title: Mycobacterium tuberculosis resistance in pulmonary TB patients in Cameroon: a phenotypic susceptibility assay.
abstract: OBJECTIVE
  To determine the resistance of Mycobacterium tuberculosis to first- and second-line agents in adult pulmonary tuberculosis (TB) patients in Cameroon using a novel phenotypic assay.
  
  
  METHODS
  Samples were collected from TB patients at Bamenda Hospital in Bamenda, Cameroon.
  
  
  METHODS
  Samples were collected consecutively from adult pulmonary TB patients over a 2-month period. TREK Sensititre(TM) MYCOTB panels were used to perform phenotypic drug susceptibility testing (DST). Susceptibility/resistance was determined by comparing minimum inhibitory concentrations to standard critical concentrations established for first- and second-line anti-tuberculosis drugs.
  
  
  RESULTS
  Of 103 sputum samples processed, growth on Löwenstein-Jensen media was confirmed in 78 samples, 65 of which were suitable for DST. Thirty-nine strains (60%) were susceptible to all first- and second-line drugs. Five strains (8%) were categorized as multidrug-resistant TB. Two strains (3%) were classified as pre-extensively drug-resistant TB. Of those isolates susceptible to first-line drugs, 20% were resistant to at least one second-line drug.
  
  
  CONCLUSIONS
  Antimicrobial resistance may be higher than assumed in TB strains in Cameroon, especially with regard to second-line drugs. There remains a need for rapid, comprehensive DST.
authors.affiliation: The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; Maine Medical Center/Tufts University School of Medicine, Portland, Maine, USA.
authors.forename: J
authors.initials: J
authors.lastname: Jubulis
authors.affiliation: The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: K
authors.initials: K
authors.lastname: Dionne
authors.affiliation: The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: G
authors.initials: G
authors.lastname: Osterhout
authors.affiliation: Regional Hospital, Bamenda, Cameroon.
authors.forename: L
authors.initials: L
authors.lastname: Ayuk
authors.affiliation: Regional Hospital, Bamenda, Cameroon.
authors.forename: C
authors.initials: C
authors.lastname: Awasom
authors.affiliation: Mezam Polyclinic HIV/AIDS Treatment Centre, Bamenda.
authors.forename: P
authors.initials: P
authors.lastname: Achu
authors.affiliation: German International Cooperation, Yaoundé, Cameroon.
authors.forename: J
authors.initials: J
authors.lastname: Noeske
authors.affiliation: Stellenbosch University, Cape Town, South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Warren
authors.affiliation: The University of Missouri-Kansas City School of Dentistry, Kansas City, Missouri, USA.
authors.forename: C
authors.initials: C
authors.lastname: McArthur
authors.affiliation: The Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: N
authors.initials: N
authors.lastname: Parrish
mesh_terms: D000995:Antitubercular Agents / Q000145:classification* / Q000627:therapeutic use*; D002163:Cameroon; D003470:Culture Media; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D003470:Culture Media