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Valencia-Trujillo D, Avila-Trejo AM, García-Reyes RL, Narváez-Díaz L, Mújica-Sánchez MA, Helguera-Repetto AC, Becerril-Vargas E, Mata-Miranda MM, Rivera-Gutiérrez S, Cerna-Cortés JF. Phenotypic and Genotypic Drug Resistance of Mycobacterium tuberculosis Strains Isolated from HIV-Infected Patients from a Third-Level Public Hospital in Mexico. Pathogens 2024; 13:98. [PMID: 38392836 PMCID: PMC10891562 DOI: 10.3390/pathogens13020098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Drug-resistant tuberculosis (TB) is associated with higher mortality rates in patients with human immunodeficiency virus (HIV). In Mexico, the number of deaths due to TB among the HIV-positive population has tripled in recent years. METHODS Ninety-three Mycobacterium tuberculosis strains isolated from the same number of HIV-infected patients treated in a public hospital in Mexico City were studied to determine the drug resistance to first- and second-line anti-TB drugs and to identify the mutations associated with the resistance. RESULTS Of the 93 patients, 82.7% were new TB cases, 86% were male, and 73% had extrapulmonary TB. Most patients (94%) with a CD4 T-lymphocyte count <350 cells/mm3 were associated with extrapulmonary TB (p <0.0001), whilst most patients (78%) with a CD4 T-lymphocyte count >350 cells/mm3 were associated with pulmonary TB (p = 0.0011). Eighty-two strains were pan-susceptible, four mono-resistant, four poly-resistant, two multidrug-resistant, and one was extensively drug-resistant. In the rifampicin-resistant strains, rpoB S531L was the mutation most frequently identified, whereas the inhA C15T and katG S315T1 mutations were present in isoniazid-resistant strains. The extensively drug-resistant strain also contained the mutation gyrA D94A. CONCLUSIONS These data highlight the need to promptly diagnose the drug resistance of M. tuberculosis among all HIV-infected patients by systematically offering access to first- and second-line drug susceptibility testing and to tailor the treatment regimen based on the resistance patterns to reduce the number of deaths in HIV-infected patients.
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Affiliation(s)
- Daniel Valencia-Trujillo
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (D.V.-T.); (R.L.G.-R.); (S.R.-G.)
- Servicio de Microbiología Clínica, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México 14080, Mexico; (L.N.-D.); (M.A.M.-S.); (E.B.-V.)
- Escuela Militar de Medicina, Centro Militar de Ciencias de la Salud, Secretaría de la Defensa Nacional, Ciudad de México 11200, Mexico;
| | - Amanda Marineth Avila-Trejo
- Laboratorio de Bioquímica Farmacológica, Departamento de Bioquímica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico;
| | - Rocío Liliana García-Reyes
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (D.V.-T.); (R.L.G.-R.); (S.R.-G.)
| | - Luis Narváez-Díaz
- Servicio de Microbiología Clínica, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México 14080, Mexico; (L.N.-D.); (M.A.M.-S.); (E.B.-V.)
| | - Mario Alberto Mújica-Sánchez
- Servicio de Microbiología Clínica, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México 14080, Mexico; (L.N.-D.); (M.A.M.-S.); (E.B.-V.)
| | - Addy Cecilia Helguera-Repetto
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México 11000, Mexico;
| | - Eduardo Becerril-Vargas
- Servicio de Microbiología Clínica, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México 14080, Mexico; (L.N.-D.); (M.A.M.-S.); (E.B.-V.)
| | - Mónica Maribel Mata-Miranda
- Escuela Militar de Medicina, Centro Militar de Ciencias de la Salud, Secretaría de la Defensa Nacional, Ciudad de México 11200, Mexico;
| | - Sandra Rivera-Gutiérrez
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (D.V.-T.); (R.L.G.-R.); (S.R.-G.)
| | - Jorge Francisco Cerna-Cortés
- Departamento de Microbiología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico; (D.V.-T.); (R.L.G.-R.); (S.R.-G.)
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Song Y, Jin Q, Qiu J, Ye D. A systematic review and meta-analysis on the correlation between HIV infection and multidrug-resistance tuberculosis. Heliyon 2023; 9:e21956. [PMID: 38034813 PMCID: PMC10682624 DOI: 10.1016/j.heliyon.2023.e21956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/22/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Background The emergence of multidrug-resistant tuberculosis (MDR-TB) in HIV-positive people poses a significant challenge to international efforts to eradicate tuberculosis (TB). Many studies found conflicting results when examining the correlation between HIV and MDR-TB. The purpose of the present investigation was to comprehensively review the literature on the association between HIV infection and MDR-TB in order to evaluate the impact of HIV on MDR-TB worldwide. Methods Utilizing the databases PubMed, Scopus, Google Scholar, and ScienceDirect, studies published between January 2000 and March 2023 that are eligible for meta-analysis were selected. Using the random-effects model, the aggregated odds ratio of the empirical relationship between HIV and MDR-TB was calculated, along with a confidence interval ranging from 0 to 95 %. Examining the asymmetry of the funnel plot and utilizing Egger's and Begg's test, the possibility of publication bias was investigated. The extent of heterogeneity was determined using the I2 statistics. Results Through a database search, we identified 1214 studies, from which we ultimately selected 15 studies involving 9667 patients. The odds ratio of 2.78 (95 % confidence interval: 1.07-7.20) between HIV/AIDS and MDR-TB indicates a significant positive correlation. Tau 2 = 3.46, chi 2 = 1440.46, df = 14, I2 = 99.0 %, z = 2.10, and p 0.05 indicate that there is substantial heterogeneity among pooled studies. Since I2 is 99 % (>50 %), a random effect model was employed. The percentage of multidrug-resistant HIV-positive patients across all included studies follows a normal distribution, as shown by a Box and whisker plot with a symmetric skewness and a mesokurtic tail and a scatter plot with a significant R2 value below 1 [R2 = 0.2476] showed the positive correlation between multidrug resistance and HIV infection. Conclusion HIV infection increases MDR-TB risk, and the preceding pooled analysis showed an increased risk trend. Thus, MDR-TB, especially in HIV-positive patients, requires early case detection, quality-assured bacteriology diagnosis, and an effective infection control program.
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Affiliation(s)
- Yulong Song
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Qian Jin
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Jihai Qiu
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Dan Ye
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
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Gobis K, Szczesio M, Olczak A, Korona-Głowniak I, Augustynowicz-Kopeć E, Mazernt-Politowicz I, Ziembicka D, Główka ML. Differences in the Structure and Antimicrobial Activity of Hydrazones Derived from Methyl 4-Phenylpicolinimidate. MATERIALS 2022; 15:ma15093085. [PMID: 35591419 PMCID: PMC9103619 DOI: 10.3390/ma15093085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022]
Abstract
Four novel methyl 4-phenylpicolinoimidate derivatives of hydrazone have been synthesized and evaluated for their antimicrobial activity, including tuberculostatic activity. The compounds obtained are condensates of hydrazonamide or hydrazide with 5-nitro-2-furaldehyde or 5-nitro-2-thiophenecarboxaldehyde. The antimicrobial activity of the tested compounds varied. Compound 3b exhibited significant activity against the tested Gram-positive bacteria (7.8–250 µg/mL). The results of structural tests revealed that the compound is the only one obtained in the form of a Z isomer. Tuberculostatic activity tests showed higher activity of derivatives 3a and 4a containing nitrofuran systems (MICs 3.1–12.5 µg/mL). This research allowed us to identify hydrazone 3b as a starting point for further optimization in the search for antimicrobial drugs. Likewise, compound 4a appears to be a good guiding structure for use in future research on new anti-tuberculosis drugs.
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Affiliation(s)
- Katarzyna Gobis
- Department of Organic Chemistry, Medical University of Gdańsk, 107 Gen. Hallera Av., 80-438 Gdansk, Poland;
- Correspondence: ; Tel.: +48-58-349-16-47
| | - Małgorzata Szczesio
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (M.S.); (A.O.); (I.M.-P.); (M.L.G.)
| | - Andrzej Olczak
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (M.S.); (A.O.); (I.M.-P.); (M.L.G.)
| | - Izabela Korona-Głowniak
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Medical University of Lublin, 1 Chodźki Str., 20-093 Lublin, Poland;
| | - Ewa Augustynowicz-Kopeć
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, 26 Płocka Str., 01-138 Warsaw, Poland;
| | - Ida Mazernt-Politowicz
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (M.S.); (A.O.); (I.M.-P.); (M.L.G.)
| | - Dagmara Ziembicka
- Department of Organic Chemistry, Medical University of Gdańsk, 107 Gen. Hallera Av., 80-438 Gdansk, Poland;
| | - Marek L. Główka
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924 Lodz, Poland; (M.S.); (A.O.); (I.M.-P.); (M.L.G.)
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Wang DM, Li QF, Zhu M, Xu YH, Liao Y. Clinical characteristic, Common sites and Drug resistance profile in Culture-confirmed EPTB/ HIV co-infection patients, Southwest of China. J Glob Antimicrob Resist 2021; 28:1-7. [PMID: 34920176 DOI: 10.1016/j.jgar.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 09/03/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES There are few reports on EPTB/HIV co-infection patients, especially the drug resistance profile of culture-confirmed EPTB. The purpose of our study was to analysis the clinical characteristic, common sites and drug resistance profile of culture-confirmed EPTB/HIV co-infection patients in recent years in southwest of China. METHODS A total of 201 EPTB/HIV co-infection cases were selected for this study. Patient demographic and clinical characteristics were collected. Mycobacterium tuberculosis drug sensitivity testing was performed using the microporousplate ratio method. RESULTS For the 2884 culture-confirmed EPTB cases recruited, patients were predominantly male1921/2884(66.6%). Mean age was 31years. Two hundred and one cases were EPTB/ HIV co-infection patients(7.0 %), from 201 cases male make up 84.6% (170/201), mean age was 42 years (range 13-86/year). During the 7-years period, the mean number of EPTB/ HIV co-infection cases was 29 per year(range 12-49/year) at this institution. Diarrhea, headache and fever were the most common presenting symptom.DST results showed the resistance to any anti-tuberculosis drug was observed in 62(30.8%) patient isolates, while multidrug-resistant TB and extensively drug-resistant TB were found in 14(7.0%) and 10(5.0%) patients, respectively. The distribution of EPTB tissue type mainly in Meningeal and Lymph node, varies between different genders. CONCLUSIONS The immune level of EPTB/HIV co-infected patients was low and most were in advanced AIDS stage. Mainly young male, and the site of EPTB was mainly in the Meningeal and Lymph node. The most common symptoms were diarrhea, headache and fever and high rates of drug resistance were found.
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Affiliation(s)
- Dong-Mei Wang
- Department of Science and education division, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China; Department of Clinical Laboratory Medicine, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China.
| | - Qing-Feng Li
- Department of Science and education division, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China; Department of Clinical Laboratory Medicine, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China.
| | - Ma Zhu
- Department of Science and education division, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China; Department of Clinical Laboratory Medicine, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China.
| | - Yuan-Hong Xu
- Department of Science and education division, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China; Department of Clinical Laboratory Medicine, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan 610061, China.
| | - Yi Liao
- Department of Clinical Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China.
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Singh A, Prasad R, Balasubramanian V, Gupta N. Drug-Resistant Tuberculosis and HIV Infection: Current Perspectives. HIV AIDS (Auckl) 2020; 12:9-31. [PMID: 32021483 PMCID: PMC6968813 DOI: 10.2147/hiv.s193059] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/09/2019] [Indexed: 01/26/2023] Open
Abstract
Drug-resistant tuberculosis (DR-TB), including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), is considered a potential obstacle for elimination of TB globally. HIV coinfection with M/XDR-TB further complicates the scenario, and is a potential threat with challenging management. Reports have shown poor outcomes and alarmingly high mortality rates among people living with HIV (PLHIV) coinfected with M/XDR-TB. This coinfection is also responsible for all forms of M/XDR-TB epidemics or outbreaks. Better outcomes with reductions in mortality have been reported with concomitant treatment containing antiretroviral drugs for the HIV component and antitubercular drugs for the DR-TB component. Early and rapid diagnosis with genotypic tests, prompt treatment with appropriate regimens based on drug-susceptibility testing, preference for shorter regimens fortified with newer drugs, a patient-centric approach, and strong infection-control measures are all essential components in the management of M/XDR-TB in people living with HIV.
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Affiliation(s)
- Abhijeet Singh
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi110007, India
| | - Rajendra Prasad
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi110007, India
- Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh226003, India
| | - Viswesvaran Balasubramanian
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, Delhi110007, India
| | - Nikhil Gupta
- Department of Internal Medicine, Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh226010, India
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Mai TQ, Martinez E, Menon R, Van Anh NT, Hien NT, Marais BJ, Sintchenko V. Mycobacterium tuberculosis Drug Resistance and Transmission among Human Immunodeficiency Virus-Infected Patients in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 2019; 99:1397-1406. [PMID: 30382014 DOI: 10.4269/ajtmh.18-0185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Vietnam has a high burden of tuberculosis (TB) and multidrug-resistant (MDR) TB, but drug resistance patterns and TB transmission dynamics among TB/human immunodeficiency virus (HIV) coinfected patients are not well described. We characterized 200 Mycobacterium tuberculosis isolates from TB/HIV coinfected patients diagnosed at the main TB referral hospital in Ho Chi Minh City, Vietnam. Phenotypic drug susceptibility testing (DST) for first-line drugs, spoligotyping, and 24-locus mycobacterial interspersed repetitive unit (MIRU-24) analysis was performed on all isolates. The 24-locus mycobacterial interspersed repetitive unit clusters and MDR isolates were subjected to whole genome sequencing (WGS). Most of the TB/HIV coinfected patients were young (162/174; 93.1% aged < 45 years) males (173; 86.5% male). Beijing (98; 49.0%) and Indo-Oceanic (70; 35.0%) lineage strains were most common. Phenotypic drug resistance was detected in 84 (42.0%) isolates, of which 17 (8.5%) were MDR; three additional MDR strains were identified on WGS. Strain clustering was reduced from 84.0% with spoligotyping to 20.0% with MIRU-24 typing and to 13.5% with WGS. Whole genome sequencing identified five additional clusters, or members of clusters, not recognized by MIRU-24. In total, 13 small (two to three member) WGS clusters were identified, with less clustering among drug susceptible (2/27; 7.4%) than among drug-resistant strains (25/27; 92.6%). On phylogenetic analysis, strains from TB/HIV coinfected patients were interspersed among strains from the general community; no major clusters indicating transmission among people living with HIV were detected. Tuberculosis/HIV coinfection in Vietnam was associated with high rates of drug resistance and limited genomic evidence of ongoing M. tuberculosis transmission among HIV-infected patients.
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Affiliation(s)
- Trinh Quynh Mai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.,Centre for Infectious Disease and Microbiology-Public Health, ICPMR, Westmead Hospital, Sydney, Australia
| | - Elena Martinez
- Centre for Infectious Disease and Microbiology-Public Health, ICPMR, Westmead Hospital, Sydney, Australia.,Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Ranjeeta Menon
- Centre for Infectious Disease and Microbiology-Public Health, ICPMR, Westmead Hospital, Sydney, Australia.,Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | | | | | - Ben J Marais
- Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
| | - Vitali Sintchenko
- Centre for Infectious Disease and Microbiology-Public Health, ICPMR, Westmead Hospital, Sydney, Australia.,Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia
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Konstantynovska O, Rekrotchuk M, Hrek I, Rohozhyn A, Rudova N, Poteiko P, Gerilovych A, Bortz E, Solodiankin O. Severe Clinical Outcomes of Tuberculosis in Kharkiv Region, Ukraine, Are Associated with Beijing Strains of Mycobacterium tuberculosis. Pathogens 2019; 8:pathogens8020075. [PMID: 31185670 PMCID: PMC6631893 DOI: 10.3390/pathogens8020075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/02/2019] [Accepted: 06/06/2019] [Indexed: 11/16/2022] Open
Abstract
Genotypic variation in Beijing lineages of Mycobacterium tuberculosis (MTB), the causative agent of tuberculosis (TB), has been associated with hyper virulence and the spread of extensively and multiple drug (X/MDR) resistant MTB strains in Eastern Europe, Central Asia, and East Asia. The clinical outcomes of 215 new cases of TB among the population of the Kharkiv region of Eastern Ukraine were analyzed to uncover factors associated with severe infection. Infecting MTB strains were profiled by 5 locus exact tandem repeats (ETRs) and 15 locus mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) genotyping. Among diverse MTB genotypes discovered in Ukraine, the Beijing genotype (MIRU-VNTR 42425) was significantly associated with risk factors for severe outcomes of disease in the study population, including TB/HIV co-infection and treatment failure. Strain replacement (superinfection) was observed in 10 patients, suggesting repeated exposure to novel MTB strains in hospital or community settings. Inclusion of MTB genotyping data may identify at-risk patients and improve treatment adherence to prevent X/MDR development for effective public health response against tuberculosis in Ukraine.
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Affiliation(s)
| | - Mariia Rekrotchuk
- National Scientific Center Institute of Experimental and Clinical Veterinary Medicine (NSC IECVM), 61023 Kharkiv, Ukraine.
| | - Ivan Hrek
- Kharkiv Medical Academy of Postgraduate Education, 61176 Kharkiv, Ukraine.
| | - Anton Rohozhyn
- Kharkiv Medical Academy of Postgraduate Education, 61176 Kharkiv, Ukraine.
| | - Nataliia Rudova
- National Scientific Center Institute of Experimental and Clinical Veterinary Medicine (NSC IECVM), 61023 Kharkiv, Ukraine.
| | - Petro Poteiko
- Kharkiv Medical Academy of Postgraduate Education, 61176 Kharkiv, Ukraine.
| | - Anton Gerilovych
- National Scientific Center Institute of Experimental and Clinical Veterinary Medicine (NSC IECVM), 61023 Kharkiv, Ukraine.
| | - Eric Bortz
- Department of Biological Sciences, University of Alaska Anchorage, Anchorage, AK 99508, USA.
| | - Oleksii Solodiankin
- National Scientific Center Institute of Experimental and Clinical Veterinary Medicine (NSC IECVM), 61023 Kharkiv, Ukraine.
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Tuberculosis risk factors and Mycobacterium tuberculosis transmission among HIV-infected patients in Vietnam. Tuberculosis (Edinb) 2019; 115:67-75. [PMID: 30948179 DOI: 10.1016/j.tube.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/18/2018] [Accepted: 02/03/2019] [Indexed: 01/28/2023]
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Zhou M, Liu S, Li Q, Wang Q, Zhu M, Cao L, Wang D, Xu Y, Zheng T, Ye Q, Hu X, Zuo H, Pei X. Drug resistance characteristics of Mycobacterium tuberculosis isolates between 2014 and 2017 in Sichuan, China: A retrospective study. PLoS One 2018; 13:e0209902. [PMID: 30596768 PMCID: PMC6312223 DOI: 10.1371/journal.pone.0209902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 12/13/2018] [Indexed: 02/05/2023] Open
Abstract
Background The prevalence of drug-resistant tuberculosis (DR-TB) has brought severe challenges to the prevention and control of tuberculosis. Studies have explored the status of antituberculosis drug (ATD) resistance in different regions of China. However, few studies have focused on DR-TB in Sichuan to date. Due to the large population in Sichuan, detailed investigations of the DR-TB burden in Sichuan are needed. The objective of this study was to investigate the drug resistance characteristics of TB isolates from tuberculosis patients with and without HIV (TB-HIV patients and TBw/oHIV patients) in Chengdu, Sichuan, China. Methods Isolates from respiratory samples of TBw/oHIV patients and TB-HIV patients hospitalized between January 2014 and December 2017 were collected. Nontuberculosis mycobacteria (NTM) were excluded. Drug sensitivity testing (DST) was performed according to the dilution method in microplates with 4 first-line ATDs and 8 second-line ATDs. TB strains were separated according to patient treatment history, patient age, calendar year and GeneXpert MTB/RIF (GeneXpert) assay results for further analysis. Results For the 7470 patients recruited, the multidrug-resistant tuberculosis (MDR-TB) rate was 2.1-fold (14.6% vs. 6.8%) higher than the national baseline level. The repeatedly admitted patients were more likely to have a resistance profile than the first-time-admitted cases in both the TB-only group (P<0.05) and the TB-HIV corresponding group (P<0.05). Among the 7273 TBw/oHIV cases and 197 TB-HIV cases, the positivity rates of acid-fast bacilli (AFB) in the TB-HIV group were significantly lower than those in the TBw/oHIV group (P<0.05). The repeatedly admitted TB-HIV patients had lower resistance rates to INH than the repeatedly admitted TBw/oHIV patients (24.4% vs. 41.5%, P<0.05). The Rifampicin-resistant TB strains in the TBw/oHIV group were more likely to be resistant to INH in the repeatedly admitted group than those in the first-time admitted patients (P<0.05). The proportions of XDR (3.6% vs. 1.3%, P<0.05) and XDR-TB/MDR-TB (7.3% vs. 2.2%, P<0.05) in all TB-HIV patients were significantly higher than those in all TBw/oHIV patients. The ratio of XDR-TB was significantly higher in the TB-HIV group than in the TBw/oHIV group (30.4% vs. 9.0%, P<0.05) and the all TB group (9.0% vs. 10.1%, P<0.05). Regarding age, the <25-year-old TB-HIV patients (9.1% vs. 0.7%, P<0.05) and 25~44-year-old TB-HIV patients (5.2% vs. 2.4%, P<0.05) were more likely to have a higher XDR proportion than their TBw/oHIV counterparts. The ATD-resistance profile in terms of different years from high to low was 2014>2015>2016≈2017 for TBw/oHIV patients. The same trend was also observed for TB-HIV patients: 2014>2015>2016≈2017. The GeneXpert TB-positive rate in the TBw/oHIV group was higher than that in the TB-HIV group [81%(639/792) vs. 65% (13/20), P<0.05]. In TBw/oHIV cases, the agreement was 92.3% and the Kappa value was 0.75. In TB-HIV cases, the agreement was 85.0% and the Kappa value was 0.32. Conclusion In Sichuan, ATD resistance has improved since 2014, but to date, it remains severe. The different resistance profiles of TBw/oHIV patients and TB-HIV patients indicates the need for personalized treatment plans. Specifically, the GeneXpert assay might be more suitable for TBw/oHIV patients than for TB-HIV patients.
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Affiliation(s)
- Mi Zhou
- Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Shan Liu
- Department of Clinical Laboratory, Affiliated Hospital of University of Electronic Science and Technology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, Sichuan Province, China
| | - Qingfeng Li
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Qiming Wang
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Ma Zhu
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Ling Cao
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Dongmei Wang
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, Public Health Clinical Center of Chengdu, Chengdu, Sichuan Province, China
| | - Tianli Zheng
- Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Qian Ye
- No.4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiuying Hu
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
| | - Haojiang Zuo
- Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail: (HZ); (XP)
| | - Xiaofang Pei
- Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail: (HZ); (XP)
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