Thumamo Pokam Benjamin D, Yeboah-Manu Dorothy, Amiteye Daniel, Asare Prince, Guemdjom Prisca Wabo, Yhiler Nchawa Yangkam, Azumah Morton Samuel Nii, Ofori-Yirenkyi Stephen, Laryea Roger, Tagoe Roger, Asuquo Anne Ebri
Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
Heliyon. 2021 Oct 9;7(10):e08152. doi: 10.1016/j.heliyon.2021.e08152. eCollection 2021 Oct.
Tuberculosis TB) and drug-resistant TB (DR-TB) continue to persist as a serious public health challenges in Ghana. Although several research has evaluated the drug resistance of complex (MTBc) strains across the country, there is a paucity of data on its magnitude as well as the various lineages circulating in the Eastern region of Ghana.
This study therefore evaluated the distribution of the various lineages of MTBc in the Eastern region of the country and the associated drug resistance.
One hundred and forty-three (143) patients with pulmonary TB attending the Eastern Regional Hospital, Koforidua/Ghana were included in the study. The BACTEC MGIT 960 tube media was used for both sputum culture and drug susceptibility of streptomycin (STR), isoniazid (INH), rifampicin (RIF) and Ethambutol (ETH). Isolates were initially typed using IS, followed by large sequence polymorphisms analysis and spoligotyping.
The majority [108 (75.5%)] of the 143 patients were male gender and the 45-54 years [46 (32.2%)] age range had the highest frequency. Forty-one (28.7%) of the 143 isolates were negative. Of the 102 spoligotyped isolates, the main sub-lineages included 45 (44.1%) Cameroon and 23 (22.5%) Ghana. SITs 61 and 53 represented the major cluster with 22/102 (21.6%) and 13/102 (12.7%) isolates respectively, while 59/65 (90.8%) isolates belonged to Lineage 4 with 27/65 (41.5%) LAM10_CAM. MDR-TB occurred in 26/79 (32.9%) isolates, and was not associated with neither gender [20/58 (34.5%) male vs 6/21 (28.6%) female, OR = 1.31; 95%CI, 0.44-3.92; p = 0.624)] nor age. No association was found between MDR-TB and the major sub-lineages [8/25 (32%) Cameroon (OR = 0.94; 95%CI, 0.34-2.59; p = 0.920) and 5/11 (45.5%) Ghana (OR = 1.87; 95%CI, 0.51-6.80; p = 0.489)], or previously treated [8/23 (34.8%), OR = 0.89; 95%CI, 0.32-2.48; p = 0.823)] patients.
Despite the serious threat posed by MDR in the study area, no sub-lineage was shown to be associated with drug resistance. Nonetheless, a sustained surveillance of drug resistance pattern is advocated. A lower proportion of was observed in the Eastern region of Ghana and will require further evaluation.
结核病（TB）和耐多药结核病（DR-TB）仍然是加纳严峻的公共卫生挑战。尽管已有多项研究评估了该国结核分枝杆菌复合群（MTBc）菌株的耐药性，但关于加纳东部地区MTBc的流行程度及其不同谱系的数据却很匮乏。
因此，本研究评估了该国东部地区MTBc不同谱系的分布情况以及相关的耐药性。
纳入了在加纳科福里杜瓦市东部地区医院就诊的143例肺结核患者。采用BACTEC MGIT 960管培养基进行痰培养，并检测链霉素（STR）、异烟肼（INH）、利福平（RIF）和乙胺丁醇（ETH）的药敏情况。分离株最初采用插入序列（IS）分型，随后进行大片段序列多态性分析和间隔寡核苷酸分型（spoligotyping）。
143例患者中，大多数[108例（75.5%）]为男性，45 - 54岁年龄段的患者频率最高[46例（32.2%）]。143株分离株中，41株（28.7%）培养阴性。在102株经间隔寡核苷酸分型的分离株中，主要亚谱系包括喀麦隆型45株（44.1%）和加纳型23株（22.5%）。国际分枝杆菌分型数据库编号（SITs）61和53代表主要聚类，分别有22/102株（21.6%）和13/102株（12.7%）分离株，而59/65株（90.8%）分离株属于4型谱系，其中27/65株（41.5%）为LAM10_CAM型。耐多药结核病在79株分离株中出现26株（32.9%），与性别[20/58例（34.5%）男性 vs 6/21例（28.6%）女性，比值比（OR） = 1.31；9５%置信区间（CI），0.44 - 3.92；p = 0.624]和年龄均无关联。耐多药结核病与主要亚谱系[喀麦隆型8/25株（32%）（OR = 0.94；95%CI，0.34 - 2.59；p = 0.920）和加纳型5/11株（45.5%）（OR = 1.87；95%CI，0.51 - 6.80；p = 0.489）]或既往治疗史[8/23例（34.8%），OR = 0.89；95%CI，0.32 - 2.48；p = 0.823]的患者均无关联。
尽管研究地区耐多药结核病构成严重威胁，但未发现任何亚谱系与耐药性相关。尽管如此，仍提倡持续监测耐药模式。加纳东部地区观察到较低比例的［此处原文缺失相关内容］，需要进一步评估。
