Pre-extensively drug-resistant tuberculosis among multidrug-resistant tuberculosis patients in Ethiopia: a laboratory-based surveillance study

BACKGROUND: The rise of drug-resistant tuberculosis (DR-TB) has presented a substantial challenge to the national tuberculosis (TB) control program. Understanding the epidemiology of pre-extensively drug-resistant tuberculosis (pre-XDR-TB) could help clinicians to adapt MDR-TB treatment regimens at...

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Detalles Bibliográficos
Autores principales: Diriba, Getu, Alemu, Ayinalem, Tola, Habteyes Hailu, Yenew, Bazezew, Amare, Misikir, Eshetu, Kirubel, Sinshaw, Waganeh, Abebaw, Yeshiwork, Meaza, Abyot, Seid, Getachew, Moga, Shewki, Zerihun, Betselot, Getu, Melak, Dagne, Biniyam, Mollalign, Hilina, Tadesse, Mengistu, Buta, Bedo, Wordofa, Niguse, Alemu, Ephrem, Erresso, Ashenafi, Hailu, Michael, Tefera, Zigba, Wondimu, Amanuel, Belhu, Tegegn, Gamtesa, Dinka Fekadu, Getahun, Muluwork, Kebede, Abebaw, Abdela, Saro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513164/
https://www.ncbi.nlm.nih.gov/pubmed/36176268
http://dx.doi.org/10.1016/j.ijregi.2022.08.012
Descripción
Sumario:BACKGROUND: The rise of drug-resistant tuberculosis (DR-TB) has presented a substantial challenge to the national tuberculosis (TB) control program. Understanding the epidemiology of pre-extensively drug-resistant tuberculosis (pre-XDR-TB) could help clinicians to adapt MDR-TB treatment regimens at an earlier stage. This study aimed to assess second-line anti-TB drug resistance among MDR-TB patients in Ethiopia using routine laboratory-based data. METHODS: Laboratory-based cross-sectional data were collected from the national TB reference laboratory and seven regional tuberculosis culture laboratories in Ethiopia from July 2019 to March 2022. The required data, such as drug-susceptibility testing (DST) results and sociodemographics, were collected on a structured checklist from laboratory registration books and electronic databases. Data were entered into a Microsoft Excel spreadsheet and analyzed using SPSS version 23. Descriptive statistics were performed to show the distribution and magnitude of drug resistance. RESULTS: Second-line drugs (SLDs) susceptibility testing was performed for 644 MDR isolates, of which 19 (3%) were found to be pre-XDR-TB cases. Of the total MDR-TB isolates, 19 (3%) were resistant to at least one fluoroquinolone drug, while 11 (1.7%) were resistant to at least one injectable second-line drug. Of the 644 MDR-TB isolates, 1.9% (5/261) pre-XDR were from new MDR-TB cases, while 3.7% (14/383) were from previously treated MDR-TB patients. The most frequently identified mutations, based on MTBDRsl results, were in codon A90V of the gyrA gene (77.3%) and A1401G of the rrs gene (45.5%). CONCLUSION: The overall prevalence of pre-XDR-TB in Ethiopia is considerable. The majority of SLD resistance mutations were in the gyrA gene at position A90V. Modern, rapid DST is necessary to enable identification of pre-XDR-TB and XDR-TB in supporting proper regimen administration for patients.

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