Emerg Infect Dis. 2021 Nov;27(11):2847-2855. doi: 10.3201/eid2711.210726.
Multidrug resistance is a major threat to global elimination of tuberculosis (TB). We performed phenotypic drug-susceptibility testing and whole-genome sequencing for 309 isolates from 342 consecutive patients who were given a diagnosis of TB in Yangon, Myanmar, during July 2016‒June 2018. We identified isolates by using the GeneXpert platform to evaluate drug-resistance profiles. A total of 191 (62%) of 309 isolates had rifampin resistance; 168 (88%) of these rifampin-resistant isolates were not genomically related, indicating the repeated emergence of resistance in the population, rather than extensive local transmission. We did not detect resistance mutations to new oral drugs, including bedaquiline and pretomanid. The current GeneXpert MTB/RIF system needs to be modified by using the newly launched Xpert MTB/XDR cartridge or line-probe assay. Introducing new oral drugs to replace those currently used in treatment regimens for multidrug-resistant TB will also be useful for treating TB in Myanmar.
耐多药是全球消除结核病（TB）的主要威胁。我们对 2016 年 7 月至 2018 年 6 月期间在缅甸仰光被诊断为结核病的 342 例连续患者的 309 个分离株进行了表型药物敏感性试验和全基因组测序。我们使用 GeneXpert 平台鉴定了分离株，以评估耐药谱。在 309 个分离株中，共有 191 个（62%）对利福平耐药；在这些利福平耐药的分离株中，有 168 个（88%）没有基因组相关性，这表明耐药性在人群中反复出现，而不是广泛的局部传播。我们没有检测到新的口服药物，包括贝达喹啉和普托马尼德的耐药突变。目前的 GeneXpert MTB/RIF 系统需要通过使用新推出的 Xpert MTB/XDR 试剂盒或线探针分析进行修改。引入新的口服药物来替代目前用于治疗耐多药结核病的治疗方案中的药物，也将有助于治疗缅甸的结核病。
