Abstract
A major challenge in the treatment of Tuberculosis (TB) is emergence of Multi-Drug Resistant Mycobacterium tuberculosis (MDRTB) strains. Efflux genes have been established to be among factors for drug resistance in Mycobacterium tuberculosis (M. tuberculosis) pulmonary infections by conferring bacterial ability to pump-out drugs from intracellular compartment, making it impossible for drugs to attain intracellular concentration lethal to the organism. There is paucity of data on the role of efflux pump in MDRTB in Nigerian strains of M. tuberculosis. Hence, the aim of this study was to detect the carriage, distribution and frequency of efflux pump genes among MDRTB and non-MDRTB isolates from participants with pulmonary tuberculosis in Lagos, Nigeria. This study was carried out on M. tuberculosis isolated from 1020 participants suspected of pulmonary tuberculosis in Lagos State, Nigeria. A total of 78 M. tuberculosis isolates were obtained from the participants suspected of pulmonary tuberculosis. Forty Eight isolates were confirmed as MDRTB and 30 non-MDRTB. Efflux pump genes were investigated in the isolates using the conventional polymerase chain reaction. Statistical analysis was carried out using the Statistical Package for Social Science (SPSS version 20) to compare the efflux pump gene results between MDRTB and non- MDRTB isolates. Different efflux genes types and frequency were detected in MDRTB and non-MDRTB isolates. Carriage of 2 or more alleles of efflux gene types Rv2486c (efpA), Rv2459c (jefA), Rv1877, Rv1002c, Rv0342, Rv2686c and drrC associated with MDR were detected. Additionally, the frequency of efflux genes alleles in MDRTB was significantly different from those in non- MDRTB isolates.
Highlights
Emergence of drug resistant M. tuberculosis strains is a major challenge in the treatment of tuberculosis (TB)
The efpA efflux gene alleles were detected with MDRTB isolates accounting for 79.7% of the alleles while non-MDRTB accounted for 23.3% (p =0.018)
This showed a significant difference between MDRTB and non-MDRTB
Summary
Emergence of drug resistant M. tuberculosis strains is a major challenge in the treatment of tuberculosis (TB). Drug efflux pumps prove to be a major challenge for the treatment of MDRTB; they require special attention to understand their functioning to combat the emerging crisis of MDR and finding a better solution for anti-TB therapy. Other studies [3] showed that the transcription of Rv1258c efflux pump gene in clinical isolates of M. tuberculosis increases upon induction by Rifampicin (RIF) and ofloxacin in a clinical multidrug-resistant M. tuberculosis isolate. This suggests that efflux pumps are involved in MDR in M. tuberculosis. Higher occurrence of drug efflux genes in drug-resistant strains of mycobacterial cell envelope have been reported [1]
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