Back to Search
Start Over
Targeted next-generation sequencing of sputum for diagnosis of drug-resistant TB: results of a national survey in Democratic Republic of the Congo.
- Source :
-
Scientific reports [Sci Rep] 2020 Jul 01; Vol. 10 (1), pp. 10786. Date of Electronic Publication: 2020 Jul 01. - Publication Year :
- 2020
-
Abstract
- The surveillance of drug resistance among tuberculosis (TB) patients is central to preventing the spread of antimicrobial resistance. The Democratic Republic of the Congo (DR Congo) is classified by the World Health Organization (WHO) as a country with a high burden of TB and multidrug-resistant TB (MDR-TB), but there are no nationally representative data on drug resistance. In 2016-2017, a national survey of TB patients was conducted in 108 microscopy centres across all 11 provinces of the country using innovative molecular approaches. Sputum samples were collected from 1,545 new and 163 previously treated patients. These were tested by the Xpert MTB/RIF assay, followed by targeted next-generation sequencing performed directly on sputum. The prevalence of rifampicin resistance was low, at 1.8% (95% CI: 1.0-3.2) among new and 17.3% (95% CI: 11.9-24.4) among previously treated patients. Resistance to pyrazinamide, fluoroquinolones and second-line injectables was also low. The prevalence of resistance to isoniazid among rifampicin-susceptible patients was higher, at 6.6% (95% CI: 4.4-9.8) among new and 8.7% (95% : 3.2-21.2) among previously treated patients. Diagnosing and treating isoniazid-resistant patients remains a challenge, given that many will be missed by the current national diagnostic algorithm that is driven by detecting rifampicin resistance by Xpert MTB/RIF. This is the first nationwide survey incorporating targeted sequencing directly on sputum. It serves as a proof-of-concept for other settings that do yet have rapid specimen transport networks or capacity to conduct culture.
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Cross-Sectional Studies
Democratic Republic of the Congo epidemiology
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Prevalence
Tuberculosis, Pulmonary diagnosis
Tuberculosis, Pulmonary drug therapy
Tuberculosis, Pulmonary epidemiology
Tuberculosis, Pulmonary genetics
High-Throughput Nucleotide Sequencing
Mycobacterium tuberculosis genetics
Sputum microbiology
Tuberculosis, Multidrug-Resistant diagnosis
Tuberculosis, Multidrug-Resistant drug therapy
Tuberculosis, Multidrug-Resistant epidemiology
Tuberculosis, Multidrug-Resistant genetics
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 32612134
- Full Text :
- https://doi.org/10.1038/s41598-020-67479-4