Isoniazid-resistant tuberculosis in Denmark: Mutations, transmission and treatment outcome - 07/08/11
, Peter Henrik Andersen b, Åse Bengaard Andersen c, Vibeke Østergaard Thomsen a
Corresponding author. International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Artillerivej 5, DK-2300, Copenhagen S, Denmark. Tel.: +45 32683705; fax: +45 32683871.Summary |
Objectives |
A retrospective study on isoniazid-resistant tuberculosis (TB) was conducted in the low-burden country, Denmark (DK). The aim was to describe treatment outcome and transmission and to evaluate a mutation analysis for high- and low-level isoniazid resistance detection.
Methods |
In the period 2002–2007, all isoniazid-resistant TB-cases were included. Molecular genotyping was performed by standardized IS6110 restriction fragment length polymorphism (RFLP). Identical isoniazid-resistant genotypes, indicating ongoing transmission, were identified from the national RFLP database. An analysis of rifampin (rpoB) and high- or low-level (katG, inhA) isoniazid resistance mutations was performed on subcultured strains.
Results |
There were 1825 culture-confirmed cases, of which 111 (6.1%) had monoresistance or polyresistance to isoniazid. Successful short- and long-term treatment outcome was achieved in 80% and 95%, respectively. Overall, the mutation analysis predicted 94% of isoniazid resistance in 111 strains. The katG S315T1 and inhA C15T1 mutations correctly identified high- and low-level isoniazid resistance in 84% and 84% of the strains, respectively.
Conclusions |
Isoniazid-resistant TB has a good prognosis in DK. High- and low- level isoniazid resistance does not affect treatment outcome of standard modified treatment. Rapid mutation detection identified the majority of isoniazid-resistant cases however the impact on treatment outcome remains to be determined.
Le texte complet de cet article est disponible en PDF.Keywords : Resistance, Therapy, Restriction fragment length polymorphism, katG, inhA, rpoB
Plan
 | The study was approved by the Biomedical Research Ethic Committee (1999-11-087) and the Danish Data Protection agency (2001-41-1018). |
Vol 60 - N° 6
P. 452-457 - juin 2010 Retour au numéro
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