Prevalence and risk factors of drug‐resistant extrapulmonary tuberculosis

Boonsarngsuk, Viboon; Mangkang, Khattiya; Santanirand, Pitak

doi:10.1111/crj.12779

Cited by 26 publications

(28 citation statements)

References 23 publications

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“…Previous studies reported from India indicated a higher MDR-TB cases proportion than our findings [25,27,28]. In contrast, two studies from Korea [26,35] one study from Thailand [24], and one study from Ethiopia [23] have reported a lower MDR-TB proportion than our findings. The possible reasons for the difference between our findings and previous studies results could be the non-adherence level, lost to follow up, poor drug supply chain management, and quality of drugs used [36].…”

Section: Discussioncontrasting

confidence: 97%

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Molecular characterization and drug resistance patterns of Mycobacterium tuberculosis complex in extrapulmonary tuberculosis patients in Addis Ababa, Ethiopia

et al. 2020

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Background Molecular characterization of Mycobacterium tuberculosis (MTB) is important to understand the pathogenesis, diagnosis, treatment, and prevention of tuberculosis (TB). However, there is limited information on molecular characteristics and drug-resistant patterns of MTB in patients with extra-pulmonary tuberculosis (EPTB) in Ethiopia. Thus, this study aimed to determine the molecular characteristics and drug resistance patterns of MTB in patients with EPTB in Addis Ababa, Ethiopia. Methods This study was conducted on frozen stored isolates of EPTB survey conducted in Addis Ababa, Ethiopia. A drug susceptibility test was performed using BACTEC-MGIT 960. Species and strain identification were performed using the Geno-Type MTBC and spoligotyping technique, respectively. Data were entered into the MIRU-VNTRplus database to assess the spoligotype patterns of MTB. Analysis was performed using SPSS version 23, and participants’ characteristics were presented by numbers and proportions. Results Of 151 MTB isolates, 29 (19.2%) were resistant to at least one drug. The highest proportion of isolates was resistant to Isoniazid (14.6%) and Pyrazinamide (14.6%). Nine percent of isolates had multidrug-resistant TB (MDR-TB), and 21.4% of them had pre-extensively drug-resistant TB (pre-XDR-TB). Among the 151 MTB isolates characterized by spoligotyping, 142 (94.6%) had known patterns, while 9 (6.0%) isolates were not matched with the MIRU-VNTRplus spoligotype database. Of the isolates which had known patterns, 2% was M.bovis while 98% M. tuberculosis. Forty-one different spoligotype patterns were identified. The most frequently identified SpolDB4 (SIT) wereSIT149 (21.2%), SIT53 (14.6%) and SIT26 (9.6%). The predominant genotypes identified were T (53.6%), Central Asia Strain (19.2%) and Haarlem (9.9%). Conclusion The present study showed a high proportion of MDR-TB and pre-XDR-TB among EPTB patients. The strains were mostly grouped into SIT149, SIT53, and SIT26. The T family lineage was the most prevalent genotype. MDR-TB and pre-XDR-TB prevention is required to combat these strains in EPTB. A large scale study is required to describe the molecular characteristics and drug resistance patterns of MTB isolates in EPTB patients.

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Section: Discussioncontrasting

confidence: 97%

“…In the current study resistance to INH was the most frequent. This proportion is higher than the earlier result reported from Ethiopia [23] and Thailand [24]. However, our finding is similar to the results reported in India [25] and South Korea [26].…”

Section: Discussionsupporting

confidence: 75%

Molecular characterization and drug resistance patterns of Mycobacterium tuberculosis complex in extrapulmonary tuberculosis patients in Addis Ababa, Ethiopia

et al. 2020

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“…Out of 85 M. tuberculosis isolates included in this study, one (3.1%) was multidrug resistant. This proportion is lower than the earlier results reported from Thailand, India and South Korea [ [22] , [23] , [24] ]. In a study conducted by Maurya et al , multidrug-resistant TB was observed in 13.4% of EPTB cases in India [ 25 ].…”

Section: Discussioncontrasting

confidence: 77%

Rifampin resistance among individuals with extrapulmonary tuberculosis: 4 years of experience from a reference laboratory

Baghbanbashi

Mousavi

Dabiri

et al. 2021

New Microbes and New Infections

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Information is limited about the drug resistance patterns in extrapulmonary tuberculosis (EPTB) in Iran. This study aimed to determine the prevalence of EPTB and to investigate the drug-resistance pattern in Mycobacterium tuberculosis strains collected from extrapulmonary samples at the Tehran regional TB reference laboratory. Extrapulmonary specimens from individuals with suspected TB referred to the TB reference laboratories in five cities of Iran were collected. Both standard conventional methods (culture and direct smear microscopy) and Xpert MTB/RIF assay were used for the identification of mycobacteria. Drug susceptibility testing was done using Xpert MTB/RIF. The proportion method on Lowenstein–Jensen medium was performed for confirmation. Between 2016 and 2020, a total of 12 050 clinical specimens from individuals with suspected TB were collected, of which 10 380 (86%) were pulmonary specimens and 1670 (14%) were extrapulmonary. Of the extrapulmonary specimens, 85 (5.0%) were positive for M. tuberculosis , and the remaining 1585 (95.0%) samples were negative by standard methods. Of 85 M. tuberculosis isolates, drug susceptibility testing was performed for 32 isolates, of which 1 (3.1%, 95% CI 0.0%–9.4%) was rifampin resistant and 31 (96.9%, 95% CI 90.1%–100%) were pan-susceptible. The rifampin-resistant isolate was also resistant to isoniazid, so was assigned as a multidrug-resistant TB. Our study indicated the frequency of drug-resistance among EPTB in Iran. Establishing rapid diagnostic methods for detection of drug-resistance in EPTB, performing drug susceptibility testing for all EPTB cases to provide effective treatment, and continuous monitoring of drug resistance, are suggested for prevention and control of drug resistance in EPTB in Iran.

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“…Previous studies have also noted that concurrent PTB-EPTB patients [9,10]. Boonsarngsuk et al [9]. demonstrated that 12.2% were of concurrent PTB-EPTB(120/986).…”

Section: Discussionmentioning

confidence: 92%

“…Tuberculous pleurisy is thought to represent primarily a hypersensitivity reaction to tuberculous protein [21]. Previous studies have also noted that concurrent PTB-EPTB patients [9,10]. Boonsarngsuk et al [9].…”

Section: Discussionmentioning

confidence: 99%

The epidemiology and association rules of concurrent pulmonary tuberculosis and extrapulmonary tuberculosis (PTB-EPTB) in China: a large-scale multi- center observational study

Kang

Chang

et al. 2020

Preprint

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Background Tuberculosis (TB) is a multi-systemic disease with a protean presentation and remains a major global health problem. Concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) are common in clinical practice. However, the information about concurrent PTB-EPTB is scarce. This study aimed to study the epidemiology of concurrent PTB-EPTB by summarizing the diagnostic types of TB and determine the association rules by a large-scale multi-center observational study in China.Methods The study was performed at 21 hospitals from 15 provinces in China. All the consecutive inpatient with confirmed TB diagnosis during the years from Jan 2011 to Dec 2017 was included in the study. The association rules of concurrent PTB-EPTB were analyzed by Apriori algorithm. Results Of 438,979 TB inpatients evaluated, the most common were PTB (82.05%), followed by tuberculous pleurisy (23.62%), etc. Concurrent PTB-EPTB occurred in 129,422 cases (29.48%). Concurrent PTB and tuberculous pleurisy was the most common concurrent PTB-EPTB types. In the fully adjusted multivariable logistic models, the odds ratio of concurrent PTB-EPTB was different by gender and age group. In PTB with concurrent EPTB, the strongest association rule was PTB with concurrent bronchial tuberculosis (lift=1.09). In EPTB with concurrent PTB, the strongest association rule was pharyngeal /laryngeal tuberculosis with concurrent PTB (lift=1.11). The confidence and lift of concurrent PTB-EPTB varied with gender and age. Conclusions There were many types of concurrent PTB-EPTB. The confidence and lift of concurrent PTB-EPTB varied with gender and age. The clinicians should be alert to the presence of concurrent PTB-EPTB and take effective treatment regimen.

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Prevalence and risk factors of drug‐resistant extrapulmonary tuberculosis

Cited by 26 publications

References 23 publications

Molecular characterization and drug resistance patterns of Mycobacterium tuberculosis complex in extrapulmonary tuberculosis patients in Addis Ababa, Ethiopia

Molecular characterization and drug resistance patterns of Mycobacterium tuberculosis complex in extrapulmonary tuberculosis patients in Addis Ababa, Ethiopia

Rifampin resistance among individuals with extrapulmonary tuberculosis: 4 years of experience from a reference laboratory

The epidemiology and association rules of concurrent pulmonary tuberculosis and extrapulmonary tuberculosis (PTB-EPTB) in China: a large-scale multi- center observational study

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