TITLE:
Molecular Detection of Resistance to Rifampin and Isoniazid among Patients Eligible for Retreatment Regimen in Côte d’Ivoire in 2012
AUTHORS:
Kouassi N’Guessan, Timothée Ouassa, Jean-Serge Assi, André Tehe, Jean-Marc Assande, André Guei, Jacquemin Kouakou
KEYWORDS:
Tuberculosis; Molecular Detection; Drug-Resistance
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.2,
June
5,
2013
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.