Drug resistance profile of Mycobacterium tuberculosis isolates from pulmonary tuberculosis patients in Jos, Nigeria

Abstract

The drug resistance profile of 100 Mycobacterium tuberculosis isolates from pulmonary tuberculosis (PTB) cases in Jos, Nigeria, was investigated between August 2006 and September 2007. Drug susceptibility testing for 50 new, 11 follow-up and 39 unclassified cases of PTB was performed on Löwenstein-Jensen medium by the proportion method, using isoniazid (0.2 microg/ml), rifampicin (40 microg/ml), ethambutol (2 microg/ml) and streptomycin (4 microg/ml). Susceptibility to all four drugs was found in 76, 62 and 55%, and multidrug resistance (combined resistance to isoniazid and rifampicin with or without resistance to any other drug) in 4, 31 and 18% of the new, unclassified and follow-up cases, respectively. Monoresistance was found in 15% of the cases. Nine of the 16 isolates (56%) showing multidrug resistance were resistant to all four drugs. These findings are critical and the risk to public health is high, particularly with an overall multidrug resistance of 16%. We suggest that TB management and control programs in Jos are revised to enhance patient's accessibility to treatment sites, promote patients' adherence to drugs, improve diagnostic practices, regularly assess drug resistance profiles, and undertake contact tracing for patients with multidrug-resistant TB.

Evaluation ofMycobacterium tuberculosisdrug susceptibility in clinical specimens from Nigeria using genotype MTBDRplus and MTBDRsl assays

“…Other publications report on a streptomycin resistance rate of 11% but did not fi nd INH mono-resistant strains [2]. The low number of isolates ranging from 32 (this study) to 50 [1,2] might account for that effect. However, we identifi ed 16% of the isolates as MDR TB stains; these strains were at least resistant to INH, RMP, STR, and EMB, and one was additionally resistant to PZA.…”

“…Only few publications that deal with the susceptibility pattern of bacteria [1,13]. However, data collected in a tertiary hospital in Nigeria report on pan-susceptibility in only 46% of the isolated TB strains [2].…”

“…However, we identifi ed 16% of the isolates as MDR TB stains; these strains were at least resistant to INH, RMP, STR, and EMB, and one was additionally resistant to PZA. The MTB prevalence described in the literature ranges between 4% and 31% [1,2]. It is suggested that the incidence of MDR tuberculosis is associated to the type of hospital.…”

“…The World Health Organization (WHO) report 2009 stated an incidence of TB at 311/100,000, a prevalence of 772,000 cases, and the rate of new sputum smear positive cases was approximately 131/100,000 per year. Studies on drug susceptibility profi les of Mycobacterium tuberculosis (MTB) in Nigeria are scarcely reported, and the prevalence of MDR strains is numeralized between 2% and 53% in new cases of TB [1,2]. Treatment on MDR TB involves second line drugs which are costly, scarce, and toxic and require longer duration of therapy [2].…”

Comparison of a DNA based PCR method with conventional methods for the detection of M. tuberculosis in Jos, Nigeria

“…Findings from a previous study in Jos, (North Central Region) had indicated that there is a need to review the procedures for TB diagnosis and treatment in Nigeria [11].…”