Kaswa Michel Kayomo, Bisuta Serge, Kabuya Georges, Lunguya Octavie, Ndongosieme André, Muyembe Jean Jacques, Van Deun Armand, Boelaert Marleen
National Tuberculosis Program, Kinshasa, Democratic Republic of Congo; Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo; Institute of Tropical Medicine, Antwerp, Belgium.
National Tuberculosis Program, Kinshasa, Democratic Republic of Congo.
PLoS One. 2014 Apr 14;9(4):e94618. doi: 10.1371/journal.pone.0094618. eCollection 2014.
Multidrug Resistant Tuberculosis (MDR-TB) is a serious threat which jeopardizes the worldwide efforts to control TB. The Democratic Republic of Congo (DRC) is one of 27 countries with a high burden of MDR-TB. Data on the magnitude, trends, and the distribution of MDR-TB in DRC are scanty. Kinshasa, the capital city of DRC which accounts for 20% of all TB cases nationwide, is notifying more than 80% of all MDR suspects. We report here a cluster of MDR-TB cases that was investigated in the Mosango health district, in the Bandundu south Province, DRC in 2008. Phenotypic Drug Sensitivity Testing and DNA sequencing were performed on 18 sputum specimens collected from 4 MDR-TB suspects and 5 household contacts. Sequencing data confirmed that the 4 suspects were indeed Rifampicin resistant cases. Sequencing of the rpoB gene showed that 3 cases (patients A, B and D) had a single mutation encoding a substitution to 526Tyr, 531Trp and 526Leu respectively. Patient C had a double mutation encoding a change to 531Leu and 633Leu. Two of the investigated cases died within 4 months of a second-line treatment course. Results highlight the need to enhance adequate laboratory services within the country for both clinical as well as surveillance purposes.
耐多药结核病（MDR-TB）是一种严重威胁，危及全球控制结核病的努力。刚果民主共和国（DRC）是耐多药结核病高负担的27个国家之一。刚果民主共和国耐多药结核病的规模、趋势和分布数据匮乏。刚果民主共和国首都金沙萨占全国所有结核病病例的20%，报告了超过80%的耐多药疑似病例。我们在此报告2008年在刚果民主共和国班顿杜省南部的莫桑戈卫生区调查的一组耐多药结核病病例。对从4名耐多药结核病疑似患者和5名家庭接触者收集的18份痰标本进行了表型药物敏感性测试和DNA测序。测序数据证实这4名疑似患者确实是耐利福平病例。rpoB基因测序显示，3例患者（患者A、B和D）分别有一个单一突变，编码526位酪氨酸、531位色氨酸和526位亮氨酸的替代。患者C有一个双重突变，编码531位亮氨酸和633位亮氨酸的变化。2例受调查病例在二线治疗疗程的4个月内死亡。结果强调需要加强该国国内用于临床和监测目的的适当实验室服务。
