Prevalence and Drug Susceptibility of Non-tuberculous mycobacteria Among Presumptive MDR-TB Patients Admitted at KIDH in Kilimanjaro, Tanzania

Abstract

Background The reports on Non-tuberculous mycobacteria (NTM) pulmonary infections associated with multidrug-resistant tuberculosis are increasing worldwide. Despite a significant increase in knowledge about NTM infections, they present a diagnostic and therapeutic challenge in resource-limited settings. This study aimed to determine the prevalence and drug susceptibility of NTM among presumptive multidrug-resistant tuberculosis patients in Tanzania. Materials and Methods A cross-sectional study was conducted from April to October 2021 on presumptive Multidrugresistant tuberculosis patients admitted at KIDH in Kilimanjaro. All isolated mycobacterial growth was characterized into MTBC and NTM and finally tested for susceptibility on the firstline anti-tuberculosis drugs. The data were analyzed using Stata version 16 (Stata Corp, College Station, TX, USA), and presented using frequency and tables. A p-value less ≤ 0.05 was considered statistically significant. Results The study population included 160 presumptive MDR-TB patients and 75% were males, NTM infections were found in 14 (8.75 %). In 17 patients that were HIV positive, 13 were infected by NTM, the Mycobacterium avium complex was the most frequently isolated NTM (9/14 patients, 64.3 %). Almost all isolates of NTM were resistant to majority of the first-line anti TB drugs. Conclusion Findings from this study indicate that HIV infected individuals who were regarded as presumptive MDR-TB patients are at high risk of NTM infections. High proportion of NTM isolates were MAC, which included M. avium and M. in tracellulare. Additionally, NTM isolates showed to be resistant to majority of the recommended first-line anti-TB drugs used in the country indicating challenging treatment outcome