Journal of global antimicrobial resistance · 2025
Drug-resistance patterns and associated mutations of Mycobacterium tuberculosis strains isolated from chronic kidney disease and diabetes mellitus patients in Ethiopia.
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Alemu Ayinalem, Diriba Getu, Seid Getachew, Mariam Solomon H, Berhe Nega, Gumi Balako
Аннотация
OBJECTIVE: To assess the drug-resistance (DR) patterns, mutations, and associated factors among tuberculosis (TB) cases identified from diabetes mellitus (DM) and chronic kidney disease patients.
METHODS: The DR patterns of 77 Mycobacterial isolates were assessed using phenotypic drug-susceptibility testing, the Xpert MTB/rifampicin (RIF) assay, the Xpert MTB/XDR assay, and line probe assays. Data were analysed using SPSS version 27. Descriptive statistics, a chi-squared test, and logistic regression were conducted. The 95% CI was determined, and a P-value <0.05 was considered a statistically significant difference.
RESULTS: Resistance pattern was determined for 76 Mycobacterial isolates, and one isolate had an invalid result. Any DR and multi-DR were detected among 25.0% (19), and 7.9% (6) isolates, respectively. Resistance to streptomycin, isoniazid (INH), RIF, ethambutol, and pyrazinamide was 11.8% (9), 13.2% (10), 10.5% (8), 6.6% (5), and 11.8%(9), respectively. Mono-DR was detected for streptomycin 3.9% (3), INH 2.6% (2), RIF 2.6% (2), and pyrazinamide 4.5% (4). One isolate was resistant to fluoroquinolones. Phenotypic and genotypic methods had concordant results in determining RIF and fluoroquinolones resistance. The common RIF and INH-resistant conferring mutations were observed at the S531L and S315T regions, respectively. Previous TB treatment and TB contact history were associated with DR-TB.
CONCLUSIONS: A quarter of TB cases identified had DR-TB, with a higher risk among patients with previous TB treatment history and had contact with TB patients, necessitating programmatic interventions, including applying infection prevention, contact tracing, and access to drug-susceptibility testing using rapid molecular methods.
METHODS: The DR patterns of 77 Mycobacterial isolates were assessed using phenotypic drug-susceptibility testing, the Xpert MTB/rifampicin (RIF) assay, the Xpert MTB/XDR assay, and line probe assays. Data were analysed using SPSS version 27. Descriptive statistics, a chi-squared test, and logistic regression were conducted. The 95% CI was determined, and a P-value <0.05 was considered a statistically significant difference.
RESULTS: Resistance pattern was determined for 76 Mycobacterial isolates, and one isolate had an invalid result. Any DR and multi-DR were detected among 25.0% (19), and 7.9% (6) isolates, respectively. Resistance to streptomycin, isoniazid (INH), RIF, ethambutol, and pyrazinamide was 11.8% (9), 13.2% (10), 10.5% (8), 6.6% (5), and 11.8%(9), respectively. Mono-DR was detected for streptomycin 3.9% (3), INH 2.6% (2), RIF 2.6% (2), and pyrazinamide 4.5% (4). One isolate was resistant to fluoroquinolones. Phenotypic and genotypic methods had concordant results in determining RIF and fluoroquinolones resistance. The common RIF and INH-resistant conferring mutations were observed at the S531L and S315T regions, respectively. Previous TB treatment and TB contact history were associated with DR-TB.
CONCLUSIONS: A quarter of TB cases identified had DR-TB, with a higher risk among patients with previous TB treatment history and had contact with TB patients, necessitating programmatic interventions, including applying infection prevention, contact tracing, and access to drug-susceptibility testing using rapid molecular methods.