Prevalence of Drug Resistance Mycobacterium Tuberculosis among Patients Seen in Coast Provincial General Hospital, Mombasa, Kenya

Ombura, Ida Pam; Onyango, Noel; Odera, Susan; Mutua, Florence; Nyagol, Joshua

doi:10.1371/journal.pone.0163994

Cited by 19 publications

(12 citation statements)

References 19 publications

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“…Patients who received retreatment had a higher risk of DR-TB, which was consistent with the results of previous studies [ 43 , 44 ]. TB patients with drug-related hepatotoxicity were more likely to have DR-TB, similar to previous observations from other studies [ 45 ].…”

Section: Discussionsupporting

confidence: 92%

Characteristics of tuberculosis patients in the integrated tuberculosis control model in Chongqing, China: a retrospective study

et al. 2020

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Background: China ranks second in the world in terms of numbers of tuberculosis (TB) cases and is one of the top three countries with the largest number of multidrug-resistant and rifampicin-resistant TB (MDR/RR-TB). It also has high mortality and low cure rates of human immunodeficiency virus (HIV)-positive TB patients. This study aimed to analyse, under the integrated TB control model, the characteristics of TB patients seeking healthcare in the largest designated TB hospital in Chongqing. Methods: This was a retrospective study of TB registers in a health facility. Record data of 1827 TB patients who had attended the Chongqing Public Health Medical Center (CPHMC) from 1 January to 31 December 2018 were included. The Statistical Package for Social Science (SPSS 18.0; IBM Corporation, Armonk, NY, USA) was used to analyse the data. Counting data were compared using the chi-square test or Fisher' s exact test. Among the results of the univariate analysis, the variables with statistical significance were included in the binomial stepwise logistic regression, with odds ratio and 95% confidence interval calculated. A two-tailed probability level of P < 0.05 was considered statistically significant. Results: The majority of registered patients were men (1197), of Han ethnicity (1670), aged 21-60 years (1331), farmer/unemployed (1075), and living in county/district (1207). Approximately 24.9% of patients (455/1827) contracted DR-TB, 6% (110/1827) were co-infected with HIV, and 41.0% (749/1827) had drug-related hepatotoxicity. Among those patients, DR-TB was more likely to develop among farmers who received retreatment and had drugrelated hepatotoxicity (P < 0.05). Women who received retreatment and lived in county/district were less likely to be HIV positive (P < 0.05). Compared with farmers, patients who were unemployed were more likely to be HIV positive, and those aged 21-60 years had a higher risk of being tested as HIV positive (P < 0.05). Conclusion: Farmers who received retreatment and had drug-related hepatotoxicity are more susceptible to DR-TB; young unemployed men have a higher risk of contracting HIV-positive TB. The demographic and clinical characteristics of TB patients should be taken into consideration in DR-TB and HIV-positive TB screening in the future.

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Section: Discussionsupporting

confidence: 92%

Characteristics of tuberculosis patients in the integrated tuberculosis control model in Chongqing, China: a retrospective study

et al. 2020

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“…1 The emergence of drug-resistant TB, which is associated with increased mortality, is a challenging concern, particularly in developing countries. 2 …”

Section: Introductionmentioning

confidence: 99%

“…MDR-TB needs long-term treatment with second-line anti-TB drugs which incur high cost and wide toxic effects. 2 , 4 So, rapid detection of antibiotic resistance in TB patients is important and helps in developing strategies aimed to control the spread of drug-resistant disease.…”

Section: Introductionmentioning

confidence: 99%

“… 5 The resistance to RIF is related to rpoB gene, which encodes the β-subunit of bacterial DNA-dependent RNA polymerase, and the significant mutations in rpoB are linked to an 81 bp region, named the rifampicin resistance determinant region (RRDR). 2 , 6 Two mechanisms involving major mutations in katG and inhA genes lead to INH resistance. katG encodes a catalase peroxidase which converts INH to its active form.…”

Section: Introductionmentioning

confidence: 99%

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Molecular detection of rifampin, isoniazid, and ofloxacin resistance in Iranian isolates of <em>Mycobacterium tuberculosis</em> by high-resolution melting analysis

Sirous¹,

Khosravi²,

Tabandeh³

et al. 2018

IDR

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BackgroundThe emergence of drug resistance among Mycobacterium tuberculosis (MTB) strains is a serious health concern worldwide. The development of rapid molecular diagnostic methods in recent years has a significant impact on the early detection of resistance to major anti-TB drugs in MTB isolates, which helps in employing appropriate treatment regimen and prevents the spread of drug-resistant strains. This study was designed to evaluate the efficacy of real-time PCR and high-resolution melting (HRM) curve analysis for the determination of resistance to rifampin (RIF), isoniazid (INH), and ofloxacin (OFX) in MTB isolates and to investigate their resistance-related mutations.MethodsHRM analysis was performed to screen 52 (32 drug-resistant and 20 fully susceptible) MTB clinical isolates for mutations in rpoB, katG, mab-inhA, and gyrA genes. The HRM results were then confirmed by DNA sequencing.ResultsIn total, 32 phenotypically resistant isolates, comprising 18 RIF-, 16 INH-, and five OFX- resistant strains, were investigated. HRM analysis successfully identified 15 out of 18 mutations in rpoB, 14 out of 16 mutations in katG and mab-inhA, and four out of five mutations in gyrA conferring resistance to RIF, INH, and OFX, respectively. The obtained sensitivity and specificity, respectively, for HRM in comparison with phenotypic susceptibility testing were found to be 83.3% and 100% for RIF, 87.5% and 100% for INH, and 80% and 100% for OFX. In five resistant strains (12.8%), no mutation was detected by using HRM and DNA sequencing.ConclusionHRM assay is a rapid, accurate, and cost-effective method possessing high sensitivity and specificity for the determination of antibiotic resistance among MTB clinical isolates and screening of their associated mutations. This method can generate results in a shorter period of time than taken by the phenotypic susceptibility testing and also allows for timely treatment and prevention of the emergence of possible MDR strains.

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“…Samples were decanted following centrifugation, and the sediments were resuspended in 3 ml of phosphate buffer solution. Aliquots were prepared from the processed samples to perform, MGIT960 culture, GenoTypeMTBDRplus assay as previously described by (Ombura et al, 2016). All the processed sputum samples were equally subjected to XpertMTBRIF assay according to the manufacturer's instructions.…”

Section: Materials and Methods:-mentioning

confidence: 99%

Comparison of Xpertmtb/Rif and Genotype Mtbdrplus Assays in the Detection of Tuberculosis and Rifampicin Resistance Among Retreatment Samples in Kenya.

Jeremiah¹

2018

IJAR

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Background: Tuberculosis (TB) is a major public health problem globally. The National TB program in Kenya has adopted number of new TB diagnostic tools. The present study investigated the performance of XpertMTBRIF and GenoTypeMTBDRplus in the diagnosis of Tuberculosis and rifampicin resistance among retreatment cases. Methods: A total of 561 TB retreatment sputum samples were subjected to XpertMTBRIF, MGIT culture and GenoTypeMTBDRplus assays. Thereafter, their performance in diagnosis of Mycobacterium tuberculosis and detection rifampicin resistance was compared. The sensitivity and specificity of the tests were determined and Receiver operating characteristic (ROC) analysis was performed to compare the diagnostic tools. Results: The area under the curve (AUC) for XpertMTBRIF MTB detection was 0.81 while that of LPA was 0.85. The AUC for Rifampicin resistance detection was 0.95 and 0.83 for XpertMTBRIF and GenoTypeMTBDRplus respectively. The sensitivity of XpertMTBRIF assay in the detection of MTB was 86.2% while the specificity was 74.9%. GenoTypeMTBDRplus exhibited a sensitivity of 87.8% and the specificity was 84%. On the other hand, XpertMTBRIF exhibited a high sensitivity (91.7%) and specificity (98.5%) in the detection of Rifampicin resistance. GenoTypeMTBDRplus had a sensitivity and specificity of 66.7% and 98.9% respectively. Comparison of the areas under the curve (AUC) for both tests revealed that there is no significant difference (p=0.16, p>0.05) in the detection of MTB as well as Rifampicin resistance (p=0.9, p>0.05). Conclusion: Based on the findings of this study the sensitivity and specificity of the two diagnostic tests, we recommend the use of XpertMTBRIF for surveillance

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Prevalence of Drug Resistance Mycobacterium Tuberculosis among Patients Seen in Coast Provincial General Hospital, Mombasa, Kenya

Cited by 19 publications

References 19 publications

Characteristics of tuberculosis patients in the integrated tuberculosis control model in Chongqing, China: a retrospective study

Characteristics of tuberculosis patients in the integrated tuberculosis control model in Chongqing, China: a retrospective study

Molecular detection of rifampin, isoniazid, and ofloxacin resistance in Iranian isolates of <em>Mycobacterium tuberculosis</em> by high-resolution melting analysis

Comparison of Xpertmtb/Rif and Genotype Mtbdrplus Assays in the Detection of Tuberculosis and Rifampicin Resistance Among Retreatment Samples in Kenya.

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