Drug susceptibility profiles and factors associated with non-tuberculous mycobacteria species circulating among patients diagnosed with pulmonary tuberculosis in Tanzania
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Background
While most Non-tuberculous mycobacteria (NTM) are saprophytic, several species have
been associated with human diseases, from localized infection to disseminated diseases.
Pulmonary NTM infections lead to TB-like disease called NTM pulmonary disease (NTM-
PD). Due to variation in treatment options among NTM species, it is necessary to identify
the species and determine drug susceptibility profiles to inform the choice of appropriate
regimen for the disease.
Design
A total of 188 culture-positive isolates from patients diagnosed with TB were screened for
NTM at the Central Tuberculosis Reference Laboratory. All NTM were further speciated
using GenoType® Mycobacterium—Common Mycobacterium and Additional species
(GenoType® CM/AS) kit. Mycobacteria avium complex (MAC) and Mycobacteria absces-
sus complex (MABC) which could not be identified with the test to species were subjected to
GenoType® Mycobacteria NTM-DR for further speciation. Using the same test, identified
MAC and MABC were genotyped to determine the drug susceptibility profile for each isolate
to macrolide and aminoglycosides.
Results
Of all isolates identified as mycobacteria, 24 (13%) were NTM. Fifteen isolates could be
identified to species level of which prevalent species was M. avium sub. intracellulare 4 (27%). A total of 10 isolates were MAC (n = 6) and MABC (n = 4) were subjected to Geno-
Type® Mycobacteria NTM-DR for determination of macrolide and aminoglycoside suscepti-
bility. Three of the four MABC had a mutation at the T28 position of the erm (41). All MAC
were susceptible to both drugs.
Conclusion
In this study, MAC was the most frequently isolated NTM species followed by MABC. While
all MAC and MABC identified, were susceptible to aminoglycosides, three MABC were
resistant to the macrolides due to mutation at position 28 of the erm (41) gene. For this, it is
important for clinicians need to rule out NTM, understand species and their drug susceptibil-
ity for optimal case management.
Description
Journal article
Keywords
TB, TB-Tanzania
Citation
https://doi.org/10.1371/journal. pone.0265358