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Drug Resistance in Tuberculous Lymphadenitis: Molecular Characterization.

Gebeyehu Assefa1,2, Kassu Desta2, Shambel Araya2

  • 1Armauer Hansen Research Institute, AHRI, Addis Ababa, Ethiopia.

Tuberculosis Research and Treatment
|April 10, 2023
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Drug-resistant tuberculosis (TB) in Ethiopia is a challenge. We found drug resistance and common gene mutations in mycobacterial isolates from tuberculous lymphadenitis (TBLN) patients, with isoniazid resistance being most common.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genetics

Background:

  • Drug-resistant tuberculosis (TB) presents a significant challenge, particularly in high-incidence countries like Ethiopia.
  • Tuberculous lymphadenitis (TBLN) is a common form of extrapulmonary TB, and understanding its drug resistance patterns is crucial.

Purpose of the Study:

  • To investigate drug resistance patterns in Mycobacterium tuberculosis (MTB) isolates from TBLN patients in Ethiopia.
  • To identify common gene mutations associated with drug resistance.
  • To perform molecular characterization of the MTB strains.

Main Methods:

  • A cross-sectional study was conducted on 218 Fine Needle Aspiration (FNA) samples from TBLN patients.
  • Mycobacterial isolates were identified using Polymerase Chain Reaction (PCR) and the RD9 test.
  • Drug resistance was assessed using the GenoType MTBDRplus assay, and spoligotyping was performed for molecular characterization.

Main Results:

  • Out of 50 culture-positive isolates, 14% exhibited drug resistance due to gene mutations.
  • Isoniazid (INH) mono-resistance was observed in 8% of isolates, linked to mutations in the *katG* gene.
  • 3% of isolates were resistant to both rifampicin and isoniazid, with mutations in *katG* and *rpoB* genes.

Conclusions:

  • The high prevalence of INH mono-resistance is a critical risk factor for the development of multidrug-resistant TB (MDR-TB).
  • Orphan and SIT53 strains were the most common spoligotypes identified.
  • The presence of drug-resistant strains with common mutations suggests potential transmission of clonal-resistant strains within the community.