Mycobacterium tuberculosis lineages and anti-tuberculosis drug resistance in reference hospitals across Viet Nam

BMC Microbiology

Research Article

Kim Lien Thi Pham¹  Duc Anh Dang¹  Thanh Hoa Thi Tran¹  Van Anh Thi Nguyen²  Anne-Laure Bañuls³  Thai Son Nguyen⁴  Nam Lien Thi Nguyen⁵  Hung Van Nguyen⁶  Ngoc Lan Thi Nguyen⁷  Marc Choisy⁸  Guy B. Marks⁹ 

[1] Department of Bacteriology, National Institute of Hygiene Epidemiology, Hanoi, Vietnam;Department of Bacteriology, National Institute of Hygiene Epidemiology, Hanoi, Vietnam;Laboratory of Tuberculosis, Department of Bacteriology, National Institute of Hygiene and Epidemiology, 10000, Hanoi, Vietnam;Department of Bacteriology, National Institute of Hygiene Epidemiology, Hanoi, Vietnam;MIVEGEC (IRD 224-CNRS 5290-Université de Montpellier), Centre IRD, Montpellier, France;Department of Microbiology, Hospital 103, Military Medical University, Hanoi, Vietnam;Department of Microbiology, Hue Central Hospital, Hue, Vietnam;Department of Microbiology, National Lung Hospital, Hanoi, Vietnam;Department of Microbiology, Pham Ngoc Thach Hospital, Ho Chi Minh city, Vietnam;MIVEGEC (IRD 224-CNRS 5290-Université de Montpellier), Centre IRD, Montpellier, France;Oxford University Clinical Research Unit, Hanoi, Vietnam;Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia;South Western Sydney Clinical School, UNSW, Sydney, Australia;

关键词: Tuberculosis;    Mycobacterium tuberculosis;    Lineage;    Drug resistance;    Reference hospital;    Vietnam;   

DOI  :  10.1186/s12866-016-0784-6

 received in 2016-03-19, accepted in 2016-07-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundMycobacterium tuberculosis, the tuberculosis (TB) pathogen, despite a low level of genetic diversity, has revealed a high variety of biological and epidemiological characteristics linked to their lineages, such as transmissibility, fitness and propensity to acquire drug resistance. This has important implications for the epidemiology of TB. We conducted this first countrywide cross-sectional study to identify the prevalent M. tuberculosis lineages and to assess their epidemiological associations and their relation to drug resistance. The study was conducted among isolates acquired in reference hospitals across Vietnam. Isolates with drug susceptibility testing profiles were identified for their lineages by spoligotyping. Logistic regression was used to investigate the association of M. tuberculosis lineages with location, age and sex of the patients and drug resistance levels.ResultsResults showed that the most prevalent lineage was Beijing (55.4 %), followed by EAI (27.5 %), T (6.4 %), LAM (1.3 %), Haarlem (1 %) and Zero type (0.3 %). The proportion of Beijing isolates in the North (70.4 %) and the South (68 %) was higher than in the Centre (28 %) (OR = 1.7 [95 % CI: 1.4–2.0], p < 0.0001), whereas the proportion of EAI isolates in the North (7.1 %) and the South (17 %) was much lower compared with the Centre (59 %) (OR = 0.5 [95 % CI: 0.4–0.6], p < 0.0001). Overall, Beijing isolates were the most likely to be drug-resistant and EAI isolates were the least likely to be drug-resistant, except in the South of Vietnam where EAI is also highly drug-resistant. The proportion of Beijing isolates was significantly higher (p < 0.01), and the proportion of EAI isolates was significantly lower (p < 0.05) in younger patients. The proportion of drug-resistance was higher in isolates collected from male patients and from patients in the middle age groups.ConclusionsThe findings suggest ongoing replacement of EAI lineage, which is mainly more drug-susceptible with highly drug-resistant Beijing lineage in all studied regions of Vietnam. Male patients of working ages should be the focus for better control to prevent the emergence of drug-resistant TB.

【 授权许可】

CC BY   
© The Author(s). 2016