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Free Content Phenotypic and genotypic analysis of multidrug-resistant tuberculosis in Ethiopia

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Abstract:

SETTING: National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia.

OBJECTIVES: To determine the drug susceptibility pattern of Mycobacterium tuberculosis isolates and to genetically characterise multidrug-resistant tuberculosis (MDR-TB) isolates.

DESIGN: A total of 107 M. tuberculosis isolates recovered during the period December 2005–August 2006 were tested for drug susceptibility against streptomycin, isoniazid, rifampicin and ethambutol (SHRE) using the proportion method on Löwenstein-Jensen medium. The MDR-TB isolates were tested against kanamycin, ciprofloxacin, capreomycin, D-cycloserine and ethionamide. Genotyping was performed using spoligotyping.

RESULTS: MDR-TB was observed in one of the 44 new cases (2.3%) and 45/63 previously treated patients (71.4%). Drug susceptibility testing against second-line drugs (SLDs) showed that 26.1% of all MDR-TB isolates were susceptible to all SLDs tested and 73.9% were resistant to one or more classes of SLD. Extensively drug-resistant (XDR) TB was detected in two isolates (4.4%). T3_ETH was the predominant spoligotype, followed by CAS_KILI. In this African setting, no Beijing spoligotype was identified.

CONCLUSION: Both MDR- and XDR-TB are present in Ethiopian patients. MDR-TB was found to be associated with T3 and Central Asian genotypes.

Keywords: Ethiopia; multidrug resistance; second-line treatment; spoligotyping; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; and Science Faculty, Addis Ababa University, Addis Ababa, Ethiopia 2: Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia 3: Science Faculty, Addis Ababa University, Addis Ababa, Ethiopia 4: St Peter's TB Specialised Hospital, Addis Ababa, Ethiopia 5: Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia 6: National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

Publication date: October 1, 2010

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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