Prevalence and molecular characterizations of seven additional drug resistance among multidrug-resistant tuberculosis in China: A subsequent study of a national survey - 18/03/21
Highlights |
• | Dlm, Lzd, Cfz and Bdq exhibit excellent in vitro activity against MDR-TB, even among the most severe drug resistant pattern, XDR-TB. |
• | High resistance rate against PZA suggests to use this drug with caution. |
• | The existence of drug resistance to all the tested drugs highlighted the necessity of a timely, feasible and reliable DST for them prior to administration. |
Summary |
The drug resistance prevalence data facilitates selection of the initial drug for treating multidrug-resistant tuberculosis (MDR-TB). The aim of this study was to investigate the prevalence and molecular characterization of seven additional types of drug resistances among MDR-TB isolates collected from the first/only nationwide drug resistance surveillance in China. A total of 391 out of the 401 MDR-TB strains were successfully recovered by Löwenstein–Jensen medium. Drug susceptibility testing was performed against moxifloxacin (Mfx), bedaquiline (Bdq), linezolid (Lzd), clofazimine (Cfz), cycloserine (Cs), delamanid (Dlm) and plink?url=3WLS1S8fZrX_slKxdXSlWGrY-yy1pTfFEZywe3tjNzLGXRTzVr7c7XYwX3mlOWwB189aJ1FnGMPyT9SfnxOVA_ (PZA). The strains were subjected to whole-genome sequencing for the analysis corresponding drug resistant genes and their profiles. 269 (68.80%) were simple MDR-TB, 28 (7.16%) were extensively drug-resistant tuberculosis (XDR-TB) and 94 (24.04%) were pre-XDR-TB. Dlm, Lzd, Cfz and Bdq presented the lowest drug resistant rates i.e. 3.32% (13/391), 3.84% (15/391),6.65% (26/391) and 7.16% (28/391), respectively. Mfx (17.39%, 68/391) and CS (13.55%, 53/391) also demonstrated strong potencies against the MDR strains, whereas PZA (38.36%, 150/391) presented much higher resistant rate. 54.41% (37/68) Mfx-resistant strains carried mutations located within gyrA or gyrB. 70.15% (94/134) PZA-resistant strains had pncA mutations. Two of the 26 Cfz-resistant isolates had mutation in Rv0678 were also resistant to Bdq. Dlm, Lzd, Cfz and Bdq exhibited excellent activity against MDR-TB, including XDR-TB. These data highlighted the necessity of a timely, feasible and reliable DST, while genotypic DST for Mfx and PZA is promising at this moment.
Le texte complet de cet article est disponible en PDF.Keywords : Tuberculosis, Multidrug-resistance, Moxifloxacin, Bedaquiline, Linezolid
Plan
Vol 82 - N° 3
P. 371-377 - mars 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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