Genotypic Diversity and Drug Susceptibility Patterns among M. tuberculosis Complex Isolates from South-Western Ghana

Yeboah-Manu, Dorothy; Asante-Poku, Adwoa; Bodmer, Thomas; Stucki, David; Koram, Kwadwo A.; Bonsu, Frank; Pluschke, Gerd; Gagneux, Sébastien

doi:10.1371/journal.pone.0021906

Cited by 62 publications

(81 citation statements)

References 28 publications

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“…This result shows once again the prevalence of Cameroon family in Cameroon even in a rearing region as described in other studies [2, 3, 10]. The same result was obtained in neighboring Nigeria [6, 18], Chad [19], and other West African Countries, among which are Ghana [20] and Burkina Faso [21, 22]. …”

Section: Discussionsupporting

confidence: 88%

Genetic Structure and Drug Susceptibility Patterns ofMycobacterium tuberculosisComplex Strains Responsible of Human Pulmonary Tuberculosis in the Major Rearing Region in Cameroon

Koro

Boock

Kaiyven

et al. 2016

BioMed Research International

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Background. Cameroon this last decade continues to present a low contribution of M. africanum and M. bovis in human tuberculosis (TB), while M. bovis was prevalent in cattle but all these pieces of information only concerned West and Center regions. Methods. We carried out the first study in Adamaoua, one of the most rearing regions of Cameroon, on the genetic structure and drug susceptibility of the MTBC strains isolated from newly diagnosed sputum smear-positive patients aged 15 years and above. For that purpose, spoligotyping, a modified 15 standard MIRU/VNTR loci typing, and the proportion method were used. Results. Four hundred and thirty-seven MTBC isolates were analyzed by spoligotyping. Of these, 423 were identified as M. tuberculosis, within the Cameroon family being dominant with 278 (65.7%) isolates; twelve (2.75%) isolates were classified as M. africanum and two as M. bovis. MIRU/VNTR typing of the most prevalent sublineage (SIT 61) suggested that this lineage is not a unique clone as thought earlier but could constitute a group of strains implicated to different pocket of TB transmission. Only M. tuberculosis sublineages were associated with antituberculosis drug resistance. Conclusion. These results showed the weak contribution of M. africanum and M. bovis to human active pulmonary tuberculosis in Cameroon even in the rearing region.

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Section: Discussionsupporting

confidence: 88%

Genetic Structure and Drug Susceptibility Patterns ofMycobacterium tuberculosisComplex Strains Responsible of Human Pulmonary Tuberculosis in the Major Rearing Region in Cameroon

Koro

Boock

Kaiyven

et al. 2016

BioMed Research International

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“…The identification of the strains revealed the presence of M. tuberculosis and M. africanum. This result compares with a previous study in Ghana by Yeboah-Manu et al [13] in which these species were detected. Resistance of members of M. tuberculosis complex to anti-TB drugs is largely a man-made problem as wild type (strains that have never been exposed to anti-TB drugs) are almost never clinically resistant; though natural resistance to specific drugs has been documented for M. bovis, i.e.…”

Section: Discussionsupporting

confidence: 61%

First Nationwide Survey on the Resistance to First Line Anti-Tuberculosis Drugs in Ghana

Addo¹,

Owusu²,

Bonsu³

et al. 2018

JTR

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Background/objective: A nationwide survey on the resistance to first line anti-tuberculosis (anti-TB) drugs was conducted in Ghana from 2007-2008 by Noguchi Memorial Institute for Medical Research in collaboration with the National Tuberculosis Control Programme. We aimed to characterize mycobacterial species causing pulmonary tuberculosis (PTB) and determine the resistance pattern to first line anti-TB drugs among newly diagnosed and previously treated PTB patients in Ghana. Methods: Two sputum samples from consented new smear positive PTB patients who had never been treated for TB or had been on anti-TB treatment for less than a month and patients who had been treated for TB previously for more than a month in selected diagnostic centres nationwide were collected for culture, identification and drug susceptibility test. Culture positive isolates were tested against streptomycin (S), isoniazid (H), rifampicin (R) and ethambutol (E) using the simplified proportion method and line probe assay (LPA). The LPA was performed in mid-2017. Results: Among 410 samples, 345 positive cultures were obtained and identified as Mycobacterium tuberculosis complex (MTBC). Of the 345 isolates, 133 were further differentiated by GenoType MTBC ® as M. tuberculosis, 126 (94.7%) and M. africanum 7 (5.3%). The overall drug resistance patterns were as follows: 43/345 (12.5%), 6/345 (1.7%), 9/345 (2.6%) and 71/345 (20.6%) were resistant to H, R, E and S respectively and 5/345 (1.4%) were multi-drug resistant (MDR). Conclusion: The results indicate high levels of resistance to S and H among new and previously treated TB patients. We recommend adequate surveillance systems including periodic national anti-TB drug resistance surveys.

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“…The analysis also shows that M. africanum seems to be disappearing in Cameroon, a Central African country, unlike in West African countries, which continue to report between 20% and 39% of cases attributable to this species (7,(10)(11)(12)(13). Previous studies have raised potential limitations concerning the difficulties in isolating and identifying M. africanum due to metabolic constraints (14) and the bias that may have characterized studies that concluded that M. africanum was regressing in Africa (11).…”

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confidence: 92%

Population Dynamics of Tuberculous Bacilli in Cameroon as Assessed by Spoligotyping

et al. 2013

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T uberculosis (TB) remains a major cause of illness and death worldwide, especially in Africa and Asia (1). In Cameroon, the incidence of all clinical forms of tuberculosis is about 25,000 new cases per year (National Tuberculosis Programme [NTP] report no. 16, May 2011).The understanding of tuberculosis transmission dynamics and epidemiology has been greatly enhanced by molecular epidemiologic studies using various DNA typing techniques in conjunction with classical epidemiological approaches (2). These techniques exploit various DNA elements as markers to assess the overall dissemination of strains. One such method is spoligotyping, which analyzes DNA polymorphism observed in the spacer sequences found in the direct repeat (DR) locus of the Mycobacterium tuberculosis complex (MTBC) genome. This technique is simple, rapid, and robust and has the advantage of enabling simultaneous distinction between MTBC isolates at subspecies level. It also measures overall diversity, thus providing information about major lineages. Furthermore, an international database has been established for the purpose of comparison of MTBC spoligotypes (3).An initial retrospective study on the characterization of M. tuberculosis genotype strains collected in the Western Region of Cameroon was carried out between July 1997 and June 1998. This area was chosen by the NTP as a model to assess the impact of various interventions. The application of spoligotyping showed the striking regression of Mycobacterium africanum as an etiologic agent of tuberculosis from 50% in the 1970s to 9% in the 1990s (4). This study also showed the predominance of a group of strains named "Cameroon family" strains, representing 43% of tuberculosis cases and designated LAM-10 CAM in SpolDB4. Further analysis confirmed that the lack of spacers 22, 23, and 24 was the specific signature of this family due to the removal of IS6110 in the DR region (5).To further investigate the genetic diversity evolution and the dynamics of the dissemination of strains in the Western Region of Cameroon, spoligotyping was used to perform a retrospective analysis on a new collection of strains obtained during a 1-year survey (February 2004 to March 2005 to evaluate the impact of tuberculosis control on resistance to antituberculosis drugs, 7 years after the first study.Bacterial strains and spoligotyping. Bacterial strains used in this study were isolated at the Mycobacteriology Reference Laboratory of the Centre Pasteur of Cameroon from pulmonary tuberculosis patients in the Western Region over a 1-year period (February 2004 to March 2005. All sputum smear-positive cases aged more than 15 years were included in the prospective survey. One sputum sample was collected from each patient in a transport medium solution (0.6% cetyl pyridinium bromide) and sent to the Mycobacteriology Reference Laboratory. Each sample was cultured on Löwenstein-Jensen (LJ) medium and LJ medium supplemented with 0.4% pyruvate. We isolated 622 MTBC strains identified by biochemical and phenotypical methods: 25...

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Genotypic Diversity and Drug Susceptibility Patterns among M. tuberculosis Complex Isolates from South-Western Ghana

Cited by 62 publications

References 28 publications

Genetic Structure and Drug Susceptibility Patterns ofMycobacterium tuberculosisComplex Strains Responsible of Human Pulmonary Tuberculosis in the Major Rearing Region in Cameroon

Genetic Structure and Drug Susceptibility Patterns ofMycobacterium tuberculosisComplex Strains Responsible of Human Pulmonary Tuberculosis in the Major Rearing Region in Cameroon

First Nationwide Survey on the Resistance to First Line Anti-Tuberculosis Drugs in Ghana

Population Dynamics of Tuberculous Bacilli in Cameroon as Assessed by Spoligotyping

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