Skip to main content
Top
Published in: BMC Clinical Pathology 1/2010

Open Access 01-12-2010 | Research article

Use of the GenoType® MTBDRplus assay to assess drug resistance of Mycobacterium tuberculosis isolates from patients in rural Uganda

Authors: Joel Bazira, Benon B Asiimwe, Moses L Joloba, Fred Bwanga, Mecky I Matee

Published in: BMC Clinical Pathology | Issue 1/2010

Login to get access

Abstract

Background

Drug resistance levels and patterns among Mycobacterium tuberculosis isolates from newly diagnosed and previously treated tuberculosis patients in Mbarara Uganda were investigated.

Methods

We enrolled, consecutively, all newly diagnosed and previously treated smear-positive TB patients aged ≥ 18 years. Isolates were tested for drug resistance against rifampicin (RIF) and isoniazid (INH) using the Genotype® MDRTBplus assay and results were compared with those obtained by the indirect proportion method on Lowenstein-Jensen media. HIV testing was performed using two rapid HIV tests.

Results

A total of 125 isolates from 167 TB suspects with a mean age 33.7 years and HIV prevalence of 67.9% (55/81) were analysed. A majority (92.8%) of the participants were newly presenting while only 7.2% were retreatment cases. Resistance mutations to either RIF or INH were detected in 6.4% of the total isolates. Multidrug resistance, INH and RIF resistance was 1.6%, 3.2% and 4.8%, respectively. The rpoβ gene mutations seen in the sample were D516V, S531L, H526Y H526 D and D516V, while one strain had a Δ1 mutation in the wild type probes. There were three strains with katG (codon 315) gene mutations while only one strain showed the inhA promoter region gene mutation.

Conclusion

The TB resistance rate in Mbarara is relatively low. The GenoType® MTBDRplus assay can be used for rapid screening of MDR-TB in this setting.
Literature
1.
go back to reference Anti-tuberculosis drug resistance in the world. Fourth global report WHO/HTM/TB/2008.394. World Health Organization, Geneva Anti-tuberculosis drug resistance in the world. Fourth global report WHO/HTM/TB/2008.394. World Health Organization, Geneva
2.
go back to reference World Health Organisation: Global tuberculosis control: surveillance, planning, financing. 2009, Geneva: WHO World Health Organisation: Global tuberculosis control: surveillance, planning, financing. 2009, Geneva: WHO
3.
go back to reference Joloba MLWC, Cave DM, Eisenach KD, Johnson JL, Okwera A, Morrissey A, Bajaksouzian S, Feagin J, Mugerwa R, et al: Determination of drug susceptibility and DNA fingerprint patterns of clinical isolates of Mycobacterium tuberculosis from Kampala, Uganda. East Afr Med J. 2000, 77: 111-115.PubMed Joloba MLWC, Cave DM, Eisenach KD, Johnson JL, Okwera A, Morrissey A, Bajaksouzian S, Feagin J, Mugerwa R, et al: Determination of drug susceptibility and DNA fingerprint patterns of clinical isolates of Mycobacterium tuberculosis from Kampala, Uganda. East Afr Med J. 2000, 77: 111-115.PubMed
4.
go back to reference Temple BAI, Ogwang S, Nabanjja H, Kayes S, Nakubulwa S, Worodria W, Levin J, Joloba M, Okwera A, et al: Rate and amplification of drug resistance among previously-treated patients with tuberculosis in Kampala, Uganda. Clin Infect Dis. 2008, 47: 1126-1134. 10.1086/592252.CrossRefPubMedPubMedCentral Temple BAI, Ogwang S, Nabanjja H, Kayes S, Nakubulwa S, Worodria W, Levin J, Joloba M, Okwera A, et al: Rate and amplification of drug resistance among previously-treated patients with tuberculosis in Kampala, Uganda. Clin Infect Dis. 2008, 47: 1126-1134. 10.1086/592252.CrossRefPubMedPubMedCentral
5.
go back to reference Asiimwe BB, et al: Mycobacterium tuberculosis spoligotypes and drug susceptibility pattern of isolates from tuberculosis patients in peri-urban Kampala, Uganda. BMC Infect Dis. 2008, 8: 101-10.1186/1471-2334-8-101.CrossRefPubMedPubMedCentral Asiimwe BB, et al: Mycobacterium tuberculosis spoligotypes and drug susceptibility pattern of isolates from tuberculosis patients in peri-urban Kampala, Uganda. BMC Infect Dis. 2008, 8: 101-10.1186/1471-2334-8-101.CrossRefPubMedPubMedCentral
6.
go back to reference Makinen JMH, Marjamaki M, Viljanen MK, Soini H: Comparison of two commercially available DNA line probe assays for detection of multidrug-resistant Mycobacterium tuberculosis. J Clin Microbiol. 2006, 44 (2): 350-352. 10.1128/JCM.44.2.350-352.2006.CrossRefPubMedPubMedCentral Makinen JMH, Marjamaki M, Viljanen MK, Soini H: Comparison of two commercially available DNA line probe assays for detection of multidrug-resistant Mycobacterium tuberculosis. J Clin Microbiol. 2006, 44 (2): 350-352. 10.1128/JCM.44.2.350-352.2006.CrossRefPubMedPubMedCentral
7.
go back to reference Miotto PPF, Cirillo DM, Migliori GB: Genotype MTBDRplus: a further step toward rapid identification of drug-resistant Mycobacterium tuberculosis. J Clin Microbiol. 2008, 46 (1): 393-394. 10.1128/JCM.01066-07.CrossRefPubMed Miotto PPF, Cirillo DM, Migliori GB: Genotype MTBDRplus: a further step toward rapid identification of drug-resistant Mycobacterium tuberculosis. J Clin Microbiol. 2008, 46 (1): 393-394. 10.1128/JCM.01066-07.CrossRefPubMed
8.
go back to reference Barnard MAH, Coetzee G, O'Brien R, Bosman ME: Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Am J Respir Crit Care Med. 2008, 177 (7): 787-792. 10.1164/rccm.200709-1436OC.CrossRefPubMed Barnard MAH, Coetzee G, O'Brien R, Bosman ME: Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Am J Respir Crit Care Med. 2008, 177 (7): 787-792. 10.1164/rccm.200709-1436OC.CrossRefPubMed
9.
go back to reference Republic of Uganda, M.o.H: National tuberculosis and Leprosy programme South Western Uganda. Annual report. 2008 Republic of Uganda, M.o.H: National tuberculosis and Leprosy programme South Western Uganda. Annual report. 2008
10.
go back to reference Kent PTKG: Public health mycobacteriology: A guide for the level III laboratory. U. S. department of Health and Human Services. Centres for Disease Control, Atlanta, Ga. 1985, Centres for Disease Control, Atlanta, Ga Kent PTKG: Public health mycobacteriology: A guide for the level III laboratory. U. S. department of Health and Human Services. Centres for Disease Control, Atlanta, Ga. 1985, Centres for Disease Control, Atlanta, Ga
11.
go back to reference Republic of Uganda, M.o.H: Manual of the National Tuberculosis and Leprosy programme in Uganda for district TB/Leprosy supervisors. 1992, First Republic of Uganda, M.o.H: Manual of the National Tuberculosis and Leprosy programme in Uganda for district TB/Leprosy supervisors. 1992, First
12.
go back to reference Laboratory services in tuberculosis control. Part 2. Microscopy. WHO document WHO/TB/98.258. Geneva. Laboratory services in tuberculosis control. Part 2. Microscopy. WHO document WHO/TB/98.258. Geneva.
13.
go back to reference Bretzel GAM, Wendl-Richter U, Adatu F, Aisu T, van Wijnen A, Sticht-Groh V: Anti-tuberculosis drug resistance surveillance in Uganda 1996-1997. Int J Tuberc Lung Dis. 1999, 3 (9): 810-815.PubMed Bretzel GAM, Wendl-Richter U, Adatu F, Aisu T, van Wijnen A, Sticht-Groh V: Anti-tuberculosis drug resistance surveillance in Uganda 1996-1997. Int J Tuberc Lung Dis. 1999, 3 (9): 810-815.PubMed
14.
go back to reference Oola J: Factors influencing Delayed diagnosis of tuberculosis in Mukono District Uganda. 2001, Institute of Public Health Oola J: Factors influencing Delayed diagnosis of tuberculosis in Mukono District Uganda. 2001, Institute of Public Health
15.
go back to reference Umubyeyi ANVG, Gasana M, Basinga P, Zawadi JP, Gatabazi J, Pauwels P, Nzabintwali F, Nyiramasarabwe L, Fissette K, Rigouts L, Struelens MJ, Portaels F: Results of a national survey on drug resistance among pulmonary tuberculosis patients in Rwanda. Int J Tuberc Lung Dis. 2007, 11 (2): 189-194.PubMed Umubyeyi ANVG, Gasana M, Basinga P, Zawadi JP, Gatabazi J, Pauwels P, Nzabintwali F, Nyiramasarabwe L, Fissette K, Rigouts L, Struelens MJ, Portaels F: Results of a national survey on drug resistance among pulmonary tuberculosis patients in Rwanda. Int J Tuberc Lung Dis. 2007, 11 (2): 189-194.PubMed
16.
go back to reference Kibiki GSMB, Dolmans WM, de Beer JL, Boeree M, Sam N, van Soolingen D, Sola C, Zanden AG: M. tuberculosis genotypic diversity and drug susceptibility pattern in HIV-infected and non-HIV-infected patients in northern Tanzania. BMC Microbiol. 2007, 7 (51): Kibiki GSMB, Dolmans WM, de Beer JL, Boeree M, Sam N, van Soolingen D, Sola C, Zanden AG: M. tuberculosis genotypic diversity and drug susceptibility pattern in HIV-infected and non-HIV-infected patients in northern Tanzania. BMC Microbiol. 2007, 7 (51):
17.
go back to reference Murray J: The white plague: down and out, or up and coming?. Am Rev Respir Dis. 1989, 140: 1788-1795.CrossRefPubMed Murray J: The white plague: down and out, or up and coming?. Am Rev Respir Dis. 1989, 140: 1788-1795.CrossRefPubMed
18.
go back to reference Nikolayevskyy V, et al: Performance of the Genotype MTBDRPlus assay in the diagnosis of tuberculosis and drug resistance in Samara, Russian Federation. BMC Clin Pathol. 2009, 9: 2-10.1186/1472-6890-9-2.CrossRefPubMedPubMedCentral Nikolayevskyy V, et al: Performance of the Genotype MTBDRPlus assay in the diagnosis of tuberculosis and drug resistance in Samara, Russian Federation. BMC Clin Pathol. 2009, 9: 2-10.1186/1472-6890-9-2.CrossRefPubMedPubMedCentral
19.
go back to reference Miotto P, et al: Use of genotype MTBDR assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis clinical strains isolated in Italy. J Clin Microbiol. 2006, 44 (7): 2485-91. 10.1128/JCM.00083-06.CrossRefPubMedPubMedCentral Miotto P, et al: Use of genotype MTBDR assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis clinical strains isolated in Italy. J Clin Microbiol. 2006, 44 (7): 2485-91. 10.1128/JCM.00083-06.CrossRefPubMedPubMedCentral
20.
go back to reference Baldeviano-Vidalon GCQ-TN, Bonilla-Asalde C, Gastiaburu-Rodriguez D, Pro-Cuba JE, Llanos-Zavalaga F: Multiple infection with resistant and sensitive M. tuberculosis strains during treatment of pulmonary tuberculosis patients. Int J Tuberc Lung Dis. 2005, 9 (10): 1155-1160.PubMed Baldeviano-Vidalon GCQ-TN, Bonilla-Asalde C, Gastiaburu-Rodriguez D, Pro-Cuba JE, Llanos-Zavalaga F: Multiple infection with resistant and sensitive M. tuberculosis strains during treatment of pulmonary tuberculosis patients. Int J Tuberc Lung Dis. 2005, 9 (10): 1155-1160.PubMed
Metadata
Title
Use of the GenoType® MTBDRplus assay to assess drug resistance of Mycobacterium tuberculosis isolates from patients in rural Uganda
Authors
Joel Bazira
Benon B Asiimwe
Moses L Joloba
Fred Bwanga
Mecky I Matee
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Clinical Pathology / Issue 1/2010
Electronic ISSN: 1472-6890
DOI
https://doi.org/10.1186/1472-6890-10-5

Other articles of this Issue 1/2010

BMC Clinical Pathology 1/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.