Phenotypic and genotypic analysis of multidrug-resistant tuberculosis in Ethiopia.
METHODS
National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia.


OBJECTIVE
To determine the drug susceptibility pattern of Mycobacterium tuberculosis isolates and to genetically characterise multidrug-resistant tuberculosis (MDR-TB) isolates.


METHODS
A total of 107 M. tuberculosis isolates recovered during the period December 2005-August 2006 were tested for drug susceptibility against streptomycin, isoniazid, rifampicin and ethambutol (SHRE) using the proportion method on Löwenstein-Jensen medium. The MDR-TB isolates were tested against kanamycin, ciprofloxacin, capreomycin, D-cycloserine and ethionamide. Genotyping was performed using spoligotyping.


RESULTS
MDR-TB was observed in one of the 44 new cases (2.3%) and 45/63 previously treated patients (71.4%). Drug susceptibility testing against second-line drugs (SLDs) showed that 26.1% of all MDR-TB isolates were susceptible to all SLDs tested and 73.9% were resistant to one or more classes of SLD. Extensively drug-resistant (XDR) TB was detected in two isolates (4.4%). T3_ETH was the predominant spoligotype, followed by CAS_KILI. In this African setting, no Beijing spoligotype was identified.


CONCLUSIONS
Both MDR- and XDR-TB are present in Ethiopian patients. MDR-TB was found to be associated with T3 and Central Asian genotypes.
Agonafir
M
M
Infectious and Other Diseases Research Department, Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia. macagonafi r@gmail.com
Lemma
E
E
Wolde-Meskel
D
D
Goshu
S
S
Santhanam
A
A
Girmachew
F
F
Demissie
D
D
Getahun
M
M
Gebeyehu
M
M
van Soolingen
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005002:Ethiopia / Q000453:epidemiology; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008828:Microbiological Techniques; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D010641:Phenotype; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
D000995:Antitubercular Agents; D004269:DNA, Bacterial