Putative extensive and pre-extensive drug resistant-tuberculosis associated with unusual genotypes on the Thailand-Myanmar border
DOI:
https://doi.org/10.1590/S1678-9946202163085Palabras clave:
Extensively drug-resistant tuberculosis, XDR-TB, Diagnosis, Genotypes, Thailand-Myanmar borderResumen
Extensive drug-resistant tuberculosis (XDR-TB) is highly life threatening and its diagnosis is usually difficult and time-consuming. Here we present the first two cases of XDR and pre-XDR-TB diagnosed in 2018 on the Thailand-Myanmar border, more specifically in Tak province. Rapid detection of XDR-TB was performed by loop-mediated isothermal amplification (LAMP), Xpert MTB/RIF, and line probe assays. Mutation analyses targeting rpoB, katG, inhA, gyrA and rrs genes showed an association with drug-resistant phenotypes, except for rifampicin resistance. Spoligotyping revealed uncommon Beijing and T2 genotypes and the analysis of M. tuberculosis interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) showed the presence of more polymorphisms. This report highlights the importance of the early detection of drug-resistant tuberculosis by molecular tests followed by phenotyping assays. Based on the up-to-date definition of XDR- and pre-XDR-TB, the susceptibility testing for bedaquiline and linezolid is required and the two reported cases may correspond to putative XDR-TB.
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Derechos de autor 2021 Janisara Rudeeaneksin, Wiphat Klayut, Sopa Srisungngam, Supranee Bunchoo, Sarawut Toonkomdang, Thanee Wongchai, Nattagarn Chuenchom, Benjawan Phetsuksiri
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
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Health Systems Research Institute
Números de la subvención 60-086