Ngouama Breli Bonheur, Djontu Jean Claude, Elion Assiana Darrel Ornelle, Mouzinga Freisnel Hermeland, Dello Mita Naomie Merveille, Abdul Jabar Babatunde Pacome Agbo Achimi, Biyogho Christopher Mebiame, Mevyann Rhett Chester, Mfoumbi Ibinda Guy Arnault Rogue, Dibamba Ndanga Micheska Epola, Okemba Okombi Franck Hardain, Ayet Michel Illoye, Siele Lemercier Khunell, Mizele Kitoti Roélie Foxie, Vouvoungui Jeannhey Christevy, Mouanga Alain Maxime, Vouidibio Mbozo Alain Brice, Penlap Veronique, Adegnika Ayola Akim, Grobusch Martin Peter, McHugh Timothy D, Zumla Ali, Ntoumi Francine
Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo.
Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of the Congo.
Ann Clin Microbiol Antimicrob. 2025 May 9;24(1):31. doi: 10.1186/s12941-025-00786-8.
WHO strategy to end Tuberculosis (TB) calls for drug susceptibility testing of Mycobacterium tuberculosis (MTB) for all patients, in high TB burden settings. Thus, this study aimed to investigate the MTB drug resistance profiles and related risk factors among patients presenting to the Antituberculosis Center of Brazzaville, Republic of Congo.
A cross-sectional study was carried out from July 2022 to August 2023 involving 1,121 presumptive pulmonary tuberculosis patients enrolled to the Antituberculosis Center of Brazzaville. Sputum samples were collected from all the study participants for the diagnosis of tuberculosis and rifampicin resistance, using the Xpert MTB/RIF (Cepheid, USA) assay. Samples positive for MTB with drug resistance to RIF were further tested for the second line anti-MTB drug susceptibility using the 10-color Xpert MTB/XDR assay.
Out of 1,121 presumptive TB patients tested, 302/1,121 (26.9%) were MTB positive. Among these, 18/302 (6.0%) had received previous TB treatment and 15/302 (5.0%) were HIV co-infected. The mean age of the study population was 34 years, with a higher prevalence in males (69.2%). Of the MTB isolates, 25/302 (8.3%) were Rifampicin-resistant, with 24/25 (96%) further confirmed as multi-resistant strains, including 6/24 (25%) pre-XDR. Risk factors for MDR-TB included a history of TB treatment (AOR = 8.96, p = 0.002) and chronic cough (AOR = 7.14, p = 0.003).
This study reveals a high level of drug-resistant tuberculosis in Brazzaville, with previous TB treatment being a significant risk factor. The findings underscore the need to strengthen molecular surveillance and TB management and control measures in the Republic of Congo.
世界卫生组织终结结核病战略要求在结核病高负担地区对所有患者进行结核分枝杆菌（MTB）药敏试验。因此，本研究旨在调查刚果共和国布拉柴维尔抗结核中心患者的MTB耐药谱及相关危险因素。
2022年7月至2023年8月进行了一项横断面研究，纳入了1121名在布拉柴维尔抗结核中心登记的疑似肺结核患者。使用Xpert MTB/RIF（美国赛沛公司）检测法从所有研究参与者中采集痰样本，用于结核病诊断和利福平耐药检测。对MTB阳性且对利福平耐药的样本，使用10色Xpert MTB/XDR检测法进一步检测二线抗MTB药物敏感性。
在1121名接受检测的疑似结核病患者中，302/1121（26.9%）为MTB阳性。其中，18/302（6.0%）曾接受过结核病治疗，15/302（5.0%）合并感染HIV。研究人群的平均年龄为34岁，男性患病率较高（69.2%）。在MTB分离株中，25/302（8.3%）对利福平耐药，其中24/25（96%）进一步确认为多重耐药菌株，包括6/24（25%）的预广泛耐药菌株。耐多药结核病的危险因素包括结核病治疗史（调整后比值比[AOR]=8.96，p=0.002）和慢性咳嗽（AOR=7.14，p=0.003）。
本研究揭示了布拉柴维尔地区耐药结核病的高水平，既往结核病治疗是一个重要危险因素。研究结果强调了在刚果共和国加强分子监测以及结核病管理和控制措施的必要性。
