Resistance of Mycobacterium tuberculosis to antibiotics in Lao PDR: first multicentric study conducted in 3 hospitals

Abstract

BackgroundIt is estimated that Lao People’s Democratic Republic (Lao PDR) ranks fifth among the seven countries most affected by TB in the WHO Western Pacific Region. However, because of late implementation of mycobacterial culture, no study on resistance to anti-TB drugs had been performed yet. The objective of this study was to document drug resistance rate among patients hospitalized for pulmonary TB in threeprovinces of Lao PDR.MethodsA cross-sectional study was conducted in three sites, one central and two regional hospitals, from April to November 2010. For each TB suspected patient sputum smear microscopy and culture on Lowenstein-Jensen media were performed. GenoType® MTBDRplus assay was used to test the susceptibility to isoniazid (INH) and rifampicin (RMP), GenoType® MTBDRsl for second-line drugs and GenoType® Mycobacterium CMAS for non-tuberculous mycobacteria (NTM).ResultsOut of 104 positive culture on Lowenstein-Jensen, 87 (83.6%) were M. tuberculosis and 17 (16.4%) were NTM. Of 73 new TB cases, 5 isolates (6.8%) were resistant to INH. Of 14 previously treated cases, 2 isolates (14.3%) were resistant to INH and one isolate was XDR.ConclusionDespite an overall rate of resistance still moderate, the frequency of mutations conferring INH monoresistance and identification of the first strain of XDR require strengthening surveillance of drug resistant tuberculosis in Lao PDR.

GenoType® MTBDRsl assay for resistance to second-line anti-tuberculosis drugs

“… Gomgnimbou 2015 Not a diagnostic accuracy study. Iem 2013 Technical article. Only one case of second‐line resistance.…”

Antimicrobial use and resistance data in human and animal sectors in the Lao PDR: evidence to inform policy

“…Of 87 (84%) M. tuberculosis cultured from 104 sputum samples, 8 (9.2%) were resistant to one or more antituberculous agents, of which seven were monoresistant to isoniazid (INH) and one was MDR that was subsequently found to be extensively drug resistant TB. 44 Somphavong et al characterised the genetics of these M. tuberculosis isolates from the national survey conducted from July 2010 to December 2011. Of 202 isolates, the East African-Indian lineage was the most common identified in all provinces, except Xiengkhuang.…”

Production of Mycobacterium Tuberculosis TB10.4 Recombinant Protein in Escherichia Coli

“…Однако в последние годы широкое распространение получили устойчивые к противотуберкулезным средствам штаммы микобактерий, лече ние вызванного ими туберкулеза проходит крайне сложно. В связи с этим важным аспектом в борьбе с данным заболеванием является предупреждение развития заболеваниявакцинация [6]. В настоящее время для предупреждения туберкулеза широко используется вакцинирование новорожденных детей живой вакциной БЦЖ.…”