Alehegn Elias, Gebreyohanns Alganesh, Berhane Bereket Woldeab, Wright Jayne A, Hundie Gadissa Bedada, Geremew Rozina Ambachew, Gorems Kasahun, Gebreyohannes Zenebe, Amare Misikir, Abebaw Yeshiwork, Diriba Getu, Zerihun Betselot, Gebremichael Amanuel Wondimu, Kassa Melkayehu, Gize Addisu
Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Addis Ababa City Administration, Farmers and Urban Agriculture Development Commission, Addis Ababa, Ethiopia.
Infect Drug Resist. 2023 Aug 22;16:5511-5522. doi: 10.2147/IDR.S415906. eCollection 2023.
Drug resistance in tuberculosis poses challenges to both the control and prevention of the disease. The extent of resistance is not well known in developing countries, including Ethiopia. This study was conducted to determine the drug resistance patterns and mutation characteristics of among extra pulmonary tuberculosis patients in selected health facilities in Addis Ababa.
A cross-sectional study was conducted from February 2022 to August 2022 in selected hospitals in Addis Ababa. Socio-demographic and clinical data were collected using structured questionnaire. complex (MTBC) isolates were tested for phenotypic drug susceptibility patterns using the growth indicator tube (MGIT) method for first-line drugs and mutation characteristics using the Line Probe Assay (LPA) method. The data were analyzed using: SPSS version 23, and a P-value ≤ 0.05 was considered statistically significant.
From a total of 308 patient samples from presumptive extra pulmonary patients, 44 (14.3%) were positive for MTBC. Any drug resistance was discovered in 25% of 44 MTBC isolates evaluated for five first-line drugs phenotypically, with isoniazid (INH) and pyrazinamide (PZA) resistance accounting for a greater proportion with 13.6% and 11.4% of the isolates, respectively. Two (4.5%) of the isolates were MDR-TB. Out of 44 isolates tested using the Geno Type MTBDR assay, 5 (11.4%) showed mutations at and 2 (4.5%) showed mutations in the genes.
Both the phenotypic and genotypic drug susceptibility test results showed a high proportion of INH resistance. All INH resistance-conferring mutations were identified from gene. The overall prevalence of MDR-TB was also high. For early case detection and treatment, expanding diagnostic capacity for first-line DST is a vital step to limit further spread of drug resistant TB strains in the study area.
结核病耐药性给疾病的控制和预防带来了挑战。在包括埃塞俄比亚在内的发展中国家,耐药程度尚不明确。本研究旨在确定亚的斯亚贝巴选定医疗机构中肺外结核病患者的耐药模式和突变特征。
2022年2月至2022年8月在亚的斯亚贝巴选定的医院进行了一项横断面研究。使用结构化问卷收集社会人口统计学和临床数据。采用生长指示管(MGIT)法对结核分枝杆菌复合群(MTBC)分离株进行一线药物表型药敏模式检测,并采用线性探针分析(LPA)法检测突变特征。使用SPSS 23版对数据进行分析,P值≤0.05被认为具有统计学意义。
在总共308份疑似肺外患者的样本中,44份(14.3%)MTBC呈阳性。在对44株MTBC分离株进行五种一线药物的表型评估中,发现25%存在任何耐药情况,其中异烟肼(INH)和吡嗪酰胺(PZA)耐药占比更大,分别占分离株的13.6%和11.4%。两株(4.5%)分离株为耐多药结核病(MDR-TB)。在使用基因分型MTBDR检测法检测的44株分离株中,5株(11.4%)在katG基因显示突变,2株(4.5%)在inhA基因显示突变。
表型和基因型药敏试验结果均显示INH耐药比例较高。所有导致INH耐药的突变均在katG基因中鉴定出来。MDR-TB的总体患病率也较高。为了早期病例检测和治疗,扩大一线药物敏感试验的诊断能力是限制耐药结核菌株在研究地区进一步传播的关键步骤。