ISONIAZID - MONORESISTANT TUBERCULOSIS IN BULGARIA

Authors

  • Stanislava Yordanova, PhD National Centre of Infectious and Parasitic Diseases
  • Ana Baykova National Centre of Infectious and Parasitic Diseases
  • Yuliana Atanasova National Centre of Infectious and Parasitic Diseases
  • Yana Todorova National Centre of Infectious and Parasitic Diseases
  • Assoc. prof. Elizabeta Bachiyska, MD, PhD National Centre of Infectious and Parasitic Diseases

Keywords:

tuberculosis, isoniazid, resistance

Abstract

Background. Isoniazid is a common drug in the treatment regimens for TB infection. Monoisoniazid resistance reduces the probability of a successful treatment outcome and increases the risk of acquiring additional drug resistance.

Material and methods. For the period 2015-2016 a total of 36 TB cases were confirmed in NRL TB, Sofia, as isoniazid-monoresistant Mycobacterium tuberculosis complex. Minimum inhibitory concentration testing for isoniazid was conducted with BАСТЕС MGIT 960 System in the following concentrations of the drug: 0.1 μg/ml, 0.15μg/ml, 0.2μg/ml, 0.3μg/ml, 0.4μg/ml. Molecular testing was performed with GenoType ® MTBDRplus in order to detect the most common mutations associated with resistance to isoniazid.

Results. Only 25% of the tested M. tuberculosis complex isolates with phenotypic isoniazid monoresistance had the S315T1 mutation in katG; all isolates were with MIC over 0.4 μg/ml. C15T in the promoter region of inhA was detected in 22.22% of cases and only 1 of them showed MIC below 0.4 μg/ml. No mutations were detected in nearly half of the cases (n=19, 52.78%) and most of these isolates were with lower MIC values (n=12). Conclusion. The rapid testing with GenoType ® MTBDRplus can be used as a screening procedure indicating whether further examination of isoniazid MIC is relevant in resistant M. tuberculosis and whether higher doses could be considered.

Author Biographies

Stanislava Yordanova, PhD, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Tuberculosis

Ana Baykova, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Tuberculosis

Yuliana Atanasova, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Tuberculosis

Yana Todorova, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Tuberculosis

Assoc. prof. Elizabeta Bachiyska, MD, PhD, National Centre of Infectious and Parasitic Diseases

Head of National Reference Laboratory for Tuberculosis

References

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Bachiyska E, Yordanova S, Atanasova Y, et al. MDR tuberculosis in Bulgaria – associated genetic mutations. InSpiro. 2016; 4(37):36-40. In Bulgarian

Bachiyska E. Microbiological studies on the aetiology of MDR tuberculosis in Bulgaria. (Doctoral thesis, Sofia, 2013). In Bulgarian

Yordanova S, Bachiyska E, Atanasova Y, et al. MDR-TB with additional fluoroquinolone resistance in Bulgaria. Probl Infect Parasit Dis. 2015; 43(2):8-11.

Yordanova S. Microbiological studies on XDR tuberculosis in Bulgaria. (Doctoral thesis, Sofia, 2017). In Bulgarian

Ghodousi A, Tagliani E, Karunaratne E, Niemann S, Perera J, Köser CU, Cirillo DM. Isoniazid resistance in Mycobacterium tuberculosis is a heterogeneous phenotype composed of overlapping MIC distributions with different underlying resistance mechanisms. Antimicrob Agents Chemother. 2019; 63:e00092.

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Published

2020-05-12

How to Cite

Yordanova, S., Baykova, A., Atanasova, Y., Todorova, Y., & Bachiyska, E. (2020). ISONIAZID - MONORESISTANT TUBERCULOSIS IN BULGARIA. PROBLEMS of Infectious and Parasitic Diseases, 48(1), 21-24. Retrieved from https://pipd.ncipd.org/index.php/pipd/article/view/29

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