Abstract
Background Molecular studies on tuberculosis (TB) are rare in low-resource countries like Benin, where data on molecular study on previously treated TB cases is unavailable. Materials and Methods From January to December 2014, all smear- and culture-positive previously treated pulmonary TB patients from all TB clinics were systematically recruited. Drug susceptibility testing and spoligotyping were performed on all isolates. Results Of the 100 patients recruited, 71 (71.0%) were relapse cases and 24 (24.0%) were failure cases, while 5 (5.0%) were default cases. Resistance rate to any first-line drug was 40.0%, while 12.0% of strains were multidrug-resistant (MDR) and no strain was extensively drug-resistant (XDR). A total of 40 distinct spoligotypes were found to be corresponding to a genotypic diversity of 40.0%. ST61 was the most predominant spoligotype with prevalence of 33.0%. In all, 31 single spoligotypes and nine clusters were observed with 2 to 33 strains per cluster giving a clustering rate of 69.0%. Euro-American (Lineage 4) was the most prevalent lineage (74.0%) and Lineage 2 was associated with resistance to streptomycin. Conclusion This first insight into genetic diversity of previously treated pulmonary TB patients in Benin showed a relatively high genetic diversity of Mycobacterium tuberculosis.
Highlights
Tuberculosis (TB) remains a global public health problem
A total of 100 isolates obtained from 100 sputum samples collected from smear-positive previously treated pulmonary TB patients all over the country were sent to the National Reference Laboratory (NRL) in Cotonou for processing
Upon arrival at the NRL, the two samples were processed for culture but only one strain per patient was used for drug susceptibility testing (DST) and DNA fingerprinting
Summary
Tuberculosis (TB) remains a global public health problem. According to World Health Organization (WHO), an estimated number of 10.4 million new cases occurred in the world in 2015 [1]. Despite use of standardized treatment regimens and a well-established National TB Program (NTP) in the country, the treatment success rate as well as the number of previously treated cases (failure, relapse, and default) has remained stable over years [2]. In contrast to new cases, previously treated cases are much more likely to harbour multidrugresistant (MDR) strains, defined as resistance to rifampicin (R) and isoniazid (H), and their characteristics may differ from those of new cases [3, 4]. Molecular studies on tuberculosis (TB) are rare in low-resource countries like Benin, where data on molecular study on previously treated TB cases is unavailable. This first insight into genetic diversity of previously treated pulmonary TB patients in Benin showed a relatively high genetic diversity of Mycobacterium tuberculosis
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