Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2020 Dec 7;15(12):e0243493. doi: 10.1371/journal.pone.0243493. eCollection 2020.
Molecular characterization of Mycobacterium tuberculosis (MTB) is important to understand the pathogenesis, diagnosis, treatment, and prevention of tuberculosis (TB). However, there is limited information on molecular characteristics and drug-resistant patterns of MTB in patients with extra-pulmonary tuberculosis (EPTB) in Ethiopia. Thus, this study aimed to determine the molecular characteristics and drug resistance patterns of MTB in patients with EPTB in Addis Ababa, Ethiopia.
This study was conducted on frozen stored isolates of EPTB survey conducted in Addis Ababa, Ethiopia. A drug susceptibility test was performed using BACTEC-MGIT 960. Species and strain identification were performed using the Geno-Type MTBC and spoligotyping technique, respectively. Data were entered into the MIRU-VNTRplus database to assess the spoligotype patterns of MTB. Analysis was performed using SPSS version 23, and participants' characteristics were presented by numbers and proportions.
Of 151 MTB isolates, 29 (19.2%) were resistant to at least one drug. The highest proportion of isolates was resistant to Isoniazid (14.6%) and Pyrazinamide (14.6%). Nine percent of isolates had multidrug-resistant TB (MDR-TB), and 21.4% of them had pre-extensively drug-resistant TB (pre-XDR-TB). Among the 151 MTB isolates characterized by spoligotyping, 142 (94.6%) had known patterns, while 9 (6.0%) isolates were not matched with the MIRU-VNTRplus spoligotype database. Of the isolates which had known patterns, 2% was M.bovis while 98% M. tuberculosis. Forty-one different spoligotype patterns were identified. The most frequently identified SpolDB4 (SIT) wereSIT149 (21.2%), SIT53 (14.6%) and SIT26 (9.6%). The predominant genotypes identified were T (53.6%), Central Asia Strain (19.2%) and Haarlem (9.9%).
The present study showed a high proportion of MDR-TB and pre-XDR-TB among EPTB patients. The strains were mostly grouped into SIT149, SIT53, and SIT26. The T family lineage was the most prevalent genotype. MDR-TB and pre-XDR-TB prevention is required to combat these strains in EPTB. A large scale study is required to describe the molecular characteristics and drug resistance patterns of MTB isolates in EPTB patients.
结核分枝杆菌（MTB）的分子特征对于理解结核病（TB）的发病机制、诊断、治疗和预防非常重要。然而，关于埃塞俄比亚肺外结核（EPTB）患者 MTB 的分子特征和耐药模式的信息有限。因此，本研究旨在确定埃塞俄比亚亚的斯亚贝巴 EPTB 患者 MTB 的分子特征和耐药模式。
本研究对在埃塞俄比亚亚的斯亚贝巴进行的 EPTB 调查中冷冻保存的分离株进行了研究。使用 BACTEC-MGIT 960 进行药物敏感性试验。使用 Geno-Type MTBC 和 spoligotyping 技术分别进行物种和菌株鉴定。将数据输入 MIRU-VNTRplus 数据库以评估 MTB 的 spoligotype 模式。使用 SPSS 版本 23 进行分析，参与者的特征以数字和比例表示。
在 151 株 MTB 分离株中，有 29 株（19.2%）至少对一种药物耐药。分离株对异烟肼（14.6%）和吡嗪酰胺（14.6%）的耐药比例最高。9%的分离株患有耐多药结核病（MDR-TB），其中 21.4%患有预广泛耐药结核病（pre-XDR-TB）。在通过 spoligotyping 鉴定的 151 株 MTB 分离株中，有 142 株（94.6%）具有已知模式，而 9 株（6.0%）分离株与 MIRU-VNTRplus spoligotype 数据库不匹配。在具有已知模式的分离株中，有 2%为 M.bovis，98%为 M. tuberculosis。鉴定出 41 种不同的 spoligotype 模式。最常见的 SpolDB4（SIT）识别为 SIT149（21.2%）、SIT53（14.6%）和 SIT26（9.6%）。鉴定出的主要基因型为 T（53.6%）、中亚株（19.2%）和 Haarlem（9.9%）。
本研究显示 EPTB 患者中 MDR-TB 和 pre-XDR-TB 的比例较高。菌株主要分为 SIT149、SIT53 和 SIT26。T 家族谱系是最常见的基因型。需要预防 MDR-TB 和 pre-XDR-TB，以对抗这些 EPTB 中的菌株。需要进行大规模研究以描述 EPTB 患者 MTB 分离株的分子特征和耐药模式。
