Rifampicin resistant Mycobacterium tuberculosis in Vietnam, 2020–2022

IF 1.9 Q3 INFECTIOUS DISEASES
Hung Van Nguyen , Hoa Binh Nguyen , Doan Thu Ha , Dinh Thi Huong , Vu Ngoc Trung , Khieu Thi Thuy Ngoc , Tran Huyen Trang , Ha Vu Thi Ngoc , Tram Trinh Thi Bich , Trieu Le Pham Tien , Hanh Nguyen Hong , Phu Phan Trieu , Luong Kim Lan , Kim Lan , Ngo Ngoc Hue , Nguyen Thi Le Huong , Tran Le Thi Ngoc Thao , Nguyen Le Quang , Thu Do Dang Anh , Nguyễn Hữu Lân , Timothy M. Walker
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引用次数: 0

Abstract

Objective

We conducted a descriptive analysis of multi-drug resistant tuberculosis (MDR-TB) in Vietnam’s two largest cities, Hanoi and Ho Chi Minh city.

Methods

All patients with rifampicin resistant tuberculosis were recruited from Hanoi and surrounding provinces between 2020 and 2022. Additional patients were recruited from Ho Chi Minh city over the same time period. Demographic data were recorded from all patients, and samples collected, cultured, whole genome sequenced and analysed for drug resistance mutations. Genomic susceptibility predictions were made on the basis of the World Health Organization’s catalogue of mutations in Mycobacterium tuberculosis associated with drug resistance, version 2. Comparisons were made against phenotypic drug susceptibility test results where these were available. Multivariable logistic regression was used to assess risk factors for previous episodes of tuberculosis.

Results

233/265 sequenced isolates were of sufficient quality for analysis, 146 (63 %) from Ho Chi Minh City and 87 (37 %) from Hanoi. 198 (85 %) were lineage 2, 20 (9 %) were lineage 4, and 15 (6 %) were lineage 1. 17/211 (8 %) for whom HIV status was known were infected, and 109/214 (51 %) patients had had a previous episode of tuberculosis. The main risk factor for a previous episode was HIV infection (odds ratio 5.1 (95 % confidence interval 1.3–20.0); p = 0.021). Sensitivity for predicting first-line drug resistance from whole genome sequencing data was over 90 %, with the exception of pyrazinamide (85 %). For moxifloxacin and amikacin it was 50 % or less. Among rifampicin-resistant isolates, prevalence of resistance to each non-first-line drug was < 20 %.

Conclusions

Drug resistance among most MDR-TB strains in Vietnam’s two largest cities is confined largely to first-line drugs. Living with HIV is the main risk factor among patients with MDR-TB for having had a previous episode of tuberculosis.

2020-2022 年越南耐利福平结核分枝杆菌感染情况
方法在 2020 年至 2022 年期间从河内及周边省份招募所有耐利福平肺结核患者。同期还从胡志明市招募了其他患者。对所有患者的人口统计学数据进行了记录,并对样本进行了采集、培养、全基因组测序和耐药性突变分析。基因组易感性预测是根据世界卫生组织的结核分枝杆菌耐药性突变目录(第 2 版)进行的。如有表型药敏试验结果,则与这些结果进行比较。结果233/265 个测序分离物的质量足以进行分析,其中 146 个(63%)来自胡志明市,87 个(37%)来自河内。198株(85%)为2系,20株(9%)为4系,15株(6%)为1系。17/211(8%)的患者已知感染了艾滋病毒,109/214(51%)的患者曾患结核病。前次发病的主要风险因素是艾滋病毒感染(几率比 5.1(95% 置信区间 1.3-20.0);p = 0.021)。根据全基因组测序数据预测一线药物耐药性的灵敏度超过 90%,但吡嗪酰胺除外(85%)。莫西沙星和阿米卡星的敏感度为 50% 或更低。在对利福平耐药的分离株中,对每种非一线药物的耐药率为 20%。艾滋病病毒感染者是耐药结核病患者曾患结核病的主要风险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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