Ann Lab Med.  2015 Sep;35(5):494-499. 10.3343/alm.2015.35.5.494.

Phenotypic and Genotypic Analysis of Anti-Tuberculosis Drug Resistance in Mycobacterium tuberculosis Isolates in Myanmar

Affiliations
  • 1Advanced Molecular Research Centre, Department of Medical Research, Yangon, Myanmar. drwahwahaung@gmail.com
  • 2National Tuberculosis Program, Nay Pyi Taw, Myanmar.
  • 3Department of Laboratory Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. cchl@pusan.ac.kr
  • 4International Tuberculosis Research Center, Changwon, Korea.
  • 5Korean Institute of Tuberculosis, Osong, Korea.
  • 6Yonsei University College of Medicine, Seoul, Korea.
  • 7Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

BACKGROUND
Tuberculosis (TB) is one of the most serious health problems in Myanmar. Because TB drug resistance is associated with genetic mutation(s) relevant to responses to each drug, genotypic methods for detecting these mutations have been proposed to overcome the limitations of classic phenotypic drug susceptibility testing (DST). We explored the current estimates of drug-resistant TB and evaluated the usefulness of genotypic DST in Myanmar.
METHODS
We determined the drug susceptibility of Mycobacterium tuberculosis isolated from sputum smear-positive patients with newly diagnosed pulmonary TB at two main TB centers in Myanmar during 2013 by using conventional phenotypic DST and the GenoType MTBDRplus assay (Hain Lifescience, Germany). Discrepant results were confirmed by sequencing the genes relevant to each type of resistance (rpoB for rifampicin; katG and inhA for isoniazid).
RESULTS
Of 191 isolates, phenotypic DST showed that 27.7% (n=53) were resistant to at least one first-line drug and 20.9% (n=40) were resistant to two or more, including 18.3% (n=35) multidrug-resistant TB (MDR-TB) strains. Monoresistant strains accounted for 6.8% (n=13) of the samples. Genotypic assay of 189 isolates showed 17.5% (n=33) MDR-TB and 5.3% (n=10) isoniazid-monoresistant strains. Genotypic susceptibility results were 99.5% (n=188) concordant and agreed almost perfectly with phenotypic DST (kappa=0.99; 95% confidence interval 0.96-1.01).
CONCLUSIONS
The results highlight the burden of TB drug resistance and prove the usefulness of the genotypic DST in Myanmar.

Keyword

Mycobacterium tuberculosis; Drug; Resistance; Genotype; Myanmar

MeSH Terms

Drug Resistance*
Genotype
Humans
Myanmar*
Mycobacterium tuberculosis*
Rifampin
Sputum
Tuberculosis
Rifampin

Cited by  1 articles

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Eun-Taek Han, Jong-Seok Lee, Jae-Hun Cheong, Chulhun L. Chang, Myat Htut Nyunt, Wah Wah Aung, Yi Yi Kyaw, Kyaw Zin Thant
Lab Med Online. 2017;7(3):94-102.    doi: 10.3343/lmo.2017.7.3.94.


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