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Multidrug-resistant tuberculosis in Port-au-Prince, Haiti

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Date
2012
Author
Ocheretina, Oksana
Morose, Willy
Gauthier, Marie
Joseph, Patrice
D'Meza, Richard
Escuyer, Vincent E
Rastogi, Nalin
Vernet, Guy
Pape, Jean W
Fitzgerald, Daniel W
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Abstract
OBJECTIVE: To determine the prevalence of multidrug-resistant tuberculosis (MDR-TB) among patients with new smear-positive pulmonary TB in Port-au-Prince, Haiti. METHODS: Sputum samples were cultured from 1 006 patients newly diagnosed with TB in 2008. The core region of the rpoB gene that is associated with resistance to rifampin was sequenced. All isolates with rpoB mutations were sent to the New York State reference laboratory for conventional drug susceptibility testing (DST). All isolates were also tested with the GenoType MTBDRplus line-probe assay. RESULTS: Mycobacterium tuberculosis was isolated from 906 patients. Twenty-six (2.9 percent) of the isolates had missense mutations or deletions in rpoB and were resistant to rifampin by DST. All 26 were also resistant to isoniazid and classified as MDR-TB. Forty-six control isolates without rpoB mutations were found to be rifampin sensitive by DST. The GenoType MTBDRplus line-probe assay correctly identified 26 MDR-TB strains. It misclassified one pansusceptible isolate as rifampin resistant. CONCLUSIONS: This study shows an MDR-TB prevalence of 2.9 percent in newly diagnosed TB patients in Haiti and suggests that rpoB sequencing and hybridization assays are good screening tools for early detection of MDR-TB.(AU)
 
OBJETIVO: Determinar la prevalencia de tuberculosis (TB) multirresistente en pacientes con TB pulmonar nueva con baciloscopia positiva en Puerto Príncipe, Haití. MÉTODOS: Se cultivaron muestras de esputo de 1 006 pacientes con diagnóstico reciente de tuberculosis efectuado durante el 2008. Se secuenció la región nuclear del gen rpoB, que se asocia con la resistencia a la rifampicina. Todos los aislados con mutaciones de rpoB se enviaron al laboratorio de referencia del estado de Nueva York para llevar a cabo un antibiograma convencional. Todos los aislados se estudiaron también con el ensayo de sonda lineal GenoType MTBDRplus. RESULTADOS: Se aisló Mycobacterium tuberculosis de 906 pacientes. Veintiséis (2,9 por ciento) de los aislados presentaban mutaciones de sentido erróneo o deleciones en rpoB y fueron resistentes a la rifampicina en el antibiograma. Los 26 aislados fueron resistentes también a la isoniacida y se clasificaron como TB multirresistente. Cuarenta y seis aislados de control sin mutaciones de rpoB resultaron sensibles a la rifampicina en el antibiograma. El ensayo de sonda lineal GenoType MTBDRplus identificó correctamente a las 26 cepas de TB multirresistente y clasificó de manera errónea un aislado sensible a múltiples fármacos como resistente a la rifampicina. CONCLUSIONES: Este estudio revela una prevalencia de TB multirresistente de 2,9 por ciento en los pacientes con TB recién diagnosticada en Haití e indica que los ensayos de secuenciación e hibridación de rpoB son estudios de detección sistemática adecuados para la detección temprana de la TB multirresistente.(AU)
 
Series
Rev Panam Salud Publica;31(3),mar. 2012
Subject
Tuberculosis; Multidrug resistant; Cross-Sectional Studies; Haiti; Tuberculosis resistente a múltiples medicamentos; Estudios Transversales; Haiti; Tuberculose Resistente a Múltiplos Medicamentos; Antituberculosos; Proteínas de Bactérias; Proteínas de Bactérias; Cidades; Estudos Transversais; Haiti; Isoniazida; Mycobacterium tuberculosis; Prevalência; Rifampina; Tuberculose Resistente a Múltiplos Medicamentos; Tuberculose Resistente a Múltiplos Medicamentos
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892012000300006
https://iris.paho.org/handle/10665.2/9351
Citation
Ocheretina, Oksana,Morose, Willy,Gauthier, Marie,Joseph, Patrice,D'Meza, Richard,Escuyer, Vincent E,Rastogi, Nalin,Vernet, Guy,Pape, Jean W,Fitzgerald, Daniel W (2012) Multidrug-resistant tuberculosis in Port-au-Prince, Haiti. Rev Panam Salud Publica;31(3) 221-224,mar. 2012. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892012000300006
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  • Pan American Journal of Public Health

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