Targeted next-generation sequencing of sputum for diagnosis of drug-resistant TB: results of a national survey in Democratic Republic of the Congo

Targeted next-generation sequencing of sputum for diagnosis of drug-resistant TB: results of a national survey in Democratic Republic of the Congo

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...

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Bibliographic Details
Published in:Scientific reports Vol. 10; no. 1; p. 10786
Main Authors: Kayomo, Michel Kaswa, Mbula, Vital Nkake, Aloni, Muriel, André, Emmanuel, Rigouts, Leen, Boutachkourt, Fairouz, de Jong, Bouke C., Nkiere, Nicolas M., Dean, Anna S.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01-07-2020
Nature Publishing Group
Subjects:
631/326/22/1434
631/326/2521
692/699/255/1856
Adolescent
Adult
Aged
Antimicrobial resistance
Child
Child, Preschool
Cross-Sectional Studies
Democratic Republic of the Congo - epidemiology
Drug resistance
Female
Fluoroquinolones
High-Throughput Nucleotide Sequencing
Humanities and Social Sciences
Humans
Infant
Infant, Newborn
Isoniazid
Male
Middle Aged
multidisciplinary
Multidrug resistance
Multidrug resistant organisms
Mycobacterium tuberculosis - genetics
Next-generation sequencing
Prevalence
Pyrazinamide
Rifampin
Science
Science (multidisciplinary)
Sputum
Sputum - microbiology
Tuberculosis
Tuberculosis, Multidrug-Resistant - diagnosis
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - epidemiology
Tuberculosis, Multidrug-Resistant - genetics
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - genetics
Democratic Republic of the Congo
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Summary: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.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-67479-4