1887

Abstract

Nosocomial transmission of is an important health issue and the detection of tuberculosis (TB) cases is the main tool for controlling this disease.

We aimed to assess the possible occurrence of nosocomial transmission of in a reference hospital for HIV/AIDS patients and evaluate both the performance of the Xpert MTB/RIF (Xpert) platform and drug resistance profiles.

We evaluated the performance of the Xpert platform. Samples that tested positive on the BACTEC MGIT 320 (MGIT320) platform were submitted for genotyping and drug susceptibility testing.

In this study, pulmonary and extrapulmonary samples from 407 patients were evaluated, and among these, 15.5 % were diagnosed with TB by the MGIT320 platform, with a TB/HIV coinfection rate of 52.4 %. The Xpert platform gave positive results for TB for 11 samples with negative results on the MGIT320 platform. In the genotyping results, 53.3 % of the strains clustered; of these strains, half were in two of the four clusters formed, and the patients had visited the hospital on the same day. Drug resistance was observed in 11.7 % of the strains.

Putative nosocomial transmission of was detected, showing that genotyping is a powerful approach for understanding the dynamics of transmission, especially in a high-burden TB and HIV landscape.

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/content/journal/jmm/10.1099/jmm.0.001089
2019-10-09
2019-10-22
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References

  1. Gandhi NR, Weissman D, Moodley P, Ramathal M, Elson I et al. Nosocomial transmission of extensively drug-resistant tuberculosis in a rural hospital in South Africa. J Infect Dis 2013;207:9–17 [CrossRef]
    [Google Scholar]
  2. Miller AC, Polgreen LA, Cavanaugh JE, Hornick DB, Polgreen PM. Missed opportunities to diagnose tuberculosis are common among hospitalized patients and patients seen in emergency departments. Open Forum Infect Dis 2015;2:ofv171 [CrossRef]
    [Google Scholar]
  3. Centers for Disease Control and Prevention (CDC) CDC grand rounds: the TB/HIV syndemic. MMWR Morb Mortal Wkly Rep 2012;61:484–489
    [Google Scholar]
  4. Gopalan N, Chandrasekaran P, Swaminathan S, Tripathy S. Current trends and intricacies in the management of HIV-associated pulmonary tuberculosis. AIDS Res Ther 2016;13:34 [CrossRef]
    [Google Scholar]
  5. World Health Organization Global Tuberculosis Report 2017 France: WHO; 2018
    [Google Scholar]
  6. Dirlikov E, Raviglione M, Scano F. Global tuberculosis control: toward the 2015 targets and beyond. Ann Intern Med 2015;163:52–58 [CrossRef]
    [Google Scholar]
  7. Silva TMda, Soares VM, Ramos MG, Santos AD. Accuracy of a rapid molecular test for tuberculosis in sputum samples, bronchoalveolar lavage fluid, and tracheal aspirate obtained from patients with suspected pulmonary tuberculosis at a tertiary referral hospital. J Bras Pneumol 2019;45:e20170451 [CrossRef]
    [Google Scholar]
  8. Bajrami R, Mulliqi G, Kurti A, Lila G, Raka L. Comparison of GeneXpert MTB/RIF and conventional methods for the diagnosis of tuberculosis in kosovo. J Infect Dev Ctries 2016;10:418–422 [CrossRef]
    [Google Scholar]
  9. Gibson J, Donnan E, Eather G. Management of rifampicin mono-resistant tuberculosis in Queensland, Australia: a retrospective case series. Respirol Case Rep 2018;6:e00366 [CrossRef]
    [Google Scholar]
  10. Park S, Jo KW, Lee SD, Kim WS, Shim TS. Treatment outcomes of rifampin-sparing treatment in patients with pulmonary tuberculosis with rifampin-mono-resistance or rifampin adverse events: a retrospective cohort analysis. Respir Med 2017;131:43–48 [CrossRef]
    [Google Scholar]
  11. Valença MS, Scaini JLR, Abileira FS, Gonçalves CV, von Groll A et al. Prevalence of tuberculosis in prisons: risk factors and molecular epidemiology. Int J Tuberc Lung Dis 2015;19:1182–1187 [CrossRef]
    [Google Scholar]
  12. Mears J, Abubakar I, Cohen T, McHugh TD, Sonnenberg P. Effect of study design and setting on tuberculosis clustering estimates using mycobacterial interspersed repetitive Units-Variable number tandem repeats (MIRU-VNTR): a systematic review. BMJ Open 2015;5:e005636 [CrossRef]
    [Google Scholar]
  13. Jagielski T, Minias A, van Ingen J, Rastogi N, Brzostek A et al. Methodological and clinical aspects of the molecular epidemiology of Mycobacterium tuberculosis and other mycobacteria. Clin Microbiol Rev 2016;29:239–290 [CrossRef]
    [Google Scholar]
  14. Kritski A, Barreira D, Junqueira-Kipnis AP, Moraes MO, Campos MM et al. Brazilian response to Global End TB Strategy : the national tuberculosis research agenda. Rev Soc Bras Med Trop 2016;49:135–145 [CrossRef]
    [Google Scholar]
  15. Smithwick RW, Stratigos CB, David HL. Use of cetylpyridinium chloride and sodium chloride for the decontamination of sputum specimens that are transported to the laboratory for the isolation of Mycobacterium tuberculosis. J Clin Microbiol 1975;1:411–413
    [Google Scholar]
  16. Supply P. 2005; Multilocus variable number tandem repeat genotyping of Mycobacterium tuberculosis: technical guide. http://www.miru-vntrplus.org/MIRU/files/MIRU-VNTRtypingmanualv6.pdf Accessed 05 June 2018
  17. Weniger T, Krawczyk J, Supply P, Niemann S, Harmsen D. MIRU-VNTRplus: a web tool for polyphasic genotyping of Mycobacterium tuberculosis complex bacteria. Nucleic Acids Res 2010;38:W326–W331 [CrossRef]
    [Google Scholar]
  18. Allix-Béguec C, Harmsen D, Weniger T, Supply P, Niemann S. Evaluation and strategy for use of MIRU-VNTRplus, a multifunctional database for online analysis of genotyping data and phylogenetic identification of Mycobacterium tuberculosis complex isolates. J Clin Microbiol 2008;46:2692–2699 [CrossRef]
    [Google Scholar]
  19. Palomino JC, Martin A, Camacho M, Guerra H, Swings J et al. Resazurin microtiter assay plate: simple and inexpensive method for detection of drug resistance in Mycobacterium tuberculosis. Antimicrob Agents Chemother 2002;46:2720–2722 [CrossRef]
    [Google Scholar]
  20. Martin A, Palomino JC, Manual P, Assay RM. (REMA). Colorimetric Assay. Drug Susceptibility Testing for Mycobacterium Tuberculosis Belgium: Institute of Tropical Medicine, Mycobacteriology Unit Antwerp; 2009
    [Google Scholar]
  21. SINAN-RS 2017; Sistema de Informação de Agravos de Notificação - RS. Banco de dados agregados do DATASUS. http://200.198.173.165/scripts/tabcgi.exe?snet/tubercrsnet; Accessed 13 August 2019
  22. Loureiro RB, Villa TCS, Ruffino-Netto A, Peres RL, Braga JU et al. [Access to the diagnosis of tuberculosis in health services in the municipality of Vitoria, state of Espírito Santo, Brazil]. Cien Saude Colet 2014;19:1233–1244 [CrossRef]
    [Google Scholar]
  23. Bartholomay P, Pelissari DM, de Araujo WN, Yadon ZE, Heldal E. Quality of tuberculosis care at different levels of health care in Brazil in 2013. Rev Panam Salud Publica 2016;39:3–11
    [Google Scholar]
  24. Masini EO, Mansour O, Speer CE, Addona V, Hanson CL et al. Using survival analysis to identify risk factors for treatment interruption among new and retreatment tuberculosis patients in Kenya. PLoS One 2016;11:e0164172 [CrossRef]
    [Google Scholar]
  25. Naidoo K, Dookie N, Naidoo K, Yende-Zuma N, Chimukangara B et al. Recurrent tuberculosis among HIV-coinfected patients: a case series from KwaZulu-Natal. Infect Drug Resist 2018;11:1413–1421 [CrossRef]
    [Google Scholar]
  26. Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis 2015;78:47–55 [CrossRef]
    [Google Scholar]
  27. Boehme CC, Nabeta P, Hillemann D, Nicol MP, Shenai S et al. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med 2010;363:1005–1015 [CrossRef]
    [Google Scholar]
  28. Rice JP, Seifert M, Moser KS, Rodwell TC. Performance of the Xpert MTB/RIF assay for the diagnosis of pulmonary tuberculosis and rifampin resistance in a low-incidence, high-resource setting. PLoS One 2017;12:e0186139 [CrossRef]
    [Google Scholar]
  29. von Groll A, Martin A, Stehr M, Singh M, Portaels F et al. Fitness of Mycobacterium tuberculosis strains of the W-Beijing and Non-W-Beijing genotype. PLoS One 2010;5:e10191 [CrossRef]
    [Google Scholar]
  30. Soares RO, de Macedo MB, von Groll A, da Silva PEA. Mycobacterium tuberculosis belonging to family LAM and sublineage RD(Rio): common strains in Southern Brazil for over 10 years. Braz J Microbiol 2013;44:1251–1255 [CrossRef]
    [Google Scholar]
  31. Conceição EC, Rastogi N, Couvin D, Lopes ML, Furlaneto IP et al. Genetic diversity of Mycobacterium tuberculosis from Pará, Brazil, reveals a higher frequency of ancestral strains than previously reported in South America. Infect Genet Evol 2017;56:62–72 [CrossRef]
    [Google Scholar]
  32. Peres RL, Vinhas SA, Ribeiro FKC, Palaci M, do Prado TN et al. Risk factors associated with cluster size of Mycobacterium tuberculosis (Mtb) of different RFLP lineages in Brazil. BMC Infect Dis 2018;18:71 [CrossRef]
    [Google Scholar]
  33. Von Groll A, Martin A, Felix C, Prata PFS, Honscha G et al. Fitness study of the RDRio lineage and Latin American-Mediterranean family of Mycobacterium tuberculosis in the city ofRio Grande, Brazil. FEMS Immunol Med Microbiol 2010;58:119–127 [CrossRef]
    [Google Scholar]
  34. Loudon RG, Bumgarner LR, Lacy J, Coffman GK. Aerial transmission of mycobacteria. Am Rev Respir Dis 1969;100:165–171 [CrossRef]
    [Google Scholar]
  35. Fuge TG, Ayanto SY. Prevalence of smear positive pulmonary tuberculosis and associated risk factors among prisoners in Hadiya zone prison, southern Ethiopia. BMC Res Notes 2016;9:201 [CrossRef]
    [Google Scholar]
  36. Hazbón MH, Bobadilla del Valle M, Guerrero MI, Varma-Basil M, Filliol I et al. Role of embB codon 306 mutations in Mycobacterium tuberculosis revisited: a novel association with broad drug resistance and IS6110 clustering rather than ethambutol resistance. Antimicrob Agents Chemother 2005;49:3794–3802 [CrossRef]
    [Google Scholar]
  37. Damtie D, Woldeyohannes D, Mathewos B. Review on molecular mechanism of first line antibiotic resistance in Mycobacterium tuberculosis. Mycobact Dis 2014;4:174
    [Google Scholar]
  38. Velayati AA, Farnia P, Mozafari M, Sheikholeslami MF, Karahrudi MA et al. High prevelance of rifampin-monoresistant tuberculosis: a retrospective analysis among Iranian pulmonary tuberculosis patients. Am J Trop Med Hyg 2014;90:99–105 [CrossRef]
    [Google Scholar]
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