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Phenotypic and genotypic analysis of anti-tuberculosis drug resistance in Mycobacterium tuberculosis isolates in Myanmar

Authors
 Wah Wah Aung ; Phyu Win Ei ; Chulhun L. Chang ; Sun Dae Song ; Sang Nae Cho ; Chang Ki Kim ; Jong Seok Lee ; Kyung Jun Kim ; Mi Mi Htwe ; Thandar Lwin ; Thyn Lei Swe ; Wint Wint Nyunt 
Citation
 Annals of Laboratory Medicine, Vol.35(5) : 494~499, 2015 
Journal Title
 Annals of Laboratory Medicine 
ISSN
 2234-3806 
Issue Date
2015
Abstract
BACKGROUND: Tuberculosis (TB) is one of the most serious health problems in Myanmar. Because TB drug resistance is associated with genetic mutation(s) relevant to responses to each drug, genotypic methods for detecting these mutations have been proposed to overcome the limitations of classic phenotypic drug susceptibility testing (DST). We explored the current estimates of drug-resistant TB and evaluated the usefulness of genotypic DST in Myanmar. METHODS: We determined the drug susceptibility of Mycobacterium tuberculosis isolated from sputum smear-positive patients with newly diagnosed pulmonary TB at two main TB centers in Myanmar during 2013 by using conventional phenotypic DST and the GenoType MTBDRplus assay (Hain Lifescience, Germany). Discrepant results were confirmed by sequencing the genes relevant to each type of resistance (rpoB for rifampicin; katG and inhA for isoniazid). RESULTS: Of 191 isolates, phenotypic DST showed that 27.7% (n=53) were resistant to at least one first-line drug and 20.9% (n=40) were resistant to two or more, including 18.3% (n=35) multidrug-resistant TB (MDR-TB) strains. Monoresistant strains accounted for 6.8% (n=13) of the samples. Genotypic assay of 189 isolates showed 17.5% (n=33) MDR-TB and 5.3% (n=10) isoniazid-monoresistant strains. Genotypic susceptibility results were 99.5% (n=188) concordant and agreed almost perfectly with phenotypic DST (kappa=0.99; 95% confidence interval 0.96-1.01). CONCLUSIONS: The results highlight the burden of TB drug resistance and prove the usefulness of the genotypic DST in Myanmar.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/141475
DOI
10.3343/alm.2015.35.5.494
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Microbiology
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