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. 2013 Dec 23;8(12):e83006.
doi: 10.1371/journal.pone.0083006. eCollection 2013.

Association between Mycobacterium tuberculosis complex phylogenetic lineage and acquired drug resistance

Courtney M Yuen  1 , Ekaterina V Kurbatova  1 , Eleanor S Click  1 , J Sean Cavanaugh  1 , J Peter Cegielski  1
Affiliations

Association between Mycobacterium tuberculosis complex phylogenetic lineage and acquired drug resistance

Courtney M Yuen et al. PLoS One. .

Abstract

Background: Development of resistance to antituberculosis drugs during treatment (i.e., acquired resistance) can lead to emergence of resistant strains and consequent poor clinical outcomes. However, it is unknown whether Mycobacterium tuberculosis complex species and lineage affects the likelihood of acquired resistance.

Methods: We analyzed data from the U.S. National Tuberculosis Surveillance System and National Tuberculosis Genotyping Service for tuberculosis cases during 2004-2011 with assigned species and lineage and both initial and final drug susceptibility test results. We determined univariate associations between species and lineage of Mycobacterium tuberculosis complex bacteria and acquired resistance to isoniazid, rifamycins, fluoroquinolones, and second-line injectables. We used Poisson regression with backward elimination to generate multivariable models for acquired resistance to isoniazid and rifamycins.

Results: M. bovis was independently associated with acquired resistance to isoniazid (adjusted prevalence ratio = 8.46, 95% CI 2.96-24.14) adjusting for HIV status, and with acquired resistance to rifamycins (adjusted prevalence ratio = 4.53, 95% CI 1.29-15.90) adjusting for homelessness, HIV status, initial resistance to isoniazid, site of disease, and administration of therapy. East Asian lineage was associated with acquired resistance to fluoroquinolones (prevalence ratio = 6.10, 95% CI 1.56-23.83).

Conclusions: We found an association between mycobacterial species and lineage and acquired drug resistance using U.S. surveillance data. Prospective clinical studies are needed to determine the clinical significance of these findings, including whether rapid genotyping of isolates at the outset of treatment may benefit patient management.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Selection of cases included in analysis.
Abbreviations: TB = tuberculosis, DST = drug susceptibility test, AR = acquired resistance.
See this image and copyright information in PMC

References

    1. Seung KJ, Gelmanova IE, Peremitin GG, Golubchikova VT, Pavlova VE, et al. (2004) The effect of initial drug resistance on treatment response and acquired drug resistance during standardized short-course chemotherapy for tuberculosis. Clin Infect Dis 39: 1321–1328. - PubMed
    1. Hanif M, Malik S, Dhingra VK (2009) Acquired drug resistance pattern in tuberculosis cases at the State Tuberculosis Centre, Delhi, India. Int J Tuberc Lung Dis 13: 74–78. - PubMed
    1. Temple B, Ayakaka I, Ogwang S, Nabanjja H, Kayes S, et al. (2008) Rate and amplification of drug resistance among previously-treated patients with tuberculosis in Kampala, Uganda. Clin Infect Dis 47: 1126–1134. - PMC - PubMed
    1. Mitchison DA (1998) How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis. Int J Tuberc Lung Dis 2: 10–15. - PubMed
    1. Chiang CY, Schaaf HS (2010) Management of drug-resistant tuberculosis. Int J Tuberc Lung Dis 14: 672–682. - PubMed

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