Investigation of Strain Diversity and Trend of Drug Resistance Pattern of the Clinical isolates from Tuberculosis lymphadenitis Patients in Two different Cities of Ethiopia
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Date
2023-06
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Addis Ababa University
Abstract
Background: Identification of Mycobacterium tuberculosis strain have a significant contribution
to the understanding of genetic diversity in a particular area. The most commonly occurring type
of extra-pulmonary tuberculosis is TB Lymphadenitis. Tuberculosis (TB) is a complicated and
chronic infectious disease and severely affect the organs. Investigating and understanding the
association between Molecular characteristics and drug susceptibility of (MTBC) strains are
important to comprehend the transmission dynamics and drug resistance pattern.
Objective: To investigate strain diversity and trends of drug resistance pattern of the clinical
isolates from Tuberculosis lymphadenitis (TBLN) patients in two different cities of Ethiopia.
Methods: Institution-based cross-sectional study was conducted from 52 previously stored isolates
collected from TBLN patients in 2019 from Ambo and from ALERT comprehensive hospital in
2021. Sub-culture using LJ, Line Probe Assay, and Spoligotyping were performed from the stored
isolates. Descriptive statistics were used to present frequency of data. A statistical analysis was
done using SPSS Version 26. A test with a P value of < 0.05 was considered statistically
significant.
Results: A total of 52 culture positive confirmed M. tuberculosis isolates have been used for drug
sensitivity testing and strain identification. Out of the 52 spoligotype patterns (strains), 29 isolates
matched the preexisting patterns in the SITVIT2 database, the rest 23 found to be new or orphan
strains according to SITVIT2 database. Classification of MTBC strains from both cities showed
the occurrence of the following predominant lineages, Euro-American (40/52 76.9%), followed by
Indo-Oceanic (2/52; 3.8%), and East-African (9/52;17.30%). isolates in two different cities were
investigated, isolates from ambo collected in 2019 identified to be sensitive for all major anti-TB
drugs. However, culture positive samples collected in 2021 from Addis Ababa have shown
resistant strain for both anti TB-drugs, 4 (15%), 3(11.5%) of them have been resistance to both
RIF and INH, and the rest 1 isolate were Mono- resistant to INH 1 (3.8%).
Conclusion: This study determines the association of drug resistant TB with corresponding lineage
and molecular epidemiology in patients with tuberculous lymphadenitis. Lineage 3 and Lineage 4
represented to be most prevalent lineage of M. tuberculosis with high clustering rates of SIT 125,
SIT149 and SIT 53, more over these lineages are associated with most of drug resistance M.
tuberculosis.
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Keywords
Extra-Pulmonary tuberculosis, Line probe assay, and Drug resistance.