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Authors Osei-Wusu S, Amo Omari M, Asante-Poku A, Darko Otchere I, Asare P, Forson A, Otu J, Antonio M, Yeboah-Manu D
Received 27 September 2017
Accepted for publication 30 November 2017
Published 22 February 2018 Volume 2018:11 Pages 239—246
DOI https://doi.org/10.2147/IDR.S152720
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Dr Sahil Khanna
Background: Drug resistance surveillance is crucial for tuberculosis (TB)
control. Therefore, our goal was to determine the prevalence of second-line
anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex
(MTBC) isolates in Ghana.
Materials and methods: One
hundred and seventeen MTBC isolates with varying first-line drug resistance
were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin
[STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and
GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA , gyrB , eis , rrs , tap , whiB7 and tlyA ) were then analyzed for
mutation.
Results: Thirty-seven (31.9%) isolates had minimum
inhibitory concentration (MIC) values ≥2 µg/mL against STR while 12 (10.3%)
isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR)
isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC =
3 µg/mL). This isolate also had the highest MIC value for AMK (MIC =
16 µg/mL) and was confirmed as resistant to AMK and MOX by the line probe
assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance
were: gyrA (G88C) and rrs (A514C and A1401G).
Conclusion: Our findings suggest the need to include routine
second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant
isolates in our diagnostic algorithm.
Keywords: tuberculosis,
drug resistance, diagnosis, Ghana, XDR