial rate of MDR-TB in the Madang area of PNG associated with mutations in specific genes. A close monitoring of drug resistance is therefore urgently required, particularly in the presence of drug-resistant M. tuberculosis transmission. In the absence of phenotypic drug susceptibility testing in PNG, molecular assays for drug resistance monitoring would be of advantage.
监测结核分枝杆菌的耐药性对于遏制结核病（TB）的传播至关重要。不幸的是，目前巴布亚新几内亚（PNG）无法进行药物敏感性测试，这会影响该国的结核病控制。我们首次报告了在 PNG 的马当地区与抗结核一线和二线药物耐药相关的结核分枝杆菌突变。进行了分子聚类分析以鉴定该地区的结核分枝杆菌传播。
表型药物敏感性测试显示至少有一种药物的耐药率为 15.7%，耐多药（MDR）TB 的耐药率为 5.2%。利福平耐药株具有 rpoB 突变 D516F、D516Y 或 S531L；异烟肼耐药株具有 katG S315T 或 inhA 启动子 C15T 突变；链霉素耐药株具有 rpsL K43R、K88Q、K88R）、rrs A514C 或 gidB V77G 突变。分子聚类分析表明存在耐药株传播的证据。
我们观察到 PNG 马当地区存在大量 MDR-TB，与特定基因中的突变有关。因此，迫切需要密切监测耐药性，特别是在存在耐药结核分枝杆菌传播的情况下。在 PNG 缺乏表型药物敏感性测试的情况下，用于耐药监测的分子检测将具有优势。
