J Jubulis1, K Dionne2, G Osterhout2, L Ayuk3, C Awasom3, P Achu4, J Noeske5, R Warren6, C McArthur7, N Parrish8. 1. The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; Maine Medical Center/Tufts University School of Medicine, Portland, Maine, USA. 2. The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. 3. Regional Hospital, Bamenda, Cameroon. 4. Mezam Polyclinic HIV/AIDS Treatment Centre, Bamenda. 5. German International Cooperation, Yaoundé, Cameroon. 6. Stellenbosch University, Cape Town, South Africa. 7. The University of Missouri-Kansas City School of Dentistry, Kansas City, Missouri, USA. 8. The Johns Hopkins Medical Institutions, Baltimore, Maryland.
Abstract
OBJECTIVE: To determine the resistance of Mycobacterium tuberculosis to first- and second-line agents in adult pulmonary tuberculosis (TB) patients in Cameroon using a novel phenotypic assay. SETTING: Samples were collected from TB patients at Bamenda Hospital in Bamenda, Cameroon. DESIGN: Samples were collected consecutively from adult pulmonary TB patients over a 2-month period. TREK Sensititre(TM) MYCOTB panels were used to perform phenotypic drug susceptibility testing (DST). Susceptibility/resistance was determined by comparing minimum inhibitory concentrations to standard critical concentrations established for first- and second-line anti-tuberculosis drugs. RESULTS: Of 103 sputum samples processed, growth on Löwenstein-Jensen media was confirmed in 78 samples, 65 of which were suitable for DST. Thirty-nine strains (60%) were susceptible to all first- and second-line drugs. Five strains (8%) were categorized as multidrug-resistant TB. Two strains (3%) were classified as pre-extensively drug-resistant TB. Of those isolates susceptible to first-line drugs, 20% were resistant to at least one second-line drug. CONCLUSION: Antimicrobial resistance may be higher than assumed in TB strains in Cameroon, especially with regard to second-line drugs. There remains a need for rapid, comprehensive DST.
OBJECTIVE: To determine the resistance of Mycobacterium tuberculosis to first- and second-line agents in adult pulmonary tuberculosis (TB) patients in Cameroon using a novel phenotypic assay. SETTING: Samples were collected from TB patients at Bamenda Hospital in Bamenda, Cameroon. DESIGN: Samples were collected consecutively from adult pulmonary TBpatients over a 2-month period. TREK Sensititre(TM) MYCOTB panels were used to perform phenotypic drug susceptibility testing (DST). Susceptibility/resistance was determined by comparing minimum inhibitory concentrations to standard critical concentrations established for first- and second-line anti-tuberculosis drugs. RESULTS: Of 103 sputum samples processed, growth on Löwenstein-Jensen media was confirmed in 78 samples, 65 of which were suitable for DST. Thirty-nine strains (60%) were susceptible to all first- and second-line drugs. Five strains (8%) were categorized as multidrug-resistant TB. Two strains (3%) were classified as pre-extensively drug-resistant TB. Of those isolates susceptible to first-line drugs, 20% were resistant to at least one second-line drug. CONCLUSION: Antimicrobial resistance may be higher than assumed in TB strains in Cameroon, especially with regard to second-line drugs. There remains a need for rapid, comprehensive DST.