INCIDENCE OF FLUOROQUINOLONE AND AMINOGLYCOSIDE RESISTANCE VIA ONLINE PROBE ASSAY IN MULTIDRUG-RESISTANT TUBERCULOSIS CASES
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Keywords
MDR-TB, Line Probe Assay, Fluoroquinolone resistance, Aminoglycoside resistance, Pre-XDR-TB, Pakistan.
Abstract
Introduction: MDR-TB is a serious public health issue in places like Pakistan that report high cases. Anti-TB treatments are made harder, and XDR-TB becomes more likely when bacteria resist drugs other than the first-line drugs.
Objective: To know how often fluoroquinolone and aminoglycoside resistance occurs by using the Line Probe Assay in cases with MDR-TB.
Materials and Methods: The study was carried out at Mayo Hospital, Lahore, From September, 2024 to February, 2025. A Line Probe Assay was used on sputum from 150 MDR-TB patients to check for mutations making the infection resistant to both FQs and AGs.
Results: Of the total cases, 42% showed FQ resistance, 19.3% showed AG resistance, and 12% showed Pre-XDR (a combination of FQ and AG resistance). The gyrA and rrs genes were observed to have the most mutations.
Conclusion: There is a high level of FQ and AG resistance. Quick detection of MDR-TB at the molecular level through LPA allows for proper treatment and management.
References
2- Diriba, G., Kebede, A., Tola, H.H., Alemu, A., Yenew, B., Moga, S., Addise, D., Mohammed, Z., Getahun, M., Fantahun, M. and Tadesse, M., 2022. Utility of line probe assay in detecting drug resistance and the associated mutations in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia. SAGE Open Medicine, 10, p.20503121221098241.
3- Dudnyk, A., Hempel, M., Lytvyniuk, O., Liudkevych, H., Matsera, V., Nikitchenko, T., Blyzniuk, S., Molina-Moya, B., Preyer, R. and Domínguez, J., 2024. Impact of line probe assay-based molecular testing on individualized treatment in patients with rifampicin-resistant tuberculosis: data from the prospective INNOVA4TB cohort study in Ukraine. Therapeutic Advances in Respiratory Disease, 18, p.17534666241249841.
4- Cao, Y., Parmar, H., Gaur, R.L., Lieu, D., Raghunath, S., Via, N., Battaglia, S., Cirillo, D.M., Denkinger, C., Georghiou, S. and Kwiatkowski, R., 2021. Xpert MTB/XDR: a 10-color reflex assay suitable for point-of-care settings to detect isoniazid, fluoroquinolone, and second-line-injectable-drug resistance directly from Mycobacterium tuberculosis-positive sputum. Journal of clinical microbiology, 59(3), pp.10-1128.
5- Agonafir, M., Belay, G., Feleke, A., Maningi, N., Girmachew, F., Reta, M. and Fourie, P.B., 2023. Profile and frequency of mutations conferring drug-resistant tuberculosis in the Central, Southeastern and Eastern Ethiopia. Infection and Drug Resistance, pp.2953-2961.
6- Rachow, A., Saathoff, E., Mindru, R., Popescu, O., Lugoji, D., Mahler, B., Merker, M., Niemann, S., Olaru, I.D., Kastner, S. and Hoelscher, M., 2022. Diagnostic performance of the AID line probe assay in the detection of Mycobacterium tuberculosis and drug resistance in Romanian patients with presumed TB. Plos one, 17(8), p.e0271297.
7- Reta, M.A., Maningi, N.E. and Fourie, P.B., 2024. Patterns and profiles of drug resistance-conferring mutations in Mycobacterium tuberculosis genotypes isolated from tuberculosis-suspected attendees of spiritual holy water sites in Northwest Ethiopia. Frontiers in Public Health, 12, p.1356826.
8- Madukaji, L., Okohu, I., Usman, S., Oyedum, U., Enagi, A., Usman, A., Adedeji, A.S., Owolagba, F., Ofuche, E., Samuels, J.O. and Jolayemi, T., 2021. Early detection of Pre-XDR TB with line probe assay in a high TB burden country. African Health Sciences, 21(3), pp.968-974.
9- Uddin, M.K.M., Cabibbe, A.M., Nasrin, R., Ghodousi, A., Nobel, F.A., Rahman, S.M., Ahmed, S., Ather, M.F., Razzaque, S.A., Raihan, M.A. and Modak, P.K., 2024. Targeted next-generation sequencing of Mycobacterium tuberculosis from patient samples: lessons learned from high drug-resistant burden clinical settings in Bangladesh. Emerging Microbes & Infections, 13(1), p.2392656.
10- Guo, Y., Lu, J., Jin, P., Qiu, Z., Yu, F., Zhu, Y. and Huang, J., 2025. Genomic characterization of multidrug-resistant tuberculosis in Shanghai, China: antibiotic resistance, virulence and transmission. JAC-Antimicrobial Resistance, 7(3), p.dlaf064.
11- Sanchini, A., Lanni, A., Giannoni, F. and Mustazzolu, A., 2024. Exploring diagnostic methods for drug-resistant tuberculosis: A comprehensive overview. Tuberculosis, p.102522.
12- Usman, A., Laura, M., Isaac, O., Saheed, U., Uche, O., Abdullahi, I.E., AS, A., Femi, O., Eke, O., Jay, O.S. and Toyin, J., 2021. Early detection of Pre-XDR TB with line probe assay in a high TB burden country.
13- Mbelele, P.M., Mpolya, E.A., Sauli, E., Mtafya, B., Ntinginya, N.E., Addo, K.K., Kreppel, K., Mfinanga, S., Phillips, P.P., Gillespie, S.H. and Heysell, S.K., 2021. Mycobactericidal effects of different regimens measured by molecular bacterial load assay among people treated for multidrug-resistant tuberculosis in Tanzania. Journal of clinical microbiology, 59(4), pp.10-1128.
14- Bhandari, A., Mahajan, R. and Ramesh, V., 2022. Drug-resistance and its impact on cutaneous tuberculosis. Indian Dermatology Online Journal, 13(5), pp.570-577.
15- Abubakar, A., 2024. Evaluation of determinants, acceptability and effectiveness of community-based management of multidrug-resistant tuberculosis (MDR-TB) in Nigeria (Doctoral dissertation, Anglia Ruskin Research Online (ARRO)).
16- Bedru, H., Fikru, M., Niguse, W., Jemal, A., Getinet, G., Gobena, A., Hailu, A. and Peter, S., 2021. Drug resistance pattern of M. tuberculosis complex in Oromia region of Ethiopia. Infection and Drug Resistance, pp.1679-1689.
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Jehan Anjum
MBBS, FCPS General Medicine, Consultant Physician, Employees Social Security Institution Polyclinic, Peshawar, Pakistan
Akhtar Ali Khan
Assistant Professor, Department of Pulmonology, Saidu Medical College and Saidu Group of Teaching Hospital Swat, Pakistan
Sara Bano
Senior Registrar Medical Unit 1, Department of Medicine, Arif Memorial Teaching Hospital, Pakistan
Omer Muhammad Naeem
Senior Registrar, Ihsan Mumtaz Teaching Hospital, Lahore, Pakistan
Hazar Khan Bugti
Assistant Professor, Pharmacology Department, Mekran Medical College Turbat, Pakistan
Dial Das
Associate Professor, Department of Pharmacology, Chandka Medical College, Larkana Sindh, Pakistan