The Ethiopian Third National Tuberculosis Drug Resistance Survey Incorporating Whole Genome Sequencing.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-07-21 eCollection Date: 2025-07-01 DOI:10.1093/ofid/ofaf367

Shewki Moga, Muluwork Getahun, Zemedu Mohammed, Ayinalem Alemu, Getu Diriba, Bazezew Yenew, Dinka Fikadu, Yeshiwork Abebaw, Misikir Amare, Ephrem Tesfaye, Abebaw Kebede, Zelalem Yaregal, Abyot Meaza, Hilina Mollalign, Biniyam Dagne, Mengistu Tadesse, Waganeh Sinshaw, Getachew Seid, Betselot Zerihun, Melak Getu, Gemechu Tadesse, Saro Abdella, Getachew Tollera, Abayneh Admas, Addisalem Yilma, Yohannes Molla, Fekadesselassie Mikru, Dawit Assefa, Tefera Girma, Beniam Feleke, Federico Di Marco, Daniela M Cirillo, Anna Dean, Andrea Maurizio Cabibbe, Eveline Klinkenberg

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引用次数: 0

Abstract

Background: Drug-resistant tuberculosis (DR-TB) is a major challenge hindering global tuberculosis control. Ethiopia conducted a third national antituberculosis (TB) drug resistance survey, and this is the first survey to report on drug resistance using whole genome sequencing (WGS) in addition to genotypic and phenotypic test results. The aim of this study was to obtain up-to-date information regarding the magnitude and pattern of drug resistance in Ethiopia.

Methods: A nationwide cross-sectional study was conducted in 217 health facilities across all Ethiopian regional states from August 2017 to January 2019. Sputum specimens were collected from patients with bacteriologically confirmed pulmonary TB to detect resistance to anti-TB drugs with Xpert MTB/RIF assay, culture-based phenotypic drug susceptibility testing (DST), and WGS with phylogenetic analysis.

Results: The prevalence of rifampicin-resistant TB (RR-TB) was 1.07% (95% confidence interval [CI], .65%-1.74%) among new cases and 6.89% (95% CI, 4.02%-11.57%) among previously treated cases. The prevalence of isoniazid-resistant, rifampicin-susceptible TB was 4.15% (95% CI, 3.11%-5.53%) among new cases and 4.41% (95% CI, 1.97%-9.57%) among previously treated cases. While resistance to fluoroquinolones was detected in 1 RR-TB case, resistance to bedaquiline and linezolid was not detected in RR-TB cases. Mycobacterium tuberculosis lineage 4 was the most common, followed by lineage 3 and lineage 1, with sublineage 4.2.2 being the most frequent.

Conclusions: The level of RR-TB remained low. Expanding baseline DST for isoniazid may help further lower the burden of DR-TB in Ethiopia.

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结合全基因组测序的埃塞俄比亚第三次全国结核病耐药性调查。

背景：耐药结核病（DR-TB）是阻碍全球结核病控制的主要挑战。埃塞俄比亚进行了第三次全国抗结核（TB）耐药性调查，这是除基因型和表型检测结果外，首次使用全基因组测序（WGS）报告耐药性的调查。这项研究的目的是获得关于埃塞俄比亚耐药程度和模式的最新信息。方法：从2017年8月至2019年1月，在埃塞俄比亚所有地区州的217家卫生机构进行了一项全国性的横断面研究。对细菌学确诊的肺结核患者采集痰标本，采用Xpert MTB/RIF试验、培养型表型药敏试验（DST）和WGS结合系统发育分析检测抗结核药物耐药性。结果：新发病例中耐利福平结核（RR-TB）患病率为1.07%(95%可信区间[CI]， 0.65% ~ 1.74%)，既往治疗病例中患病率为6.89% （95% CI, 4.02% ~ 11.57%）。异烟肼耐药、利福平敏感结核病的患病率在新病例中为4.15% (95% CI, 3.11%-5.53%)，在既往治疗病例中为4.41% （95% CI, 1.97%-9.57%）。1例耐氟喹诺酮类药物耐药，未检出贝达喹啉和利奈唑胺耐药。结核分枝杆菌谱系4最常见，其次是谱系3和谱系1，亚谱系4.2.2最常见。结论：RR-TB的水平仍然很低。扩大异烟肼的基线DST可能有助于进一步降低埃塞俄比亚耐药结核病的负担。

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

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.