The T2 Mycobacterium tuberculosis genotype, predominant in Kampala, Uganda, shows negative correlation with antituberculosis drug resistance.
Surveillance of the circulating Mycobacterium tuberculosis complex (MTC) strains in a given locality is important for understanding tuberculosis (TB) epidemiology. We performed molecular epidemiological studies on sputum smear-positive isolates that were collected for anti-TB drug resistance surveillance to establish the variability of MTC lineages with anti-TB drug resistance and HIV infection. Spoligotyping was performed to determine MTC phylogenetic lineages. We compared patients' MTC lineages with drug susceptibility testing (DST) patterns and HIV serostatus. Out of the 533 isolates, 497 (93.2%) had complete DST, PCR, and spoligotyping results while 484 (90.1%) participants had results for HIV testing. Overall, the frequency of any resistance was 75/497 (15.1%), highest among the LAM (34.4%; 95% confidence interval [CI], 18.5 to 53.2) and lowest among the T2 (11.5%; 95% CI, 7.6 to 16.3) family members. By multivariate analysis, LAM (adjusted odds ratio [OR(adj)], 5.0; 95% CI, 2.0 to 11.9; P < 0.001) and CAS (OR(adj), 2.9; 95% CI, 1.4.0 to 6.3; P = 0.006) families were more likely to show any resistance than was T2. All other MTC lineages combined were more likely to be resistant to any of the anti-TB drugs than were the T2 strains (OR(adj), 1.7; 95% CI, 1.0 to 2.9; P = 0.040). There were no significant associations between multidrug resistance and MTC lineages, but numbers of multidrug-resistant TB strains were small. No association was established between MTC lineages and HIV status. In conclusion, the T2 MTC lineage negatively correlates with anti-TB drug resistance, which might partly explain the reported low levels of anti-TB drug resistance in Kampala, Uganda. Patients' HIV status plays no role with respect to the MTC lineage distribution.
National Tuberculosis and Leprosy Program, Kampala, Uganda.
Deus
D
Lukoye
Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
Fred A
FA
Katabazi
National Tuberculosis Reference Laboratory, Kampala, Uganda.
Kenneth
K
Musisi
Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
David P
DP
Kateete
Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
Benon B
BB
Asiimwe
Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
Moses
M
Okee
Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda National Tuberculosis Reference Laboratory, Kampala, Uganda.
Moses L
ML
Joloba
Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands KNCV Tuberculosis Foundation, The Hague, The Netherlands f.cobelens@aighd.org.
Frank G J
FG
Cobelens
D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D062486:Public Health Surveillance; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology*; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
D000995:Antitubercular Agents