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Molecular Epidemiology of Isoniazid-resistant M tuberculosis in Port-au-Prince, Haiti.
Walsh, Kathleen F; Lee, Myung Hee; Chaguza, Chrispin; Pamphile, Widman; Royal, Gertrude; Escuyer, Vincent; Pape, Jean W; Fitzgerald, Daniel; Cohen, Ted; Ocheretina, Oksana.
Afiliación
  • Walsh KF; General Internal Medicine, Weill Cornell Medicine, New York, New York, USA.
  • Lee MH; Center for Global Health, Weill Cornell Medicine, New York, New York, USA.
  • Chaguza C; Center for Global Health, Weill Cornell Medicine, New York, New York, USA.
  • Pamphile W; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, Connecticut, USA.
  • Royal G; Groupe Haitian d'Etude du Sarcoma da Kaposi at des Infections Opportunistas (GHESKIO), Port-au-Prince, Haiti.
  • Escuyer V; Groupe Haitian d'Etude du Sarcoma da Kaposi at des Infections Opportunistas (GHESKIO), Port-au-Prince, Haiti.
  • Pape JW; Wadsworth Center, New York State Department of Health, Albany, New York, USA.
  • Fitzgerald D; Center for Global Health, Weill Cornell Medicine, New York, New York, USA.
  • Cohen T; Groupe Haitian d'Etude du Sarcoma da Kaposi at des Infections Opportunistas (GHESKIO), Port-au-Prince, Haiti.
  • Ocheretina O; Center for Global Health, Weill Cornell Medicine, New York, New York, USA.
Open Forum Infect Dis ; 11(8): ofae421, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39119477
ABSTRACT

Background:

Isoniazid-resistant, rifampin-susceptible tuberculosis (Hr-TB) is associated with poor treatment outcomes and higher rates of acquisition of further drug resistance during treatment. Due to a lack of widespread diagnostics, Hr-TB is frequently undetected and its epidemiology is incompletely understood.

Methods:

We studied the molecular epidemiology of Hr-TB among all patients diagnosed with culture-positive pulmonary tuberculosis between January 1 and June 30, 2017, at an urban referral tuberculosis clinic in Port-au-Prince, Haiti. Demographic and clinical data were extracted from the electronic medical record. Archived diagnostic Mycobacterium tuberculosis isolates were tested for genotypic and phenotypic isoniazid resistance using the Genotype MTBDRplus assay (Hain, Nehren, Germany) and culture-based testing, respectively. All isoniazid-resistant isolates and a randomly selected subset of isoniazid-susceptible isolates underwent whole-genome sequencing to confirm the presence of mutations associated with isoniazid resistance, to validate use of Genotype MTBDRplus in this population, and to identify potential transmission links between isoniazid-resistant isolates. Results and

Conclusions:

Among 845 patients with culture-positive pulmonary tuberculosis in Haiti, 65 (7.7%) had Hr-TB based on the Genotype MTBDRplus molecular assay. Age < 20 years was significantly associated with Hr-TB (odds ratio, 2.39; 95% confidence interval, 1.14, 4.70; P = .015). Thirteen (20%) isoniazid-resistant isolates were found in 5 putative transmission clusters based on a single nucleotide polymorphism distance of ≤ 5. No patients in these transmission clusters were members of the same household. Adolescents are at higher risk for Hr-TB. Strains of isoniazid-resistant M tuberculosis are actively circulating in Haiti and transmission is likely occurring in community settings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Haiti Idioma: En Revista: Open Forum Infect Dis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Haiti Idioma: En Revista: Open Forum Infect Dis Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos