Article
Laboratory-based study of drug resistance and genotypic profile of multidrug-resistant tuberculosis isolates in Salvador, Bahia, Brazil
Registro en:
SOUSA, Erivelton de Oliveira et al. Laboratory-based study of drug resistance and genotypic profile of multidrug-resistant tuberculosis isolates in Salvador, Bahia, Brazil. Journal of the Brazilian Society of Tropical Medicine, v. 55, p. 1-10, 2022.
1678-9849
10.1590/0037-8682-0013-2022
Autor
Sousa, Erivelton de Oliveira
Carneiro, Rita Terezinha de Oliveira
Montes, Fátima Cristina Onofre Fandinho
Conceição, Emilyn Costa
Bartholomay, Patricia
Marinho, Jamocyr Moura
Lima, Karla Valéria Batista
Natividade, Marcio Santos da
Araújo, Wildo Navegantes de
Matos, Eliana Dias
Barbosa, Theolis
Resumen
Fundação de Amparo a Pesquisa do Estado da Bahia (FAPESB).
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Background: Surveillance of multidrug resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB) is essential to guide disease dissemination control measures. Brazil contributes to a significant fraction of tuberculosis (TB) cases worldwide, but only few reports addressed MDR/XDR-TB in the country. Methods: This cross-sectional, laboratory-based study describes the phenotypic resistance profiles of isolates obtained between January 2008 and December 2011 in Bahia, Brazil, and sociodemographic, epidemiological, and clinical characteristics (obtained from mandatory national registries) of the corresponding 204 MDR/XDR-TB patients. We analyzed the mycobacterial spoligotyping and variable number of tandem repeats of mycobacterial interspersed repetitive units in 12-loci profiles obtained from Salvador. Results: MDR/XDR-TB patients were predominantly male, had a median age of 43 years, belonged to black ethnicity, and failed treatment before MDR-TB diagnosis. Nearly one-third of the isolates had phenotypic resistance (evaluated by mycobacteria growth indicator tube assay) to second-line anti-TB drugs (64/204, 31%), of which 22% cases (14/64) were diagnosed as XDR-TB. Death was a frequent outcome among these individuals and was associated with resistance to second-line anti-TB drugs. Most isolates successfully genotyped belonged to the Latin-American Mediterranean (LAM) Family, with an unprecedented high proportion of LAM10-Cameroon subfamily bacilli. More than half of these isolates were assigned to a unique cluster by the genotyping methods performed. Large clusters of identical genotypes were also observed among LAM SIT42 and SIT376 strains. Conclusions: We highlight the need for strengthening local and national efforts to perform early detection of TB drug resistance and to prevent treatment discontinuation to limit the emergence of drug-resistant strains.