Molecular characterization and drug resistance pattern of Mycobacterium tuberculosis complex among confirmed extrapulmonary tuberculosis cases in Addis Ababa, Ethiopia
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Date
2020-06
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Addis Abeba University
Abstract
Background: Molecular characterization and drug-resistant of Mycobacterium tuberculosis is a
valuable tool in understanding the pathogenesis, diagnosis treatment, and prevention of
tuberculosis. However, there is limited information on molecular characterization, and drugresistant
patterns of Mycobacterium tuberculosis in patients with extrapulmonary tuberculosis in
Ethiopia.
Objective: This study aimed to determine the molecular characteristic and drug resistance
patterns of Mycobacterium tuberculosis complex among confirmed extrapulmonary tuberculosis
cases in Addis Ababa, Ethiopia
Methods: A laboratory-based cross-sectional study was conducted among confirmed
extrapulmonary tuberculosis cases in Addis Ababa, Ethiopia in a period between November
2019 and April 2020. Drug susceptibility test was performed using BACTEC-MGIT 960 and
Line probe assay. Strain identification was performed using the Geno-Type MTBC and
spoligotyping technique. Data were entered into the international spoligotyping database to
assess the spoligotype patterns of Mycobacterium tuberculosis. Data was analyzed by SPSS
version 23 and participants’ characteristics were presented by number and proportion.
Results: Of 151 Mycobacterium tuberculosis complex isolates, 29 (19.2%) were resistant to at
least one drug, and 14 (9.3%) were identified as multidrug-resistant tuberculosis. Besides,
21.4% (3/14) of isolates had pre-extensively drug-resistant tuberculosis. S315Tl (11.9% (18/151)
was the most common isoniazid mutation observed in the katG gene. The spoligotyping of the
151 isolates resulted in 41 different spoligotype patterns. The most abundantly represented SITs
were: SIT149 21.2% (33/151), SIT53 14.6% (22/151) and SIT26 9.6% (14/151). The most
predominant lineage was T family 55.0% (83/151), Central Asia Strain 19.2% (29/151) and
Haarlem consisted of 8.0% (12/151). Also, 5 (3.3%) isolates had no matching with the database.
Conclusion: The present study showed a high proportion of multidrug-resistant tuberculosis and
pre-extensively drug-resistant tuberculosis among EPTB patients. The strain was mostly grouped
into SIT149, SIT53, and SIT26. A large scale is required to define the molecular characteristics
and drug resistance of Mycobacterium tuberculosis in extrapulmonary tuberculosis patients.
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Keywords
Extrapulmonary Tuberculosis, Molecular typing, Mutations, multidrug-resistant tuberculosis and pre-extensively drug-resistant tuberculosis