Resistance to First-line Drugs in Clinical Isolates of Mycobacterium tuberculosis in Isfahan

Document Type : Original Article(s)

Authors

1 MSc, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Assistant Professor, Department of Microbiology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran

3 Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Tuberculosis (TB) remains a serious public health problem worldwide, causing millions of deaths annually. It is estimated that one-third of the world population is infected with latent TB. Drug-resistant TB is considered a major and growing global threat. In this study, we aimed to indicate the drug-susceptibility of Mycobacterium tuberculosis isolates from patients, presented to Mollahadi Sabzevari Tuberculosis Center in Isfahan, Iran to the first-line drugs.
Methods: In this study, Mycobacterium tuberculosis was isolated from 438 patients with pulmonary tuberculosis referred to the Regional Reference Laboratory of tuberculosis in Isfahan province during 2017-2019, 33 resistant isolates were studied. Drug susceptibility testing to first-line drugs was performed by proportion method, and the H37Rv reference strain sensitive to all drugs was used for quality control.
Findings: Out of 438 isolates, 20 isolates (37.7%) were drug-sensitive and 33 isolates (62.3%) were resistant to the first-line drug by phenotypic method, which was isoniazid (INH) 22 isolates (66.7%), rifampin (RIF)
18 isolates (54.5%), ethambutol (EMB) 4 isolates (12.1%) and pyrazinamide (PZA) 5 isolates (15.2%) respectively. Also, 10 isolates (30.3%) were multidrug-resistant tuberculosis (MDR-TB).
Conclusion: The pattern of drug resistance in Mycobacterium tuberculosis is different in each region and in the Isfahan region due to the increasing drug resistance of tuberculosis. Further research is needed to determine the drug resistance of Mycobacterium tuberculosis.

Keywords

References

  1. Lee H, Bang HE, Bai GH, Cho SN. Novel polymorphic region of the rpoB gene containing Mycobacterium species-specific sequences and its use in identification of mycobacteria. J Clin Microbiol 2003; 41(5): 2213-8.
  2. Laws M, Jin P, Rahman KM. Efflux pumps in Mycobacterium tuberculosis and their inhibition to tackle antimicrobial resistance. Trends Microbiol 2022; 30(1): 57-68.
  3. Ramakrishnan L. Revisiting the role of the granuloma in tuberculosis. Nat Rev Immunol 2012; 12(5): 352-66.
  4. Berrocal-Almanza LC, Harris RJ, Collin SM, Muzyamba MC, Conroy OD, Mirza A, et al. Effectiveness of nationwide programmatic testing and treatment for latent tuberculosis infection in migrants in England: a retrospective, population-based cohort study. Lancet Public Health 2022; 7(4): e305-15.
  5. Almeida Da Silva PEA, Palomino JC. Molecular basis and mechanisms of drug resistance in Mycobacterium tuberculosis: classical and new drugs. J Antimicrob Chemother 2011; 66(7): 1417-30.
  6. Kaniga K, Hasan R, Jou R, Vasiliauskienė E, Chuchottaworn C, Ismail N, et al. Bedaquiline drug resistance emergence assessment in multidrug-resistant tuberculosis (MDR-TB): a 5-year prospective in vitro surveillance study of bedaquiline and other second-line drug susceptibility testing in MDR-TB isolates. J Clin Microbiol 2022; 60(1): e02919-20.
  7. Somoskovi A, Parsons LM, Salfinger M. The molecular basis of resistance to isoniazid, rifampin, and pyrazinamide in Mycobacterium tuberculosis. Respir Res 2001; 2(3): 164-8.
  8. Deelder W, Napier G, Campino S, Palla L, Phelan J, Clark TG. A modified decision tree approach to improve the prediction and mutation discovery for drug resistance in Mycobacterium tuberculosis. BMC Genomics 2022; 23(1): 46.
  9. Schmalstieg AM, Srivastava S, Belkaya S, Deshpande D, Meek C, Leff R, et al. The antibiotic resistance arrow of time: efflux pump induction is a general first step in the evolution of mycobacterial drug resistance. Antimicrob Agents Chemother 2012; 56(9): 4806-15.
  10. Norouzi F, Moghim S, Farzaneh S, Fazeli H, Salehi M, Nasr Esfahani B. Significance of the coexistence of non-codon 315 katG, inhA, and oxyR-ahpC intergenic gene mutations among isoniazid-resistant and multidrug-resistant isolates of Mycobacterium tuberculosis: a report of novel mutations. Pathog
    Glob Health 2022; 116(1): 22-9.
  11. Ghosh HK, Cobb M, Pacey DP, Conklin S. Experience with a simplification of the petroff method for laboratory diagnosis of mycobacteria in sputum. Pathology 1978; 10(3): 257-61.
  12. Cook VJ, Turenne CY, Wolfe J, Pauls R, Kabani A. Conventional methods versus 16S ribosomal DNA sequencing for identification of nontuberculous mycobacteria: cost analysis. J Clin Microbiol 2003; 41(3): 1010-5.
  13. Riyahi Zaniani F, Moghim S, Mirhendi H, Ghasemian Safaei H, Fazeli H, Salehi M, et al. Genetic lineages of mycobacterium tuberculosis isolates in Isfahan, Iran. Curr Microbiol 2017; 74(1): 14-21.
  14. Mulcahy GM, Kaminski ZC, Albanese EA, Sood R, Pierce M. IS6110-based PCR methods for detection of Mycobacterium tuberculosis. J Clin Microbiol 1996; 34(5): 1348-9.
  15. Forbes BA, Hall GS, Miller MB, Novak SM, Rowlinson MC, Salfinger M, et al. Practical guidance for clinical microbiology laboratories: mycobacteria. Clin Microbiol Rev 2018; 31(2): e00038-17.
  16. Motavaf B, Keshavarz N, Ghorbanian F, Firuzabadi S, Hosseini F, Bostanabad SZ. Detection of genomic mutations in katG and rpoB genes among multidrug-resistant Mycobacterium tuberculosis isolates from Tehran, Iran. New Microbes New Infect 2021; 41: 100879.
  17. Sirous M, Khosravi AD, Tabandeh MR, Salmanzadeh S, Ahmadkhosravi N, Amini S. Molecular detection of rifampin, isoniazid, and ofloxacin resistance in Iranian isolates of Mycobacterium tuberculosis by high-resolution melting analysis. Infect Drug Resist 2018; 11: 1819-29.
  18. Safari M, Moghim S, Salehi M, Jafari R, Nasr Esfahani B. Sequence-based detection of first-line and second-line drugs resistance-associated mutations in Mycobacterium tuberculosis isolates in Isfahan, Iran. Infect Genet Evol 2020; 85: 104468.
  19. Mohammadi B, Mohajeri P, Rouhi S, Ramazanzadeh R. The relationship between embb306 and embb406 mutations and ethambutol resistant in Mycobacterium tuberculosis isolated from patiens in west of Iran. Med J Islam Repub Iran 2018; 32: 117.
  20. Keikha M. The genetic diversity of pncA & rpsA gene in clinical isolates of Mycobacterium tuberculosis in Isfahan Province [in Persian]. [Thesis]. Isfahan, Iran: Isfahan University of Medical Sciences; 2018.
Journal of Isfahan Medical School
Volume 40, Issue 685
1st Week, November
November and December 2022
Pages 654-658

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History

  • Receive Date: 09 May 1401
  • Accept Date: 16 July 1401

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