Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana; West African Centre for Cell Biology of Infectious Pathogens, UG, Ghana; Department of Biochemistry, Cell and Molecular Biology, UG, Ghana.
Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana.
Int J Infect Dis. 2021 May;106:13-22. doi: 10.1016/j.ijid.2021.02.110. Epub 2021 Mar 2.
To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015.
Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness.
The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection.
Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.
回顾性调查 2012 年 7 月至 2015 年 12 月期间进行的一项前瞻性基于人群的研究中招募的肺结核（TB）患者中复发性结核病（rcTB）的原因。
对 rcTB 病例中获得的结核分枝杆菌复合菌株进行标准分枝杆菌基因分型工具、全基因组测序和系统发育分析，以评估菌株相关性。
大多数（58.3%，21/36）rcTB 发作的研究参与者在治疗后 12 个月内出现 TB 复发。在初次发作时，19.4%（7/36）的参与者中发现了异烟肼（INH）耐药菌株，其中 29%（2/7）也对利福平耐药。在 TB 复发时，发现更大比例的参与者（27.8%，10/36）存在 INH 耐药菌株，其中 40%（4/10）为耐多药结核菌株。rcTB 归因于 75.0%（27/36）的参与者的复发（相同菌株）和 25.0%（9/36）的再感染。
我们的研究结果表明，先前因治疗不充分导致的未解决感染可能是 rcTB 的主要原因。
