Prevalence of drug-resistant tuberculosis in Iran: Systematic review and meta-analysis

Nasiri, Mohammad Javad; Dabiri, Hossein; Darban-Sarokhalil, Davood; Rezadehbashi, Maryam; Zamani, Samin

doi:10.1016/j.ajic.2014.07.017

Cited by 46 publications

(48 citation statements)

References 10 publications

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“…The rates of resistance to this drug have been reported from 4.0% among new cases to 31.0% in previously treated cases [22]. In our study, we detected 10 MDR M. tuberculosis isolates; of those, 9 had coresistance to EMB.…”

Section: Discussionmentioning

confidence: 48%

Frequency of mutational changes in the embB among the ethambutol-resistant strains of Mycobacterium tuberculosis in Iran

Rezaei

Haeili

Mohajeri

et al. 2016

J Infect Dev Ctries

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Introduction: Early detection of drug resistant tuberculosis is one of the main priorities of TB control program. Ethambutol (EMB) is a firstline anti-TB drug that is effective for preventing treatment failures caused by Mycobacterium tuberculosis strains that are resistant to other drugs. The aim of this study was to sequence the embB gene to characterize the mutations causing resistance to EMB and to analyze the relationship between bacterial genotype and EMB resistance among M. tuberculosis isolates in Iran. Methodology: A total of 20 M. tuberculosis isolates comprising 10 multidrug-resistant (MDR) and 10 non-MDR isolates, recovered from TB patients in four regions: Tehran, Isfahan, Zahedan, Khorasan, were analyzed. Mutational profiling was performed by amplifying and sequencing the embB gene. Spoligotyping was carried out to characterize the bacterial genotype. Results: Phenotypic EMB resistance was found in 13 strains. Mutations affecting ethambutol resistance-determining region (ERDR) of the embB were identified in 6 of 13 EMB-resistant isolates. The majority of these mutations resulted in amino acid substitution at position 306 (M306V). A novel mutation at codon 366 was identified (S366L) in one isolate. Ural was the most predominant genotype in the studied population. Beijing genotype was associated with both MDR and EMB resistance in which all mutations occurred at codon 306 of the embB gene. Conclusion: A significant association between Beijing genotype and EMB resistance was found, mainly due to mutations at embB306. Results of this study can be used as a basis to develop or improve rapid molecular tests to monitor drug-resistant strains in this country.

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Section: Discussionmentioning

confidence: 48%

Frequency of mutational changes in the embB among the ethambutol-resistant strains of Mycobacterium tuberculosis in Iran

Rezaei

Haeili

Mohajeri

et al. 2016

J Infect Dev Ctries

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“…There is little information on their frequency and distribution among SM-resistant isolates from different localities, particularly Iran [6]. The present findings revealed that 75% of the SM-resistant isolates had a mutation in the rpsL or rrs genes.…”

Section: Discussionmentioning

confidence: 67%

“…In the present study of 100 monoresistant and polyresistant MTB isolates, 22% were MDR and 32% showed resistance to SM. A recent metaanalysis from Iran showed that the highest rate of resistance in new and previously treated cases was seen against SM (19%) and INH (47%) [6]. Moreover, the authors demonstrated a rate of MDR-TB in 5.1% of new cases and 33.7% in retreatment cases.…”

Section: Discussionmentioning

confidence: 92%

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Frequency of rrs and rpsL mutations in streptomycin-resistant Mycobacterium tuberculosis isolates from Iranian patients

Khosravi

Etemad

Hashemzadeh

et al. 2017

Journal of Global Antimicrobial Resistance

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“…11,12 In addition, the consistent increase in NTM infections challenges the implement of the directly observed treatment, short course (DOTS) program, a strategy whereby TB is treated according to the positive results from sputum smear acid-fast bacilli microscopy test. As a result of the DOTS program, most NTM-infected patients are very likely to be treated with the most prescribed antituberculous agents when acid-fast bacilli have been detected in their sputum smear before the confirmative NTM identification results are available.…”

Section: Resultsmentioning

confidence: 99%

Mycobacterial Prevalence and Antibiotic Resistance Frequency Trends in Taiwan of Mycobacterial Clinical Isolates From 2002 to 2014

et al. 2016

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Tuberculosis, caused by Mycobacterium tuberculosis complex (MTBC) infections, is one of the most widespread infectious diseases worldwide. Nontuberculous mycobacteria (NTM) also cause chronic pulmonary infections, however, NTM infection is generally overlooked.This study analyzed the frequencies of MTBC and NTM clinical isolates from 181,132 specimens obtained from patients in Taiwan suspected of having a pulmonary mycobacterial infection from 2002 to 2014. The resistant rates to 4 first-line antibiotics (isoniazid, ethambutol, rifampicin, and streptomycin) of 9079 clinical MTBC isolates were also examined by the modified agar proportion method.Overall, the mycobacterial isolation rate was 8.65%, and this consisted of MTBC isolation rate of 5.01% and NTM isolation rate of 3.63%. The prevalence of MTBC isolates among the identified mycobacterial strains could be seen to decrease significantly from 82.5% in 2002 to 41.18% in 2014. Notably, the corresponding NTM prevalence increased 3.36 fold from 17.54% in 2002 to 58.82% in 2014. The frequencies of MTBC and NTM isolates showed a reciprocal trend with the crossing over occurring in the years 2010 and 2011. Although the resistance rates of the MTBC isolates to isoniazid and streptomycin were relatively stable over the study period, resistance rates of the MTBC isolates against rifampicin and ethambutol fluctuated across the study period. Overall, the incidence of multidrug resistance was relatively consistent at about 1.74%.The diagnosis, identification, and susceptibility tests for NTM should be standardized and integrated into appropriate clinical settings to cope with the increase in NTM infections. In addition, the documentation of the antibiotic resistance rates of MTBC clinical isolates to the antibiotic treatments most often clinically prescribed over a decade provides valuable clues and reference points for effective mycobacterial control.

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Prevalence of drug-resistant tuberculosis in Iran: Systematic review and meta-analysis

Cited by 46 publications

References 10 publications

Frequency of mutational changes in the embB among the ethambutol-resistant strains of Mycobacterium tuberculosis in Iran

Frequency of mutational changes in the embB among the ethambutol-resistant strains of Mycobacterium tuberculosis in Iran

Frequency of rrs and rpsL mutations in streptomycin-resistant Mycobacterium tuberculosis isolates from Iranian patients

Mycobacterial Prevalence and Antibiotic Resistance Frequency Trends in Taiwan of Mycobacterial Clinical Isolates From 2002 to 2014

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