Sublineages of Mycobacterium tuberculosis Beijing genotype strains and unfavorable outcomes of anti-tuberculosis treatment.
The influence of Mycobacterium tuberculosis (MTB) lineages/sublineages on unfavorable tuberculosis (TB) treatment outcomes is poorly understood. We investigated the effects of Beijing genotype sublineages and other factors contributing to treatment outcome. Patients newly diagnosed with sputum smear-positive and culture-positive TB in Hanoi, Vietnam, participated in the study. After receiving anti-TB treatment, they were intensively followed up for the next 16 months. MTB isolates collected before treatment were subjected to drug susceptibility testing, and further analyzed to determine MTB (sub) lineages and their clonal similarities. Of 430 patients, 17 had treatment failure and 30 had TB recurrence. Rifampicin resistance was associated with treatment failure {adjusted odds ratio = 6.64 [95% confidence interval (CI), 1.48-29.73]}. The modern Beijing genotype was significantly associated with recurrent TB within 16 months [adjusted hazard ratio = 3.29 (95% CI, 1.17-9.27)], particularly after adjustment for the relevant antibiotic resistance. Human immunodeficiency virus coinfection and severity on chest radiographs were not significantly associated with unfavorable outcomes. Our findings provide further understanding of the influence of MTB strains on unfavorable treatment outcomes. Multiple risk factors should be considered for the optimal management of TB.
Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, Tokyo, Japan; National Center for Global Health and Medicine-Bach Mai Hospital (NCGM-BMH) Medical Collaboration Center, Hanoi, Viet Nam. Electronic address: lehang0310@gmail.com.
Nguyen T L
NT
Hang
Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan. Electronic address: maeda@jata.or.jp.
Shinji
S
Maeda
Department of Pathophysiology and Host Defense, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: nkeicho-tky@umin.ac.jp.
Naoto
N
Keicho
Hanoi Lung Hospital, Hanoi, Viet Nam. Electronic address: phamhuuthuong.hth@gmail.com.
Pham H
PH
Thuong
Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: endoh@research.twmu.ac.jp.
Hiroyoshi
H
Endo
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics* / Q000472:pathogenicity; D016017:Odds Ratio; D010641:Phenotype; D016016:Proportional Hazards Models; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use*; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014744:Vietnam; D055815:Young Adult
D000995:Antitubercular Agents; D012293:Rifampin
Beijing genotype; Recurrence; Sublineage; Treatment failure; Vietnam