We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Molecular Epidemiology of Isoniazid-resistant M tuberculosis in Port-au-Prince, Haiti.
- Authors
Walsh, Kathleen F; Lee, Myung Hee; Chaguza, Chrispin; Pamphile, Widman; Royal, Gertrude; Escuyer, Vincent; Pape, Jean W; Fitzgerald, Daniel; Cohen, Ted; Ocheretina, Oksana
- Abstract
Background Isoniazid-resistant, rifampin-susceptible tuberculosis (Hr-TB) is associated with poor treatment outcomes and higher rates of acquisition of further drug resistance during treatment. Due to a lack of widespread diagnostics, Hr-TB is frequently undetected and its epidemiology is incompletely understood. Methods We studied the molecular epidemiology of Hr-TB among all patients diagnosed with culture-positive pulmonary tuberculosis between January 1 and June 30, 2017, at an urban referral tuberculosis clinic in Port-au-Prince, Haiti. Demographic and clinical data were extracted from the electronic medical record. Archived diagnostic Mycobacterium tuberculosis isolates were tested for genotypic and phenotypic isoniazid resistance using the Genotype MTBDR plus assay (Hain, Nehren, Germany) and culture-based testing, respectively. All isoniazid-resistant isolates and a randomly selected subset of isoniazid-susceptible isolates underwent whole-genome sequencing to confirm the presence of mutations associated with isoniazid resistance, to validate use of Genotype MTBDR plus in this population, and to identify potential transmission links between isoniazid-resistant isolates. Results and Conclusions Among 845 patients with culture-positive pulmonary tuberculosis in Haiti, 65 (7.7%) had Hr-TB based on the Genotype MTBDR plus molecular assay. Age < 20 years was significantly associated with Hr-TB (odds ratio, 2.39; 95% confidence interval, 1.14, 4.70; P =.015). Thirteen (20%) isoniazid-resistant isolates were found in 5 putative transmission clusters based on a single nucleotide polymorphism distance of ≤ 5. No patients in these transmission clusters were members of the same household. Adolescents are at higher risk for Hr-TB. Strains of isoniazid-resistant M tuberculosis are actively circulating in Haiti and transmission is likely occurring in community settings.
- Subjects
WHOLE genome sequencing; MYCOBACTERIUM tuberculosis; TUBERCULOSIS; SINGLE nucleotide polymorphisms; ELECTRONIC health records
- Publication
Open Forum Infectious Diseases, 2024, Vol 11, Issue 8, p1
- ISSN
2328-8957
- Publication type
Article
- DOI
10.1093/ofid/ofae421