Mycobacterial Lineages Associated with Drug Resistance in Patients with Extrapulmonary Tuberculosis in Addis Ababa, Ethiopia

Abstract

Background. In Ethiopia, tuberculosis (TB) is one of the most common causes of illness and death. However, there is limited information available on lineages associated with drug resistance among extrapulmonary tuberculosis patients in Ethiopia. In this study, researchers looked into Mycobacterium tuberculosis lineages linked to drug resistance in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia. Methods. On 151 Mycobacterium tuberculosis isolates, a cross-sectional analysis was performed. Spoligotyping was used to characterize mycobacterial lineages, while a phenotypic drug susceptibility test was performed to determine the drug resistance pattern. Data were analyzed using SPSS version 23. Results. Among 151 Mycobacterium tuberculosis complex (MTBC) genotyped isolates, four lineages (L1–L4), and Mycobacterium bovis were identified. The predominantly identified lineage was Euro-American (73.5%) followed by East-African-Indian (19.2%). Any drug resistance (RR) and multidrug-resistant (MDR) tuberculosis was identified among 16.2% and 7.2% of the Euro-American lineage, respectively, while it was 30.8% and 15.4% among the East-African-Indian lineages. Among all three preextensively drug-resistance (pre-XDR) cases identified, two isolates belong to T3-ETH, and the other one strain was not defined by the database. There was no statistically significant association between any type of drug resistance and either lineage or sublineages of Mycobacterium tuberculosis. Conclusion. A higher proportion of any type of drug resistance and MDR was detected among the East-African-Indian lineage compared to others. However, there was no statistically significant association between any type of drug resistance and either lineages or sublineages. Thus, the authors recommend a large-scale study.

Mycobacterium tuberculosis Sub-Lineage 4.2.2/SIT149 as Dominant Drug-Resistant Clade in Northwest Ethiopia 2020–2022: In-silico Whole-Genome Sequence Analysis

“…20 Different sub-lineages, including L4.2.2/SIT149, T3-ETH, Haarlem, CAS, EAI5, and L3/SIT25, have been identified in Ethiopia, showing different levels of resistance. [21][22][23][24] It was noted that L4.2.2. ETH/SIT149 is known by different names in Ethiopian literatures.…”

Patterns and profiles of drug resistance-conferring mutations in Mycobacterium tuberculosis genotypes isolated from tuberculosis-suspected attendees of spiritual holy water sites in Northwest Ethiopia

“…The observed association between MTB genotypes and drug resistance in Ethiopia highlights the importance of understanding the genetic diversity of the pathogen in combating drug-resistant TB ( 63 , 73 , 74 ). The diversity of MTB genotypes circulating in the country, coupled with specific mutations conferring drug resistance, underscores the need for a comprehensive approach to TB control ( 73 , 75 ). A lack of comprehensive data on the molecular epidemiology of DR-TB strains in Ethiopia further complicates the implementation of molecular diagnostics.…”

“…A lack of comprehensive data on the molecular epidemiology of DR-TB strains in Ethiopia further complicates the implementation of molecular diagnostics. Yet, in Ethiopia, the link between resistance to anti-TB drugs and MTB genotypes is a complex and multifactorial phenomenon ( 75 ). Thus, characterizing DR-TB genotypes and understanding the prevalence and distribution of resistance-associated gene mutations for key anti-TB drugs is essential for guiding treatment strategies and monitoring the emergence of new resistance patterns in the country ( 21 ).…”

Mycobacterium tuberculosis Lineage Distribution Using Whole-Genome Sequencing and Bedaquiline, Clofazimine, and Linezolid Phenotypic Profiles among Rifampicin-Resistant Isolates from West Java, Indonesia

“…Currently, M. tuberculosis has nine lineage strains distributed across many parts of the world [ 18 ]. The lineages include Indo-Oceanic (L1), East Asian/Beijing (L2), East African-Indian (L3), European-American (L4), West African 1 (L5), West African (L6), Aethiops vetus (L7) [ 19 ], and East African (L8 [ 20 ] and L9 [ 18 , 21 ]). Several molecular identification methods have been developed from these strains of M. tuberculosis , including IS6110-RFLP, MIRU-VNTR, and spoligotyping.…”