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ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 5  |  Page : 125-126

Genotypic analysis of multidrug-resistant tuberculosis isolates from extra pulmonary tuberculosis cases in tertiary care centers in Northern India


1 Department of Microbiology, All Institute of Medical Sciences, Jodhpur, India
2 Department of Pulmonary Medicine, King George's Medical University, Lucknow, India
3 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Date of Web Publication17-Feb-2017

Correspondence Address:
Anand K Maurya
Department of Microbiology, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.ijmyco.2016.09.027

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  Abstract 


Objective/background: Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem. The diagnosis of MDR-TB is of paramount importance in establishing appropriate clinical management and infection control measures. Rapid detection of MDR-TB allows the establishment of an effective treatment regimen, minimizes the risk of further resistance, and limits the spread of drug-resistant strains. The aim of this study is to determine the genotypic characterization of MDR-TB isolates from extra pulmonary tuberculosis (EPTB) cases in tertiary care centers in Northern India.
Methods: This study was a prospective study. In total, 756 extra pulmonary specimens were collected from patients with suspected tuberculosis in two tertiary care hospitals in Northern India. Specimens were processed for Ziehl–Neelsen staining, culture, and first-line drug susceptibility test using BacT/ALERT 3D system and GenoType MTBDRplus assay for genotypic analysis of MDR-TB. MDR-TB strains were further processed by novel multiplex polymerase chain reaction for rapid identification of Beijing and non-Beijing strains associated with MDR-TB.
Results: Of these 164 Mycobacterium tuberculosis complex isolates, 100 (60.9%) strains were fully susceptible and 64 (39.1%) strains were resistant. We noted that the prevalence of MDR-TB among EPTB was 22 (13.4%). The prevalence of MDR-TB was 11.4% in new cases and 19.1% in previously treated cases (p <0.05). Ser531Leu mutation was the predominant mutation noted, and Ser315Thr mutation was more prevalent among the MDR-TB isolates (p <0.05). The proportion of Beijing strains was significantly higher among MDR-TB strains (72.7%, p <0.05).
Conclusion: The prevalence (13.4%) of MDR-TB among EPTB was high, and the most prominent mutations in rpoB, katG, and inhA genes were S531L (67.3%), S315T1 (94.5%), and C15T (20%), respectively. Beijing stains are significantly associated with MDR-TB among EPTB in this region. We found that the transmission of prominent mutations contributes to an unexpected increase in primary resistance, including MDR-TB cases in Northern India.

Keywords: Multidrug-resistant tuberculosis, Mycobacterium tuberculosis complex, Tuberculosis


How to cite this article:
Maurya AK, Nag VL, Kant S, Kushwaha RS, Dhole TN. Genotypic analysis of multidrug-resistant tuberculosis isolates from extra pulmonary tuberculosis cases in tertiary care centers in Northern India. Int J Mycobacteriol 2016;5, Suppl S1:125-6

How to cite this URL:
Maurya AK, Nag VL, Kant S, Kushwaha RS, Dhole TN. Genotypic analysis of multidrug-resistant tuberculosis isolates from extra pulmonary tuberculosis cases in tertiary care centers in Northern India. Int J Mycobacteriol [serial online] 2016 [cited 2019 Nov 17];5, Suppl S1:125-6. Available from: http://www.ijmyco.org/text.asp?2016/5/5/125/200373




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None.






 

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