Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center

Feliciano, Cinara Silva; Nascimento, Margarida Maria Pásseri do; Anselmo, Lívia Maria Pala; Pocente, Renata Helena Candido; Bellissimo-Rodrigues, Fernando; Bollela, Valdes Roberto

doi:10.1590/1414-431x20154458

Cited by 16 publications

(13 citation statements)

References 21 publications

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“…14 In many countries, such as Brazil and Mozambique, commercial liquid culture is available only in national or supranational reference laboratories, and DST results can take more than 3–4 months after the clinical specimen has been collected and sent for testing. 15 …”

Section: Discussionmentioning

confidence: 99%

Detection of katG and inhA mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

et al. 2016

int j tuberc lung dis

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SUMMARY BACKGROUND Depending on the presence of mutations that determine isoniazid (INH) susceptibility (katG and inhA), Mycobacterium tuberculosis may be susceptible to high doses of INH or ethionamide (ETH). OBJECTIVE To describe the INH resistance profile and association of katG mutation with previous INH treatment and level of drug resistance based on rapid molecular drug susceptibility testing (DST) in southern Brazil and central Mozambique. DESIGN Descriptive study of 311 isolates from Ribeirão Preto, São Paulo, Brazil (2011–2014) and 155 isolates from Beira, Mozambique (2014–2015). Drug resistance patterns and specific gene mutations were determined using GenoType® MTBDRplus. RESULTS katG gene mutations were detected in 12/22 (54.5%) Brazilian and 32/38 (84.2%) Mozambican isolates. inhA mutations were observed in 9/22 (40.9%) isolates in Brazil and in 4/38 (10.5%) in Mozambique. Both katG and inhA mutations were detected in respectively 1/22 (5%) and 2/38 (5.2%). The difference in the frequency of katG mutations in Brazil and Mozambique was statistically significant (P = 0.04). katG mutations were present in 68.8% (33/48) of patients previously treated with INH and 31.2% (15/48) of patients without previous INH. This difference was not statistically significant (P = 0.223). CONCLUSION INH mutations varied geographically; molecular DST can be used to guide and accelerate decision making in the use of ETH or high doses of INH.

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Section: Discussionmentioning

confidence: 99%

Detection of katG and inhA mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

et al. 2016

int j tuberc lung dis

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“…Because of the high prevalence of HIV in Mozambique, HIV infection was common among patients with DR-TB infection (62.5 %) although there is no association between HIV and drug resistant TB [ 21 – 23 ]. However, it was shown by the epidemics of DR-TB in Kwazulu Natal, South Africa (SA) that there is high case fatality among DR-TB/HIV co-infected patients [ 24 , 25 ] so rapid diagnosis of drug resistance and guided treatment is important both for improved outcomes and to avoid progression to XDR-TB or “TDR-TB”.…”

Section: Discussionmentioning

confidence: 99%

Drug-resistant tuberculosis in Central Mozambique: the role of a rapid genotypic susceptibility testing

et al. 2016

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BackgroundGenotypic molecular testing may be very helpful for tuberculosis (TB) drug-resistance surveillance and for treatment guidance in low resource settings.MethodsDescriptive analysis of M. tuberculosis isolates from Beira Central Hospital, Mozambique, during 2014–2015. Genotype MTBDRplus and MTBDRsl were used and patient medical records reviewed.To explore genotypic susceptibility profile of Mycobacterium tuberculosis, to first and second line drugs (SLD) in Beira Mozambique.ResultsOf 155 isolates, 16.1 % (25) were multidrug resistant (MDR), 8.4 % (13) isoniazid-monoresistant and 1.3 % (2) rifampicin-monoresistant. Among MDR-TB, 22.2 % showed primary and 77.8 % represented acquired resistance. The majority of patients with drug resistance had a history of previous TB treatment. Among 125 isolates tested for ethambutol and SLD, 7.2 % (9) were resistant to ethambutol, 4.8 % (6) to fluoroquinolones and 0.8 % (1) to ethambutol and fluoroquinolones. Resistance to injectable SLD was not detected.ConclusionsAs far as we know this is the first report of a genotypic testing used to provide information about SLD resistance in Mozambique, where phenotypic susceptibility testing is usually unavailable. Extensively drug resistant TB was not detected in this isolates from Beira Mozambique.

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“…1604 citations were later deleted, resulting in 200 selected references for full‐text screening. After reading the full texts of the 200 articles, 143 were excluded, and 57 articles were included in our review [8‐64]. Thirty‐four of 57 publications included data from more than one population type, yielding an equivalent of 91 studies ( n = 32 962 participants).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of multidrug‐resistant tuberculosis in Latin America and the Caribbean: a systematic review and meta‐analysis

Tengan

Figueiredo

Leite

et al. 2020

Tropical Med Int Health

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Objectives To evaluate the prevalence of multidrug‐resistant tuberculosis (MDR‐TB) in individuals living in Latin America and the Caribbean (LAC). Methods We searched the MEDLINE, Embase and Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) databases until 08 August 2019 for all studies on the subject, without time or language restrictions. Original studies reporting the prevalence of infection with Mycobacterium tuberculosis resistant to isoniazid and rifampicin simultaneously (MDR) in LAC, the prevalence of resistance in cases with no previous treatment (new cases) and the prevalence of resistance in previously treated cases were selected. Considering the expected heterogeneity between studies, all analyses were performed using the random effects model, and heterogeneity was assessed using the I2 statistic. Results We included 91 studies from 16 countries. The estimated overall prevalence was 13.0% (95% CI 12.0–14.0%), and the heterogeneity between studies was substantial (I2 = 96.1%). In the subgroup analyses, it was observed that the prevalence of MDR‐TB among new cases was 7.0% (95% CI 6.0–7.0%) and in previously treated cases was 26.0% (95% CI 24.0–28.0%). Conclusions This review highlights multidrug resistance to antituberculosis drugs in LAC, indicating that prevention strategies have not been effective. Government institutions should invest heavily in strategies for early diagnosis and the rapid availability of effective treatments and prioritise adequate protection for health professionals. In addition, screening programmes should be adopted to prevent secondary cases.

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Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center

Cited by 16 publications

References 21 publications

Detection of <I>kat</I>G and <I>inh</I>A mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

Detection of <I>kat</I>G and <I>inh</I>A mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

Drug-resistant tuberculosis in Central Mozambique: the role of a rapid genotypic susceptibility testing

Prevalence of multidrug‐resistant tuberculosis in Latin America and the Caribbean: a systematic review and meta‐analysis

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