Generic placeholder image

Infectious Disorders - Drug Targets

Author(s): Eltayib H. Ahmed Abakur, Tarig M.S. Alnour*, Faisel Abuduhier, Fahad M.A. Albalawi and Khalid A.S. Alfifi

DOI: 10.2174/1871526519666190326141550

DownloadDownload PDF Flyer Cite As
Emergence of Heteroresistance Mycobacterium Tuberculosis in Saudi Arabia

Page: [491 - 494] Pages: 4

  • * (Excluding Mailing and Handling)

Explore Articles
About Journal
For Authors
For Editors
For Reviewers

Abstract

Purpose: Heteroresistant Mycobacterium tuberculosis (MTB) is defined as a group of drug-susceptible and resistant bacteria in a single clinical specimen from tuberculosis (TB) patients. Heteroresistance of MTB is considered a preliminary stage to full resistance. The present study aimed to determine the heteroresistance in Mycobacterium tuberculosis in Tabuk province, in the north of the Kingdom of Saudi Arabia.

Method: GenoType MTBDRplus assay was used to determine mutations associated with isoniazid and rifampicin resistance.

Results: A total number of 46 confirmed M. tuberculosis positive sputum samples were scanned for heteroresistance. The present study revealed 3 (6.5%) heteroresistant mutations to either rpoB gene alone, 2 (4.4%) to rpoB and 1 (2.2%) to inhA genes.

Conclusion: The detection of heteroresistant mutations could guide the initiation of an appropriate regimen of treatment.

Keywords: Heteroresistance, Mycobacterium tuberculosis, drug resistance, rpoB mutation, inhA mutation, Tuberculosis (TB).

[1]
Faye1 B, Jessika I, Seck M C, Ndour C T, Gueye P A L, Fatoumata B, Sarr M, Grillo M, Reed S, Dieye A. Molecular Evaluation of Resistance to Rifampicin and Isoniazid of Tu-berculosis Patients by test “Genotype® MTBDR Plus” in Sen-egal. J. Trop. Dis., 2018, 6, 5.
[2]
Engström, A.; Hoffner, S.; Juréen, P. Detection of heteroresistant Mycobacterium tuberculosis by pyrosequencing. J. Clin. Microbiol., 2013, 51(12), 4210-4212.
[http://dx.doi.org/10.1128/JCM.01761-13] [PMID: 24048543]
[3]
Al-Hajoj, S.A. Tuberculosis in Saudi Arabia: can we change the way we deal with the disease? J. Infect. Public Health, 2010, 3(1), 17-24.
[http://dx.doi.org/10.1016/j.jiph.2009.12.001] [PMID: 20701887]
[4]
Hofmann-Thiel, S.; van Ingen, J.; Feldmann, K.; Turaev, L.; Uzakova, G.T.; Murmusaeva, G.; van Soolingen, D.; Hoffmann, H. Mechanisms of heteroresistance to isoniazid and rifampin of Mycobacterium tuberculosis in Tashkent, Uzbekistan. Eur. Respir. J., 2009, 33(2), 368-374.
[http://dx.doi.org/10.1183/09031936.00089808] [PMID: 18829680]
[5]
Operario, D.J.; Koeppel, A.F.; Turner, S.D.; Bao, Y.; Pholwat, S.; Banu, S.; Foongladda, S.; Mpagama, S.; Gratz, J.; Ogarkov, O.; Zhadova, S.; Heysell, S.K.; Houpt, E.R. Prevalence and extent of heteroresistance by next generation sequencing of multidrug-resistant tuberculosis. PLoS One, 2017, 12(5)e0176522
[http://dx.doi.org/10.1371/journal.pone.0176522] [PMID: 28545050]
[6]
Kumar, P.; Balooni, V.; Sharma, B.K.; Kapil, V.; Sachdeva, K.S. Singh. High degree of multi-drug resistance and hetero-resistance in pulmonary TB patients from Punjab state of In-dia. Tuberculosis (Edinb.), 2014, 94, 70-83.
[http://dx.doi.org/10.1016/j.tube.2013.10.001]
[7]
Pholwat, S.; Stroup, S.; Foongladda, S.; Houpt, E. Digital PCR to detect and quantify heteroresistance in drug resistant Mycobacterium tuberculosis. PLoS One, 2013, 8(2)e57238
[http://dx.doi.org/10.1371/journal.pone.0057238] [PMID: 23468945]
[8]
Liang, B; Tan, Y; Li, Z; Tian, X; Du, C; Li, H; Li, G; Yao, X; Wang, Z; Xu, Y; Li, Q Highly sensitive detection of isoniazid heteroresistance in My-cobacterium tuberculosis by DeepMelt assay. J. Clin. Microbiol., 2018, 56, e01239-e17.
[9]
Kargarpour Kamakoli, M.; Sadegh, H.R.; Farmanfarmaei, G.; Masoumi, M.; Fateh, A.; Javadi, G.; Rahimi Jamnani, F.; Vaziri, F.; Siadat, S.D. Evaluation of the impact of polyclonal infection and heteroresistance on treatment of tuberculosis patients. Sci. Rep., 2017, 7, 41410.
[http://dx.doi.org/10.1038/srep41410] [PMID: 28120910]
[10]
Coll, F.; McNerney, R.; Preston, M.D.; Guerra-Assunção, J.A.; Warry, A.; Hill-Cawthorne, G.; Mallard, K.; Nair, M.; Miranda, A.; Alves, A.; Perdigão, J.; Viveiros, M.; Portugal, I.; Hasan, Z.; Hasan, R.; Glynn, J.R.; Martin, N.; Pain, A.; Clark, T.G. Rapid determination of anti-tuberculosis drug resistance from whole-genome sequences. Genome Med., 2015, 7(1), 51.
[http://dx.doi.org/10.1186/s13073-015-0164-0] [PMID: 26019726]
[11]
Al-Orainey, I.; Alhedaithy, M.A.; Alanazi, A.R.; Barry, M.A.; Almajid, F.M. Tuberculosis incidence trends in Saudi Arabia over 20 years: 1991-2010. Ann. Thorac. Med., 2013, 8(3), 148-152.
[http://dx.doi.org/10.4103/1817-1737.114303] [PMID: 23922609]
[12]
Al Ammari, M.; Al Turaiki, A.; Al Essa, M.; Kashkary, A.M.; Eltigani, S.A.; Ahmed, A.E. Drug resistant tuberculosis in Saudi Arabia: an analysis of surveillance data 2014-2015. Antimicrob. Resist. Infect. Control, 2018, 7, 12.
[http://dx.doi.org/10.1186/s13756-018-0306-4] [PMID: 29387346]
[13]
Folkvardsen, D.B.; Thomsen, V.Ø.; Rigouts, L.; Rasmussen, E.M.; Bang, D.; Bernaerts, G.; Werngren, J.; Toro, J.C.; Hoffner, S.; Hillemann, D.; Svensson, E. Rifampin heteroresistance in Mycobacterium tuberculosis cultures as detected by phenotypic and genotypic drug susceptibility test methods. J. Clin. Microbiol., 2013, 51(12), 4220-4222.
[http://dx.doi.org/10.1128/JCM.01602-13] [PMID: 24068005]
[14]
Mekonnen, D.; Admassu, A.; Mulu, W.; Amor, A.; Benito, A.; Gelaye, W.; Biadglegne, F.; Abera, B. Multidrug-resistant and heteroresistant Mycobacterium tuberculosis and associated gene mutations in Ethiopia. Int. J. Infect. Dis., 2015, 39, 34-38.
[http://dx.doi.org/10.1016/j.ijid.2015.06.013] [PMID: 26119857]
[15]
Gupta, R; Thakur, R; Kushwaha, S; Jalan, N; Rawat, P; Gupta, P; Aggarwal, A; Gupta, M; Manchanda, V Isoniazid and rifampic-in heteroresistant Mycobacterium tuberculosis isolated from tuberculous meningitis patients in India. India journal of tuberculosis., 2018, 6, 552-556.
[16]
Chakravorty, S.; Aladegbami, B.; Thoms, K.; Lee, J.S.; Lee, E.G.; Rajan, V.; Cho, E.J.; Kim, H.; Kwak, H.; Kurepina, N.; Cho, S.N.; Kreiswirth, B.; Via, L.E.; Barry, C.E., III; Alland, D. Rapid detection of fluoroquinolone-resistant and heteroresistant Mycobacterium tuberculosis by use of sloppy molecular beacons and dual melting-temperature codes in a real-time PCR assay. J. Clin. Microbiol., 2011, 49(3), 932-940.
[http://dx.doi.org/10.1128/JCM.02271-10] [PMID: 21191047]
[17]
Tolani, M.P.; D’souza, D.T.; Mistry, N.F. Drug resistance mutations and heteroresistance detected using the GenoType MTBDRplus assay and their implication for treatment outcomes in patients from Mumbai, India. BMC Infect. Dis., 2012, 12, 9.
[http://dx.doi.org/10.1186/1471-2334-12-9] [PMID: 22260344]