Mutational analysis in drug resistant Mycobacterium tuberculosis in Western Uttar Pradesh

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Abstract

Background

Multi-drug resistant tuberculosis (MDR-TB) results in treatment failure and poor clinical outcomes. This study was carried out with the aim to determine the pattern of drug resistance against Mycobacterium tuberculosis towards first line ATT (anti-tubercular treatment) in sputum smear–positive patients using Line Probe Assay (LPA).

Methods

A cross sectional prospective study was carried out in a tertiary care Hospital of Meerut. A total of 898 sputum samples (on spot and early morning) collected from 449 suspected pulmonary tuberculosis patients as per RNTCP guidelines were screened by microscopy. Decontamination was done by N-acetyl-l-cysteine and sodium hydroxide. Then smear positive samples were subjected to 1st line drug susceptibility testing (DST) using LPA GenoType® MTBDRplus (HAIN Life Science) assay, a molecular method which allows rapid detection of Rifampicin (Rif) and Isoniazid (INH) resistance.

Results

The overall burden of MDR TB in this geographical area was 7.9 %. Mono-resistance with Rif alone was around 2.8 %. However, the mono-resistance with INH (inhA gene) and INH (katG gene) was 2.8 % and 1.1 % respectively. Drug resistance of Rif was due to mutations in rpoB gene while resistances to INH were more commonly due to mutation in inhA gene followed by katG gene. TB was more commonly seen in the age group of 30–59 years (43.8 %) and predominantly in males.

Conclusion

Tuberculosis positivity rate is high in Western Uttar Pradesh. Burden of MDR TB in Western Uttar Pradesh was similar to National data. Line probe assay can be used as a primary method to diagnose multi drug resistant TB as done in present study which can help in earlier initiation of correct therapy.

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北方邦西部耐药结核分枝杆菌的突变分析
背景耐多药结核病(MDR-TB)会导致治疗失败和不良的临床疗效。本研究旨在使用线性探针分析法(LPA)确定痰涂片阳性患者对一线 ATT(抗结核治疗)的结核分枝杆菌耐药性模式。根据 RNTCP 指南,共对从 449 名肺结核疑似患者处采集的 898 份痰样(现场和清晨)进行了显微镜筛查。用 N-acetyl-l-cysteine 和氢氧化钠进行去污。然后使用 LPA GenoType® MTBDRplus(HAIN 生命科学公司)测定法对涂片阳性样本进行一线药敏试验(DST),该分子方法可快速检测利福平(Rif)和异烟肼(INH)耐药性。仅对 Rif 产生单耐药性的比例约为 2.8%。然而,INH(inhA基因)和INH(katG基因)的单耐药性分别为2.8%和1.1%。对 Rif 的耐药性是由于 rpoB 基因的突变造成的,而对 INH 的耐药性更常见于 inhA 基因的突变,其次是 katG 基因的突变。结核病多见于 30-59 岁年龄组(43.8%),男性居多。北方邦西部的 MDR 结核病负担与全国数据相似。正如本研究中所做的那样,线性探针测定可作为诊断耐多药结核病的主要方法,有助于尽早开始正确的治疗。
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来源期刊
Indian Journal of Tuberculosis
Indian Journal of Tuberculosis Medicine-Infectious Diseases
CiteScore
2.80
自引率
0.00%
发文量
103
期刊介绍: Indian Journal of Tuberculosis (IJTB) is an international peer-reviewed journal devoted to the specialty of tuberculosis and lung diseases and is published quarterly. IJTB publishes research on clinical, epidemiological, public health and social aspects of tuberculosis. The journal accepts original research articles, viewpoints, review articles, success stories, interesting case series and case reports on patients suffering from pulmonary, extra-pulmonary tuberculosis as well as other respiratory diseases, Radiology Forum, Short Communications, Book Reviews, abstracts, letters to the editor, editorials on topics of current interest etc. The articles published in IJTB are a key source of information on research in tuberculosis. The journal is indexed in Medline
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