Cadmus Simeon Idowu, Diarra Bassirou, Traore Brehima, Maiga Mamoudou, Siddiqui Sophia, Tounkara Anatole, Falodun Olutayo, Lawal Wole, Adewole Isaac Folurunso, Murphy Rob, van Soolingen Dick, Taiwo Babafemi
Tuberculosis and Brucellosis Research Laboratories, Department of Veterinary Public Health & Preventive Medicine, University of Ibadan, Ibadan 200005, Nigeria.
Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali.
J Pathog. 2016;2016:6547363. doi: 10.1155/2016/6547363. Epub 2016 Mar 23.
In Nigeria, one of the highest tuberculosis (TB) burdened nations, sputum smear microscopy is routinely employed for TB diagnosis at Directly Observed Treatment Short-Course (DOTS) Centers. This diagnostic algorithm does not differentiate Mycobacterium tuberculosis complex (MTC) from nontuberculous mycobacteria (NTM). Between December 2008 and January 2009, consecutive patients diagnosed with TB were screened for inclusion at 10 DOTS centers in Ibadan, Nigeria. To verify Mycobacterium species in patients diagnosed, we cultured and identified mycobacterial isolates using PCR, line probe assay, and spoligotyping techniques. From 48 patients screened, 23 met the inclusion criteria for the study. All the 23 study patients had a positive culture. Overall, we identified 11/23 patients (48%) with MTC only, 9/23 (39%) with NTM only, and 3/23 (13%) with evidence of both MTC and NTM. Strains of MTC identified were Latin American Mediterranean (LAM) genotype (n = 12), M. africanum (n = 1), and the genotype family T (n = 1). Four M. avium-intracellulare-M. scrofulaceum complexes, one M. chelonae complex, one M. abscessus, and one M. intracellulare were identified. Our findings underscore the need to incorporate molecular techniques for more precise diagnosis of TB at DOTS centers to improve clinical outcomes and safe guard public health, particularly in TB endemic countries.
在尼日利亚这个结核病负担最重的国家之一，痰涂片显微镜检查在直接观察短程治疗（DOTS）中心被常规用于结核病诊断。这种诊断算法无法区分结核分枝杆菌复合群（MTC）和非结核分枝杆菌（NTM）。2008年12月至2009年1月期间，在尼日利亚伊巴丹的10个DOTS中心对连续诊断为结核病的患者进行了纳入筛查。为了验证确诊患者的分枝杆菌种类，我们使用聚合酶链反应（PCR）、线性探针分析和间隔寡核苷酸分型技术对分枝杆菌分离株进行培养和鉴定。在筛查的48名患者中，23名符合研究纳入标准。所有23名研究患者培养结果均为阳性。总体而言，我们鉴定出仅感染MTC的患者有11/23（48%），仅感染NTM的患者有9/23（39%），同时感染MTC和NTM的患者有3/23（13%）。鉴定出的MTC菌株为拉丁美洲地中海（LAM）基因型（n = 12）、非洲分枝杆菌（n = 1）和基因型家族T（n = 1）。鉴定出4株鸟分枝杆菌 - 胞内分枝杆菌 - 瘰疬分枝杆菌复合群、1株龟分枝杆菌复合群、1株脓肿分枝杆菌和1株胞内分枝杆菌。我们的研究结果强调，有必要在DOTS中心采用分子技术以更精确地诊断结核病，从而改善临床结局并保障公众健康，特别是在结核病流行国家。
