دورية أكاديمية

Molecular Profile of Drug Resistance in Tuberculous Meningitis From Southwest China.

التفاصيل البيبلوغرافية
العنوان: Molecular Profile of Drug Resistance in Tuberculous Meningitis From Southwest China.
المؤلفون: Lina Duo1, Binwu Ying1, Xingbo Song1, Xiaojun Lu1, Yuanxin Ye1, Hong Fan2, Junping Xin3, Lanlan Wang1 huaxiwangll@gmail.com
المصدر: Clinical Infectious Diseases. 12/1/2011, Vol. 53 Issue 11, p1067-1073. 7p.
مصطلحات موضوعية: *DRUG resistance, *MEDICAL care of tuberculosis patients, *TUBERCULOSIS mortality, *MICROBIAL sensitivity tests, *GENETIC mutation, MENINGITIS prevention
مصطلحات جغرافية: SOUTHWEST China
مستخلص: Background. Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis and causes high mortality and morbidity. Isoniazid resistance is strongly predictive of death in patients with TBM. Methods. In the present study, using polymerase chain reaction (PCR) and Genotype MTBDRplus line-probe assay, we investigated the drug resistance in patients with TBM living in Southwest China. Results. Our results showed that only one-third of patients with TBM had a positive result for Mycobacterium tuberculosis culture from cerebrospinal fluid (CSF). PCR-based detection of M. tuberculosis DNA in CSF is not only an alternative diagnostic approach for TBM but also can be further used for the detection of drug resistance when combined with the MTBDRplus assay, the results of which were consistent with the classic drug susceptibility test. However, it further provided the molecular profile of the mutations can be conducted much faster than the classic drug susceptibility test can (1 day vs 30-40 days, respectively). In the studied 30 CSF samples from patients with TMB, we found a rate of 64.29% for isoniazid resistance, 39.29% for rifampicin resistance, and 32.14% for multidrug-resistant tuberculosis, which is relatively higher than the reported resistance in pulmonary tuberculosis. However, the molecular profile indicated that the most frequently observed mutations in the rpoB and katG genes are also responsible for drug resistance in TBM. Conclusions. Our data suggest that the MTBDRplus line-probe assay is capable of detecting drug resistance for the CSF samples that have a PCR-positive result. We recommend PCR-based diagnosis and drug resistance test as routine assays for patients with suspected TBM. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
الوصف
تدمد:10584838
DOI:10.1093/cid/cir663