Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia
Objective: Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia. Methods...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
|
| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579423000670 |
| _version_ | 1797372049395548160 |
|---|---|
| author | Getu Balay Kedir Abdella Wakjira Kebede Mulualem Tadesse Zegeye Bonsa Mekidim Mekonnen Misikir Amare Gemeda Abebe |
| author_facet | Getu Balay Kedir Abdella Wakjira Kebede Mulualem Tadesse Zegeye Bonsa Mekidim Mekonnen Misikir Amare Gemeda Abebe |
| author_sort | Getu Balay |
| collection | DOAJ |
| description | Objective: Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia. Methods: A Phenotypic Drug Susceptibility Testing (DST) of PZA with BACTEC MGIT 960 was conducted at the Mycobacteriology Research Center of Jimma University (MRC-JU) from June to November 2021 on sixty-six Mycobacterium tuberculosis complex (MTBC) isolates from previously treated TB cases. SPSS software package version 21 was used. The differences in the proportion of PZA resistance between the groups were compared using the chi squared test. Logistic regression was used to identify the association between PZA resistance and treatment outcomes. Results: Among 66 MTBC isolates (49 rifampicin-resistant and 17 rifampicin-sensitive) included in this study, 31.8 % were resistant to PZA. The proportion of PZA resistance was almost three times higher in previously treated TB cases with rifampicin resistance than in rifampicin-sensitive patients (38.8 % vs. 11.8 %, p = 0.039). An unfavorable treatment outcome was documented for 23 % (15/65) of the participants. Patients with PZA resistance were almost four times more likely to have an unfavorable treatment outcome than patients with PZA sensitive (aOR 4.2, 95 % CI: 1.13–15.3). Conclusions: The prevalence of PZA resistance was high compared to the pooled PZA resistance estimated worldwide. The majority of TB cases with PZA resistance had an unfavorable treatment outcome. PZA susceptibility testing should be included in the multidrug-resistant TB diagnostic algorithm to improve management of these patients. |
| first_indexed | 2024-03-08T18:29:47Z |
| format | Article |
| id | doaj.art-7a31cc382fd745c293064b0dee28f12e |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-03-08T18:29:47Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-7a31cc382fd745c293064b0dee28f12e2023-12-30T04:44:31ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942024-02-0134100411Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, EthiopiaGetu Balay0Kedir Abdella1Wakjira Kebede2Mulualem Tadesse3Zegeye Bonsa4Mekidim Mekonnen5Misikir Amare6Gemeda Abebe7Mycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia; Corresponding author.School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaMycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia; School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaMycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia; School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaMycobacteriology Research Center, Institute of Health, Jimma University, Jimma, EthiopiaSchool of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaEthiopian Public Health Institute, National Tuberculosis Reference Laboratory, Addis Ababa, EthiopiaMycobacteriology Research Center, Institute of Health, Jimma University, Jimma, Ethiopia; School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, EthiopiaObjective: Pyrazinamide (PZA) susceptibility testing is important to develop evidence-based algorithms for case management. We aimed to assess the prevalence of PZA-resistance and its impact on treatment outcomes in previously treated tuberculosis (TB) cases in southwestern Oromia, Ethiopia. Methods: A Phenotypic Drug Susceptibility Testing (DST) of PZA with BACTEC MGIT 960 was conducted at the Mycobacteriology Research Center of Jimma University (MRC-JU) from June to November 2021 on sixty-six Mycobacterium tuberculosis complex (MTBC) isolates from previously treated TB cases. SPSS software package version 21 was used. The differences in the proportion of PZA resistance between the groups were compared using the chi squared test. Logistic regression was used to identify the association between PZA resistance and treatment outcomes. Results: Among 66 MTBC isolates (49 rifampicin-resistant and 17 rifampicin-sensitive) included in this study, 31.8 % were resistant to PZA. The proportion of PZA resistance was almost three times higher in previously treated TB cases with rifampicin resistance than in rifampicin-sensitive patients (38.8 % vs. 11.8 %, p = 0.039). An unfavorable treatment outcome was documented for 23 % (15/65) of the participants. Patients with PZA resistance were almost four times more likely to have an unfavorable treatment outcome than patients with PZA sensitive (aOR 4.2, 95 % CI: 1.13–15.3). Conclusions: The prevalence of PZA resistance was high compared to the pooled PZA resistance estimated worldwide. The majority of TB cases with PZA resistance had an unfavorable treatment outcome. PZA susceptibility testing should be included in the multidrug-resistant TB diagnostic algorithm to improve management of these patients.http://www.sciencedirect.com/science/article/pii/S2405579423000670Retreatment tuberculosisPyrazinamide susceptibility testingTreatment outcome |
| spellingShingle | Getu Balay Kedir Abdella Wakjira Kebede Mulualem Tadesse Zegeye Bonsa Mekidim Mekonnen Misikir Amare Gemeda Abebe Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Retreatment tuberculosis Pyrazinamide susceptibility testing Treatment outcome |
| title | Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia |
| title_full | Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia |
| title_fullStr | Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia |
| title_full_unstemmed | Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia |
| title_short | Resistance to pyrazinamide in Mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in Southwestern Oromia, Ethiopia |
| title_sort | resistance to pyrazinamide in mycobacterium tuberculosis complex isolates from previously treated tuberculosis cases in southwestern oromia ethiopia |
| topic | Retreatment tuberculosis Pyrazinamide susceptibility testing Treatment outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2405579423000670 |
| work_keys_str_mv | AT getubalay resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT kedirabdella resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT wakjirakebede resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT mulualemtadesse resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT zegeyebonsa resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT mekidimmekonnen resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT misikiramare resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia AT gemedaabebe resistancetopyrazinamideinmycobacteriumtuberculosiscomplexisolatesfrompreviouslytreatedtuberculosiscasesinsouthwesternoromiaethiopia |