Molecular Detection of Resistance to Rifampin and Isoniazid among Patients Eligible for Retreatment Regimen in Côte d’Ivoire in 2012

Kouassi N’Guessan, Timothée Ouassa, Jean-Serge Assi, André Tehe, Jean-Marc Assande, André Guei, Jacquemin Kouakou

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Institut Pasteur de Cote d’Ivoire, Laboratoire National de Référence de la Tuberculose, Abidjan, Cote d’Ivoire.

DOI: 10.4236/aid.2013.32010                

Abstract

Drug-resistant tuberculosis is an important health problem in Cote d’Ivoire. Patients of category I treatment are based on 2RHZE/4RH regimen. For the patients of category II, the 2RHZES/1RHZE/5HRE regimen is systematically initiated. Study objective was to describe the susceptibility profile to Rifampin and Isoniazid among previously treated patients who are eligible for retreatment and who had received the 2RHZES/1RHZE/5HRE regimen in Cote d’Ivoire with a molecular method in 2012. Two sputum samples were collected to each patient recruited in the reference regional centres for tuberculosis. Sputum samples were decontaminated by NALC method. The DNA extraction was realized with 500 μl of decontaminated sputum sample with smear-positive. MTBDRplus assay version 1.0 was performed according to the manufacturer’s instruction. An internal quality control program with positive and negative controls was implemented for interpretation of results. A total of 278 patients were enrolled, 148 (53.2%) were recurrent TB cases, 118 (42.5%) failure cases, and 12 (4.3%) defaulters. From sputum of previously treated patients, mutli-drug resistant tuberculosis was diagnosed for 60 (69.8%, 95% IC, 60% - 80%) treated with the 2RHZE/4RH regimen, 24 (75%, 95% IC, 60% - 90%) with the 2RHZES/1RHZE/5HRE regimen, 60 (41%, 95% IC, 33% - 49%) recurrent TB cases, and 4 (33.3%) defaulters. The comparison of resistance rates to Rifampin estimated from sputum samples in the categories of treatment failures and the recurrence TB cases showed a statistically significant difference. In Cote d’Ivoire, genotype^? MTBDRplus assay has permitted to estimate the prevalence of MDR-TB in categories of previously treated patients for tuberculosis.

Keywords

Tuberculosis; Molecular Detection; Drug-Resistance

Conflicts of Interest

The authors declare no conflicts of interest.

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