Molecular epidemiology study of Mycobacterium tuberculosis and its susceptibility to anti-tuberculosis drugs in Indonesia

Abstract

BackgroundGenotyping of Mycobacterium tuberculosis helps to understand the molecular epidemiology of tuberculosis and to address evolutionary questions about the disease spread. Certain genotypes also have implications for the spread of infection and treatment. Indonesia is a very diverse country with a population with multiple ethnicities and cultures and a history of many trade and tourism routes. This study describes the first attempt to map the molecular epidemiology of TB in the Indonesian archipelago.MethodFrom 2008 to 2011, 404 clinical specimens from sputum-smear (SS+) TB patients, age ≥15 years, were collected from 16 TB referral primary health centers (PHC) in 16 provincial capitals in Indonesia. Susceptibility testing to first line drugs was conducted for 262 samples using the agar proportion method as per WHO guidelines. Spoligotyping was done on all samples.ResultsNinety-three of the 404 samples (23 %) were from the Beijing family, making it the predominant family in the country. However, the geographic distribution of the family varied by region with 86/294 (29.3 %) in the western region, 6/72 (8.3 %) in the central region, and 2/72 (2.8 %) in the eastern region (p < 0.001). The predominant genotype in the central and eastern regions was from the East-African-Indian (EAI) family, comprising 15.3 % (11/72), and 26.3 % (10/38) of the isolates, respectively. Drug susceptibility to first-line anti-TB drugs was tested in 262 isolates. 162 (61.8 %) isolates were susceptible to all TB drugs, 70 (26.7 %) were mono-resistant 16 (6.1 %) were poly-resistant, and 14 (5.4 %) were multi-drug resistant (MDR). The proportion of Beijing family isolates in the susceptible, mono-resistant, poly-resistant, and MDR groups was 33/162 (20.4 %), 28/70 (40.0 %), 6/16 (37.5 %), and 3/14 (21.4 %), respectively. Overall, resistance of the Beijing family isolates to any of the first line TB drugs was significantly higher than non-Beijing families [37/71 (52.1 %) vs. 63/191 (33.0 %) (p-value = 0.003)].ConclusionThe distribution of Mycobacterium tuberculosis genotypes in Indonesia showed high genetic diversity and tended to vary by geographic regions. Drug susceptibility testing confirmed that the Beijing family of M.tb in Indonesia exhibited greater resistance to first line anti-TB drugs than did other families.

Resistance Ratios of Mycobacterium tuberculosis Complex Strains Isolated in Erzurum Regional Tuberculosis Laboratory Against Major Antituberculosis Drugs

“…Endonezya'da Lisdawati ve ark. (11) 262 izolatla yapmış oldukları çalış-mada 14 (% 5.4) suşun ÇİD-MTK olduğu sonucuna varmışlardır.…”

Characterization of Mycobacterium tuberculosis isolates from Hebei, China: genotypes and drug susceptibility phenotypes

“…The male/female sex ratio in Hebei reached 2.26 (705/312), which is higher than the average level. A strong opinion claimed the gender bias in TB infection, which means that the prevalence of TB was higher in men than in women [ 32 ]. In comparison to new cases, we found that the proportion of males in the retreatment panel was significantly larger than females.…”

Molecular Diagnosis of Tuberculosis

“…1 Recently, a genotyping study of Mycobacterium tuberculosis (MTB) was performed in Indonesia to reveal the TB molecular epidemiology and showed a high genetic diversity that varied by geographical aspects and found that the Beijing strain was the predominant strain in Indonesia. 2 …”