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Diversity of Mycobacterium tuberculosis and drug resistance in different provinces of Papua New Guinea.

Ley SD, Harino P, Vanuga K, Kamus R, Carter R, Coulter C, Pandey S, Feldmann J, Ballif M, Siba PM, Phuanukoonnon S, Gagneux S, Beck HP - BMC Microbiol. (2014)

Bottom Line: Multi-drug resistant (MDR) TB was found in 2.8% of all tested cases (6/212).The highest amount of MDR TB was found in Alotau in Milne Bay Province (4.6%).Due to the high prevalence of Lineage 2 in Milne Bay Province and given the frequent association of this lineage with drug resistance, monitoring of the latter should especially be scaled up in that province.

View Article: PubMed Central - PubMed

Affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. serej.ley@unibas.ch.

ABSTRACT

Background: Papua New Guinea (PNG) is a high tuberculosis (TB) burden country of the WHO Western Pacific Region, but so far research on drug resistance (DR) and genotypes of Mycobacterium tuberculosis (M. tuberculosis) was only conducted in few provinces in the country. The aim of the present study was to obtain baseline data on the level of drug resistance and the genotypic diversity of circulating M. tuberculosis in additional provinces and to investigate the differences between three selected sites across PNG.

Results: Genotyping of 147 M. tuberculosis clinical isolates collected in Goroka, Eastern Highlands Province, in Alotau, Milne Bay Province and in Madang, Madang Province revealed three main lineages of M. tuberculosis: Lineage 4 (European-American lineage), Lineage 2 (East-Asian lineage) and Lineage 1 (Indo-Oceanic lineage). All three lineages were detected in all three sites, but the individual lineage compositions varied significantly between sites. In Madang Lineage 4 was the most prevalent lineage (76.6%), whereas in Goroka and Alotau Lineage 2 was dominating (60.5% and 84.4%, respectively) (p < 0.001). Overall, phenotypic drug susceptibility testing showed 10.8% resistance to at least one of the first-line drugs tested. Of all resistant strains (23/212) 30.4% were Streptomycin mono-resistant, 17.4% were Isoniazid mono-resistant and 13% were Rifampicin mono-resistant. Multi-drug resistant (MDR) TB was found in 2.8% of all tested cases (6/212). The highest amount of MDR TB was found in Alotau in Milne Bay Province (4.6%).

Conclusion: A large number of drug resistant TB infections are present in the country and MDR TB has already been detected in all three surveyed regions of PNG, highlighting the importance of monitoring drug resistance and making it a high priority for the National Control Program. Due to the high prevalence of Lineage 2 in Milne Bay Province and given the frequent association of this lineage with drug resistance, monitoring of the latter should especially be scaled up in that province.

No MeSH data available.


Related in: MedlinePlus

Flow chart of cohort sample size development from screening to genotyping.
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Fig1: Flow chart of cohort sample size development from screening to genotyping.

Mentions: A total of 449 patients enrolled into our study were diagnosed with TB of any type. From 396 of these patients sputum samples could be collected and of these 335 (74.6%) samples were available for study purposes (see Figure 1). From 212 (63.3%) of the available samples M. tuberculosis were successfully grown in culture and drug susceptibility testing (DST) was performed. Details of population characteristics per study site are described in Table 1.Figure 1


Diversity of Mycobacterium tuberculosis and drug resistance in different provinces of Papua New Guinea.

Ley SD, Harino P, Vanuga K, Kamus R, Carter R, Coulter C, Pandey S, Feldmann J, Ballif M, Siba PM, Phuanukoonnon S, Gagneux S, Beck HP - BMC Microbiol. (2014)

Flow chart of cohort sample size development from screening to genotyping.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4264550&req=5

Fig1: Flow chart of cohort sample size development from screening to genotyping.
Mentions: A total of 449 patients enrolled into our study were diagnosed with TB of any type. From 396 of these patients sputum samples could be collected and of these 335 (74.6%) samples were available for study purposes (see Figure 1). From 212 (63.3%) of the available samples M. tuberculosis were successfully grown in culture and drug susceptibility testing (DST) was performed. Details of population characteristics per study site are described in Table 1.Figure 1

Bottom Line: Multi-drug resistant (MDR) TB was found in 2.8% of all tested cases (6/212).The highest amount of MDR TB was found in Alotau in Milne Bay Province (4.6%).Due to the high prevalence of Lineage 2 in Milne Bay Province and given the frequent association of this lineage with drug resistance, monitoring of the latter should especially be scaled up in that province.

View Article: PubMed Central - PubMed

Affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland. serej.ley@unibas.ch.

ABSTRACT

Background: Papua New Guinea (PNG) is a high tuberculosis (TB) burden country of the WHO Western Pacific Region, but so far research on drug resistance (DR) and genotypes of Mycobacterium tuberculosis (M. tuberculosis) was only conducted in few provinces in the country. The aim of the present study was to obtain baseline data on the level of drug resistance and the genotypic diversity of circulating M. tuberculosis in additional provinces and to investigate the differences between three selected sites across PNG.

Results: Genotyping of 147 M. tuberculosis clinical isolates collected in Goroka, Eastern Highlands Province, in Alotau, Milne Bay Province and in Madang, Madang Province revealed three main lineages of M. tuberculosis: Lineage 4 (European-American lineage), Lineage 2 (East-Asian lineage) and Lineage 1 (Indo-Oceanic lineage). All three lineages were detected in all three sites, but the individual lineage compositions varied significantly between sites. In Madang Lineage 4 was the most prevalent lineage (76.6%), whereas in Goroka and Alotau Lineage 2 was dominating (60.5% and 84.4%, respectively) (p < 0.001). Overall, phenotypic drug susceptibility testing showed 10.8% resistance to at least one of the first-line drugs tested. Of all resistant strains (23/212) 30.4% were Streptomycin mono-resistant, 17.4% were Isoniazid mono-resistant and 13% were Rifampicin mono-resistant. Multi-drug resistant (MDR) TB was found in 2.8% of all tested cases (6/212). The highest amount of MDR TB was found in Alotau in Milne Bay Province (4.6%).

Conclusion: A large number of drug resistant TB infections are present in the country and MDR TB has already been detected in all three surveyed regions of PNG, highlighting the importance of monitoring drug resistance and making it a high priority for the National Control Program. Due to the high prevalence of Lineage 2 in Milne Bay Province and given the frequent association of this lineage with drug resistance, monitoring of the latter should especially be scaled up in that province.

No MeSH data available.


Related in: MedlinePlus