Drug resistance and associated genetic mutations among patients with suspected MDR-TB in Uttar Pradesh, India

Jain, A. and Singh, P. K. and Chooramani, G. and Dixit, P. and Malhotra, H. S. (2016) Drug resistance and associated genetic mutations among patients with suspected MDR-TB in Uttar Pradesh, India Int J Tuberc Lung Dis, 20 (7). pp. 870-875.

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Abstract

SETTING: Programmatic Management of Drug-Resistant Tuberculosis (PMDT) programme in 32 districts of Uttar Pradesh (UP), India. OBJECTIVE: To provide epidemiological status of multidrug-resistant tuberculosis (MDR-TB) and associated microbial genetic mutations among suspected cases in UP. DESIGN: We retrospectively studied and tested using line-probe assay (LPA) 4895 retreatment patients with suspected MDR-TB who were enrolled for PMDT during 2012-2015. The demographic characteristics of cases, LPA-determined drug resistance, the genetic mutation profile, trends in drug resistance over the study period as well as the comparative performance of LPA and phenotypic drug susceptibility testing (DST) were analysed. RESULTS: MDR-TB and rifampicin-resistant TB (RR-TB) were confirmed in respectively 34.5% and 40.3% cases. The RR-TB detection rate (a valid proxy for MDR-TB) initially declined during the study period. Age ⩿30 years and implemented MDR-TB suspicion criteria were independent predictors for RR-TB (P <0.01). LPA indicated predominant distribution of S531L (1483/1970, 75.3%) and S315T1 (1981/2116, 93.6%) mutations in the rpoB and katG genes, respectively, and had >94.0% agreement with phenotypic DST in determining rifampicin/isoniazid resistance. CONCLUSION: MDR-TB prevalence in retreatment cases is very high, highlighting the need to reduce the development and transmission of drug-resistant TB.

Item Type: Article
Uncontrolled Keywords: Mycobacterium tuberculosis; Multidrugresistant tuberculosis; Line-probe assay; GenoTypew MTBDRplus assay
Subjects: Tuberculosis > PMDT
Tuberculosis > Drug Resistant TB
Institutions: National Task Force, Zonal Task Force & State Task Force of Medical Colleges
Depositing User: Mr SANJAY SINGH
Date Deposited: 06 Sep 2016 06:58
Last Modified: 06 Sep 2016 06:58
URI: http://tbresearch.ntiindia.org.in/id/eprint/2224

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