Abstract
Background: Drug-resistant tuberculosis (TB) is a serious problem. We investigated drug resistance-conferring mutations and lineages of Mycobacterium tuberculosis (MTB) isolated from patients with previous treatment history in Hanoi, Vietnam.
Methods: Retreated patients with smear- and culture-positive pulmonary TB were recruited. Mycobacterial DNA samples were analyzed using Illumina HiSeq (150 bp x2) and MiSeq (250 bp x2) systems. Drug resistance-conferring mutations and lineage-specific variations were identified using the TB-Profiler’s variation lists and other tools. Polytomous logistic regression models were used to investigate associations between mutations, lineages and epidemiological factors.
Results: Representative mutations included katG S315T (60.5%), rpsL K43R (37.2%), rpoB S450L (15.4%), embB M306V (7.4%), and gyrA (D94Y) (6.5%). Genotypic multidrug resistance accounted for 39.1%. katG S315T was mainly carried by MTB lineage 2 (65.4%), and less frequently seen in lineages 1 and 4 (22.2% and 40.7%, respectively) (P = 0.006). Whereas rpoB S450L was observed mainly in lineage 4, rpoB H445Y was more frequent in lineage 2 (P = 0.037); rpoB H445Y was also more frequently seen in patients with multiple treatments than those with a single past episode (19.4% vs. 4.9%, P = 0.007). History of multiple treatments was associated with rpoB H445Y mutation, even after adjustment for MTB lineages (adjusted odds ratio = 5.76 [95% confidence interval: 1.75−18.97]).
Conclusions: In Hanoi city, drug resistance-conferring mutations are prevailing differently depending on MTB lineages and treatment history. Confirmation of sterilizing cure is important for better TB control.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA2135.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019