Abstract | OBJECTIVES: METHODS: A retrospective cohort study was conducted from 2013 to 2018 in Jiangsu Province, China. Phenotypic Hr-TB were identified by drug susceptibility testing on Lowenstein-Jensen medium and using a Mycobacterium Growth Indicator Tube 960 (MGIT 960) system, and mutations in the katG 315 codon and inhA promoter nucleotides -8, -15 and -16 were determined by GenoType MTBDRplus and sequencing. All of the Hr-TB patients enrolled were followed up until June 2019. RESULTS: A total of 1416 smear-positive sputum samples were collected, of which 57 were excluded due to the presence of nontuberculous mycobacteria. Finally, 63/1359 (4.6%) were determined as Hr-TB. After follow-up, 11 Hr-TB patients (17.5%) showed an unfavourable outcome, of whom 5 (7.9%) relapsed, 4 (6.3%) had treatment failure and 2 (3.2%) died. A total of 52 isolates (82.5%) were detected with either katG 315 or inhA promoter nucleotide -8, -15 or -16 mutations, whereas no canonical mutations were found in 8 isolates (12.7%); 3 isolates failed in mutation detection. TB history was found to be associated with unfavourable outcomes for Hr-TB (odds ratio = 6.13, 95% confidence interval 1.05-35.82; P = 0.04). However, mutations in katG 315 and the inhA promoter region were not found to be associated with Hr-TB unfavourable outcomes (P = 0.15). CONCLUSION: Unfavourable outcomes for Hr-TB are serious in eastern China, especially for previously treated patients. Meanwhile, current genetic determination of Hr-TB is inadequate.
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Authors | Yan Shao, Yishu Li, Honghuan Song, Guoli Li, Yan Li, Limei Zhu, Wei Lu, Cheng Chen |
Journal | Journal of global antimicrobial resistance
(J Glob Antimicrob Resist)
Vol. 22
Pg. 847-853
(09 2020)
ISSN: 2213-7173 [Electronic] Netherlands |
PMID | 32739538
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved. |
Chemical References |
- Antitubercular Agents
- Isoniazid
|
Topics |
- Antitubercular Agents
(pharmacology)
- China
- Humans
- Isoniazid
(pharmacology)
- Microbial Sensitivity Tests
- Mutation
- Mycobacterium tuberculosis
(genetics)
- Retrospective Studies
- Treatment Outcome
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