Drug Resistance Conferring Mutation and Genetic Diversity of Mycobacterium tuberculosis Isolates in Tuberculosis Lymphadenitis Patients; Ethiopia.
Drug Resistance Conferring Mutation and Genetic Diversity of Mycobacterium tuberculosis Isolates in Tuberculosis Lymphadenitis Patients; Ethiopia.
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DOI：
10.2147/idr.s298683
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发表时间：
2021
影响因子：
3.9
通讯作者：
Mihret A
中科院分区：
文献类型：
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作者：
Ayalew S;Wegayehu T;Taye H;Wassie L;Girma S;Berg S;Mihret A
结核性淋巴结炎（TBLN）是埃塞俄比亚日益严重的公共卫生问题。然而，目前关于结核分枝杆菌耐药基因突变和遗传多样性的信息有限。从TBLN患者分离的结核病菌株。对91株M进行了耐药性和遗传多样性分析.从2016年至2017年收集的培养阳性TBLN患者中分离的结核病菌株。使用GenoType MTBDRplus VER 2.0检测赋予耐药性的突变。此后，使用spoligotyping对分离株进行分型。在91株菌株中，分别在2株（2.2%）和6株（6.6%）分离株中观察到利福平（RIF）和异烟肼（INH）耐药突变。两株RIF耐药株rpoB基因第531位密码子发生突变，氨基酸发生S531 L改变。6株INH耐药菌株中，4株KatG基因第315位密码子突变，氨基酸改变为S315 T; 1株inhA基因第15位密码子突变，氨基酸改变为C15 T;所有耐药分离株均来自未经治疗的TBLN患者。主要鉴定的Spoligo国际型（SIT）分别为SIT 25、SIT 149和SIT 53，占菌株总数的43%。分离物分为四个主要谱系：谱系1（2，2.2%）、谱系3（38，41.7%）、谱系4（49，53.8%）和谱系7（2，2.2%）。4/6株（66.7%）具有耐药突变的菌株属于聚类菌株（具有共享SIT的菌株）。在初治TBLN患者中检测到耐药基因突变，以及在聚集菌株中检测到耐药菌株，可能提示耐药菌株在社区中传播。这需要仔细考虑，以防止抗药性克隆在该国的传播。
Tuberculosis lymphadenitis (TBLN) is a growing public health concern in Ethiopia. However, there is limited information available on gene mutations conferring drug resistance and genetic diversity of M. tuberculosis isolates from TBLN patients. Drug resistance and genetic diversity analysis were done on 91 M. tuberculosis isolates from culture positive TBLN patients collected between 2016 and 2017. Detection of mutations conferring resistance was carried out using GenoType MTBDRplus VER 2.0. Thereafter, isolates were typed using spoligotyping. Out of the 91 strains, mutations conferring resistance to rifampicin (RIF) and isoniazid (INH) were observed in two (2.2%) and six (6.6%) isolates, respectively. The two RIF resistant isolates displayed a mutation at codon 531 in the rpoB gene with amino acid change of S531L. Among the six INH resistant strains, four isolates had shown mutation at the KatG gene at codon 315 with amino acid change of S315T, one isolate had a mutation at the inhA gene at codon 15 with amino acid change of C15T and one isolate had a mutation at the inhA gene with unknown amino acid change. All drug resistant isolates were from treatment naive TBLN patients. The dominantly identified Spoligo International Types (SITs) were SIT25, SIT149, and SIT53, respectively; these accounted for 43% of the total number of strains. The isolates were grouped into four main lineages; Lineage 1 (2, 2.2%), Lineage 3 (38, 41.7%), Lineage 4 (49, 53.8%) and Lineage 7 (2, 2.2%). Four out of six (66.7%) isolates with drug resistance conferring mutations belonged to clustered strains (strains with shared SIT). The detection of drug resistant conferring mutation in treatment naïve TBLN patients together with detection of drug resistant isolates among clustered strains might suggest resistant strains' transmission in the community. This needs to be carefully considered to prevent the spread of drug resistant clones in the country.