PREVALENCE OF RIFAMPICIN-RESISTANT TUBERCULOSIS AND ITS ASSOCIATED FACTORS IN A TERTIARY HEALTH CARE CENTRE, SOUTH-WEST NIGERIA: A 5-YEAR REVIEW

Background: Tuberculosis is a chronic disease with associated high morbidity and mortality. In recent decades, there has been an increase in resistance to drugs used in the treatment of tuberculosis. This is a major stumbling block in the global fight against tuberculosis. This study was to demonstrate the current prevalence of rifampicinresistant tuberculosis and its associated predisposing factors in a Teaching Hospital in Nigeria. Methods: This was a cross-sectional retrospective study involving 359 consecutive patients with bacteriologically confirmed tuberculosis seen between January 2015 and December 2019. Drug susceptibility testing was performed for rifampicin using GeneXpert MTB/RIF assay. Relevant information was obtained from the clinical records of the patients with the use of a well-structured proforma. The data obtained were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0. Results: There were a total of 359 patients out of which the majority, 235 (65.5%) were males. The mean age was 39.78+16.31 (range 1 - 90 years). A larger percentage of the subjects were new cases of tuberculosis (n=312, 86.9%), 49(13.6%) were HIV positive. The overall prevalence of rifampicin resistance found was 2.5% (n=9/359). There was a significant association between gender (p=0.005) and re-treatment (p=0.003). There was no significant association between rifampicin resistance and other factors including age and HIV. Conclusion: Male gender and patients on re-treatment for tuberculosis are more at risk of developing resistance to rifampicin in our environment. There is a need to ensure compliance with all guidelines in the management of tuberculosis to prevent an increase in drug resistance.

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Prevalence of rifampicin-resistant tuberculosis and its associated factors in a tertiary health care center, South-west Nigeria.

10.21203/rs.3.rs-153296/v1 ◽

2021 ◽

Author(s):

Abiodun Ronke Ojewuyi ◽

Abiona Oluwadamilola Odeyemi ◽

Abimbola Ololade Odeyemi ◽

Amadin Aitua Olotu ◽

Tunde Oladipo

Keyword(s):

Care Center ◽

Relevant Information ◽

Drug Susceptibility ◽

Drug Susceptibility Testing ◽

Rifampicin Resistance ◽

High Morbidity ◽

Cross Sectional ◽

Health Care Center ◽

Resistant Tuberculosis ◽

Clinical Records

Abstract Background Tuberculosis is a chronic disease with associated high morbidity and mortality. In recent decades, there has been an increase in resistance to drugs used in treatment of tuberculosis. This is a major stumbling block in the global fight against tuberculosis. This study was to demonstrate the current prevalence of rifampicin-resistant tuberculosis and its associated predisposing factors in a Teaching Hospital in Nigeria.Methods This was a cross-sectional retrospective study involving 359 consecutive patients with bacteriologically confirmed tuberculosis seen between January 2015 and December 2019. Ethical approval was obtained from relevant authority. Drug susceptibility testing was performed for rifampicin using GeneXpert MTB/RIF assay. Relevant information was obtained from the clinical records of the patients with use of a well-structured proforma. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0.Results There were a total of 359 patients out of which majority, 235 (65.5%) were males. The mean age was 39.78+16.31 (range 1 - 90 years). A larger percentage of the subjects were new cases of tuberculosis (n=312, 86.9%), 49(13.6%) were HIV positive. The overall prevalence of rifampicin resistance found was 2.5% (n=9/359). There was significant association between gender (p=0.005) and re-treatment (p=0.003). There was no significant association between rifampicin resistance and other factors including age and HIV.Conclusion Male gender and patients on re-treatment for tuberculosis are more at risk of developing resistance to rifampicin in our environment. There is a need to ensure compliance with all guidelines in the management of tuberculosis to prevent an increase in drug resistance.

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Prevalence of rifampicin-resistant tuberculosis and its associated factors in a tertiary health care center, South-west Nigeria: A 5-year review

10.21203/rs.3.rs-153296/v2 ◽

2021 ◽

Author(s):

Abiodun Ronke Ojewuyi ◽

Abiona Oluwadamilola Odeyemi ◽

Abimbola Ololade Odeyemi ◽

Amadin Aitua Olotu ◽

Tunde Oladipo

Keyword(s):

Care Center ◽

Relevant Information ◽

Drug Susceptibility ◽

Drug Susceptibility Testing ◽

Rifampicin Resistance ◽

High Morbidity ◽

Cross Sectional ◽

Health Care Center ◽

Resistant Tuberculosis ◽

Clinical Records

Abstract BackgroundTuberculosis is a chronic disease with associated high morbidity and mortality. In recent decades, there has been an increase in resistance to drugs used in the treatment of tuberculosis. This is a major stumbling block in the global fight against tuberculosis. This study was to demonstrate the current prevalence of rifampicin-resistant tuberculosis and its associated predisposing factors in a Teaching Hospital in Nigeria.MethodsThis was a cross-sectional retrospective study involving 359 consecutive patients with bacteriologically confirmed tuberculosis seen between January 2015 and December 2019. Drug susceptibility testing was performed for rifampicin using GeneXpert MTB/RIF assay. Relevant information was obtained from the clinical records of the patients with the use of a well-structured proforma. The data obtained were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0.ResultsThere were a total of 359 patients out of which the majority, 235 (65.5%) were males. The mean age was 39.78+16.31 (range 1 - 90 years). A larger percentage of the subjects were new cases of tuberculosis (n=312, 86.9%), 49(13.6%) were HIV positive. The overall prevalence of rifampicin resistance found was 2.5% (n=9/359). There was a significant association between gender (p=0.005) and re-treatment (p=0.003). There was no significant association between rifampicin resistance and other factors including age and HIV.ConclusionMale gender and patients on re-treatment for tuberculosis are more at risk of developing resistance to rifampicin in our environment. There is a need to ensure compliance with all guidelines in the management of tuberculosis to prevent an increase in drug resistance.

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Discordance of the Repeat GeneXpert MTB/RIF test for Rifampicin resistance detection among patients Initiating MDR-TB treatment in Uganda

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab173 ◽

2021 ◽

Author(s):

Willy Ssengooba ◽

Jean de Dieu Iragena ◽

Kevin Komakech ◽

Iginitius Okello ◽

Joanitah Nalunjogi ◽

...

Keyword(s):

Drug Susceptibility ◽

Cross Sectional Study ◽

Drug Susceptibility Testing ◽

Resistance Rate ◽

Rifampicin Resistance ◽

P Value ◽

Smear Microscopy ◽

Cross Sectional ◽

Tb Treatment ◽

Mdr Tb

Abstract Background The Global Laboratory Initiative (GLI) guidelines recommend to repeat GeneXpertMTB/RIF (XpertMTB/RIF) in patients with a low-pretest probability of rifampicin-resistance (RR). Design/Methods In a cross-sectional study using results of sputum specimens collected from participants screened for the STREAM 2 trial. We recruited all patients with XpertMTB/RIF RR-TB detected who were referred for RR/MDR-TB treatment initiation at Mulago National Referral Hospital, Kampala, between September 2017 and October 2019. At baseline, smear microscopy, repeat XpertMTB/RIF, Xpert Ultra and MTBDRplus assays were done on sputum specimens. Culture-based drug-susceptibility testing (DST) were done on discordant specimens. We analysed the prevalence and factors associated with discordance between initial and repeat XpertMTB/RIF RR and false XpertMTB/RIF RR. False XpertMTB/RIF RR was defined as no RR detected by any of Xpert Ultra, LPA or culture DST (reference comparator). Results A total of 126/130 patients had repeat XpertMTB/RIF results of which, 97 (77.0%) had M. tuberculosis detected of whom, 81 (83.5%) had RR detected, and 1 (1.0%) had RR indeterminate. The prevalence of discordant XpertMTB/RIF RR was 15/96 (15.6%) whereas false XpertMTB/RIF RR prevalence was 10/96 (10.4%). Low bacillary load sputum specimens were more likely to have discordant XpertMTB/RIF RR and false XpertMTB/RIF RR results, aOR (p-value: 95%CI), 0.04 (0.01; 0.00-0.37) and 0.02 (0.01; 0.01-0.35) respectively. Conclusion Our findings show a high false-positive rifampicin resistance rate in low TB burden patients, which calls for repeat testing in order to prevent unnecessary prescription of anti MDR-TB therapy.

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Drug Susceptibility Profile of Mycobacterium tuberculosis Isolated from Patients Visiting National Tuberculosis Centre, Nepal

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v5i0.22314 ◽

2018 ◽

Vol 5 ◽

pp. 63-68

Author(s):

S. Dahal ◽

M.R. Banjara ◽

D. Khadka ◽

G. Ghimire ◽

S. Sharma

Keyword(s):

Mycobacterium Tuberculosis ◽

Drug Susceptibility ◽

Cross Sectional Study ◽

Drug Susceptibility Testing ◽

Biochemical Tests ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

National Tuberculosis ◽

Mdr Tb ◽

Lowenstein Jensen

Objectives: The objective of this study was to assess drug susceptibility pattern of Mycobacterium tuberculosis (MTB). Methods: This cross-sectional study was carried out among 145 clinically suspected and previously treated pulmonary tuberculosis patients visiting National Tuberculosis Centre, Bhaktapur, Nepal. After obtaining written informed consent, questionnaire was administered and sputum samples were collected from each patient. Each sample was subjected to Ziehl-Neelsen (ZN) staining and cultured on Lowenstein Jensen (LJ) medium at 37ºC for 8 weeks. MTB isolates were identified by growth rate and colony morphology, confirmed by biochemical tests and drug susceptibility testing (DST) of identified isolates was performed by proportion method. Results: A total of 49.7% (n=72) sputum samples were positive for MTB by culture and 46.9% (n=68) were positive by ZN staining. Among culture positive isolates of MTB (n= 72), 25% (n=18) were resistant to at least one drug. The prevalence of multi drug resistant tuberculosis (MDR-TB) was 15.3% (n=11) of which 5.56% (n=4) were resistant to rifampicin (RIF) only, 1.39% (n= 1) were resistant to isoniazid (INH) only. Out of 18 resistant isolates, 61.1% (n=11) were resistant to both RIF and INH, 21.43% (n=3) resistant to INH were susceptible to RIF and 26.67% (n=4) resistant to RIF were susceptible to INH. Smoking (P=0.001) and coughing (P=0.009) were statistically significant with isolation of MTB. Conclusion: Since the prevalence of MDR-TB was high, MDR-TB strains should be identified in order to initiate second line treatment.

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Factors Contributing to the High Prevalence of Multidrug- Resistant/Rifampicin-Resistant Tuberculosis: A Study From Russia

10.21203/rs.3.rs-1130356/v1 ◽

2021 ◽

Author(s):

Ilia Bykov ◽

Olga Dyachenko ◽

Pavel Ratmanov ◽

Qunhong Wu

Keyword(s):

Influencing Factors ◽

Drug Susceptibility ◽

Multidrug Resistant ◽

Drug Susceptibility Testing ◽

Epidemiological Surveillance ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

High Prevalence ◽

Cavitary Disease ◽

Major Factors

Abstract Background: Rapidly growing prevalence of multidrug-resistant/Rifampicin-resistant tuberculosis (MDR/RR-TB; resistance to Isoniazid and Rifampicin/Isolated resistance to Rifampicin) is putting in jeopardy the WHO End TB strategy. This study aimed to identify factors contributing to the high prevalence of MDR/RR-TB in Khabarovsk krai region of Russia.Methods: A cross-sectional retrospective study was conducted. Clinical, demographic and drug susceptibility testing data on 1440 patients were analyzed. Factors associated with MDR/RR-TB were identified through logistic regression analysis, along with in-depth interviews with eight patients, five healthcare managers and five doctors.Findings: 618 patients (42.9%) were identified with MDR/RR-TB. Patients with a history of imprisonment were 16.53 times (95% CI 5.37 to 50.88,) more likely to have MDR/RR-TB, whereas re-treatment patients were 2.82 times (95% CI 2.16 to 3.66) more likely to have MDR/RR-TB. Other influencing factors included presence of disability (AOR is 2.32, 95% CI 1.38 to 3.89) and cavitary disease (AOR is 1.76, 95% CI 1.37 to 2.25). Poor knowledge, progressive tiredness of prolonged TB treatment and inability to hospitalize infectious patients without their consent were perceived by the interviewees as major influencing factors. Conclusions: Incarceration and treatment history, regardless of outcome, were identified as major factors influencing MDR/RR-TB prevalence. It is essential for TB care system to eliminate legal loopholes, which deprive doctors of means to enforce quarantine procedures and epidemiological surveillance on infected patients, former and current inmates. In addition, increasing people’s awareness of TB, early detection and appropriate treatment of patients with TB are needed for successfully combating MDR/RR-TB.

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Patterns of Drug Resistance Among Tuberculosis Patients in West and Northwestern Iran

The Open Respiratory Medicine Journal ◽

10.2174/1874306401610010029 ◽

2016 ◽

Vol 10 (1) ◽

pp. 29-35 ◽

Cited By ~ 2

Author(s):

Leyla Sahebi ◽

Khalil Ansarin ◽

Parviz Mohajeri ◽

Majid Khalili ◽

Amir Monfaredan ◽

...

Keyword(s):

Drug Resistance ◽

Drug Susceptibility ◽

Drug Susceptibility Testing ◽

Effective Control ◽

Cross Sectional ◽

Tb Treatment ◽

Resistant Tuberculosis ◽

Mdr Tb ◽

History Of ◽

Hiv Negative

Background: Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases. Objective: The goal of this cross-sectional study (2011-2013;2013) was to examine the patterns of TB drug resistance among HIV-negative pulmonary TB patients in regions near the Iranian border. Method: To this end, MTB isolates were harvested from 300 HIV-negative, pulmonary smear-positive TB patients from the northwest and west Iranian border provinces. Isolates were subjected to first and second-line drug susceptibility testing by the 1% proportion method. Demographic and clinical data were provided using a questionnaire and information from patient records. Results were analyzed using SPSS-18. Results: The mean age of the patients was 52.03 years and 54.3% were male. The prevalence of resistance to any TB drug was 13.6% (38 cases). Eleven percent of the new treatment TB group (28 patients) and 40.7% of the retreatment TB group (11 patients) were resistant to all TB drugs. Twelve (4.3%) patients had multidrug-resistant tuberculosis (MDR-TB) (2.38% in the new TB treatment group and 23.1% in the retreatment group). One patient had extensively drug-resistant tuberculosis (XDR-TB). There was a statistically significant relationship between TB drug resistance and smoking (p=0.02) and a history of migration from village to city (p=0.04), also between TB drug resistance and recurrence of TB in patients that had previously received treatment (p<0.001). Conclusion: Knowledge of drug resistance patterns for new and previously treated cases is critical for effective control of MDR-TB in different regions of the country. The burden of MDR-TB in retreatment cases was high. Previous TB treatment was one of the most important mokers and those who had a history of rural to urban migration were at high risk for the occurrence of TB drug resistance.

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Comparative study of different methods of microscopy followed by a culture method in the detection of mycobacterium tuberculosis in clinically and radiologically suspected cases of pulmonary tuberculosis

IP International Journal of Medical Microbiology and Tropical Diseases ◽

10.18231/j.ijmmtd.2021.024 ◽

2021 ◽

Vol 7 (2) ◽

pp. 108-115

Author(s):

Aarthi Sridhar ◽

Anjana Gopi ◽

Abhilasha Dalal ◽

Divya Ravi

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Culture Method ◽

Drug Susceptibility ◽

Cross Sectional Study ◽

Drug Susceptibility Testing ◽

Cross Sectional ◽

Indicator Tube ◽

Resistant Tuberculosis ◽

Mdr Tb

To compare the sensitivity of 2 microscopic methods for the diagnosis of Mycobacterium tuberculosis (M.tb) along with culture and drug susceptibility testing to first line drugs.: The cross-sectional study comprises 200 suspected cases of pulmonary tuberculosis both clinically and radiologically in KIMS, Bangalore over a period of 2 years. Samples (sputum/BAL fluid) were collected, processed and stained by Ziehl Neelson (ZN) and Fluorescent methods. Culture and drug susceptibilty testing was done for Streptomycin, Isoniazid, Rifampicin and Ethambutol by Mycobacterium growth indicator tube (MGIT) method after decontamination.Fischer’s test : 1. Out of 200 samples: 1.120 were male and 80 were female; 2. 18 were positive by Ziehl Neelson, 21 by Fluorescent and 28 by culture; 3. Majority of the patients belonged to age group 41-50 years (23%); 4. InMGIT, 26 were M.tb and 2 were Non-tubercular mycobacteria; 5. Out of 26 M.tb isolates, 4 were resistant to streptomycin, 6 to isoniazid, 2 to rifampicin and 9 to ethambutol.1. The sensitivity of Fluorescent staining (64.28%) is higher than that of Ziehl-Neelson (51.7%); 2. In MGIT, 26 were M.tb and 2 were Non tubercular mycobacteria; 3. 2 were Multi-drug resistant- tuberculosis (MDR-TB) This study made us aware of the need for prompt detection, identification and appropriate treatment of Tuberculosis due to the rising incidence of MDR-TB.

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Rifampicin mono-resistant tuberculosis is not the same as multidrug-resistant tuberculosis: a descriptive study from Khayelitsha, South Africa

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00364-21 ◽

2021 ◽

Author(s):

Zubeida Salaam-Dreyer ◽

Elizabeth M. Streicher ◽

Frederick A. Sirgel ◽

Fabrizio Menardo ◽

Sonia Borrell ◽

...

Keyword(s):

South Africa ◽

Critical Concentration ◽

Drug Susceptibility ◽

Multidrug Resistant ◽

Drug Susceptibility Testing ◽

Rifampicin Resistance ◽

Potential Contribution ◽

Resistant Tuberculosis ◽

Mdr Tb ◽

High Level

Rifampicin mono-resistant TB (RMR-TB, rifampicin resistance and isoniazid susceptibility) constitutes 38% of all rifampicin-resistant TB (RR-TB) in South Africa and is increasing. We aimed to compare RMR-TB with multidrug-resistant TB (MDR-TB) within a high TB, RR-TB and HIV burden setting. Patient-level clinical data and stored RR-TB isolates from 2008-2017 with available whole genome sequencing (WGS) data were used to describe risk factors associated with RMR-TB and to compare rifampicin-resistance (RR) conferring mutations between RMR-TB and MDR-TB. A subset of isolates with particular RR-conferring mutations were subjected to semi-quantitative rifampicin phenotypic drug susceptibility testing. Among 2,041 routinely diagnosed RR-TB patients, 463 (22.7%) had RMR-TB. HIV-positive individuals (adjusted Odds Ratio 1.4, 95% CI 1.1-1.9) and diagnosis between 2013-2017 versus 2008-2012 (aOR 1.3, 1.1-1.7) were associated with RMR-TB. Among 1,119 (54.8%) patients with available WGS data showing RR-TB, significant differences in the distribution of rpoB RR-conferring mutations between RMR-TB and MDR-TB isolates were observed. Mutations associated with high-level RR were more commonly found among MDR-TB isolates (811/889, 90.2% versus 162/230, 70.4% among RMR-TB, p<0.0001). In particular, the rpoB L430P mutation, conferring low-level RR, was identified in 32/230 (13.9%) RMR-TB versus 10/889 (1.1%) in MDR-TB (p<0.0001). Among 10 isolates with an rpoB L430P mutation, 7 were phenotypically susceptible using the critical concentration of 0.5 μg/ml (range 0.125-1 μg/ml). The majority (215/230, 93.5%) of RMR-TB isolates showed susceptibility to all other TB drugs, highlighting the potential benefits of WGS for simplified treatment. These data suggest that the evolution of RMR-TB differs from MDR-TB with a potential contribution from HIV infection.

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Risk factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil

Revista de Saúde Pública ◽

10.1590/s1518-8787.2017051006688 ◽

2017 ◽

Vol 51 (0) ◽

Cited By ~ 5

Author(s):

Geisa Fregona ◽

Lorrayne Belique Cosme ◽

Cláudia Maria Marques Moreira ◽

José Luis Bussular ◽

Valdério do Valle Dettoni ◽

...

Keyword(s):

Previous Treatment ◽

Drug Susceptibility ◽

Multidrug Resistant ◽

Drug Susceptibility Testing ◽

Espírito Santo ◽

Factors Associated ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

History Of ◽

Espirito Santo

ABSTRACT OBJECTIVE To analyze the prevalence and factors associated with multidrug-resistant tuberculosis in Espírito Santo, Brazil. METHODS This is a cross-sectional study of cases of tuberculosis tested for first-line drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin) in Espírito Santo between 2002 and 2012. We have used laboratory data and registration of cases of tuberculosis – from the Sistema Nacional de Agravos de Notificação and Sistema para Tratamentos Especiais de Tuberculose. Individuals have been classified as resistant and non-resistant and compared in relation to the sociodemographic, clinical, and epidemiological variables. Some variables have been included in a logistic regression model to establish the factors associated with resistance. RESULTS In the study period, 1,669 individuals underwent anti-tuberculosis drug susceptibility testing. Of these individuals, 10.6% showed resistance to any anti-tuberculosis drug. The rate of multidrug resistance observed, that is, to rifampicin and isoniazid, has been 5%. After multiple analysis, we have identified as independent factors associated with resistant tuberculosis: history of previous treatment of tuberculosis [recurrence (OR = 7.72; 95%CI 4.24–14.05) and re-entry after abandonment (OR = 3.91; 95%CI 1.81–8.43)], smoking (OR = 3.93; 95%CI 1.98–7.79), and positive culture for Mycobacterium tuberculosis at the time of notification of the case (OR = 3.22; 95%CI 1.15–8.99). CONCLUSIONS The partnership between tuberculosis control programs and health teams working in the network of Primary Health Care needs to be strengthened. This would allow the identification and monitoring of individuals with a history of previous treatment of tuberculosis and smoking. Moreover, the expansion of the offer of the culture of tuberculosis and anti-tuberculosis drug susceptibility testing would provide greater diagnostic capacity for the resistant types in Espírito Santo.

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