Molecular analysis of Mycobacterium tuberculosis causing multidrug-resistant tuberculosis meningitis

Maxine Caws, G. E. Thwaites, P. M. Duy, D. Q. Tho, N. T. Ngoc Lan, D. V. Hoa, T. T. Hong Chau, M. N. Thu Huyen, P. T. Hoang Anh, N. V.V. Chau, N. T. Chinh, K. Stepniewska, J. Farrar

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

SETTING: Tertiary referral hospitals in southern Vietnam. OBJECTIVE: Molecular characterisation of multidrug-resistant (MDR) tuberculous meningitis (TBM). DESIGN: Mycobacterium tuberculosis isolates from the cerebrospinal fluid (CSF) of 198 Vietnamese adults were compared with 237 isolates from patients with pulmonary tuberculosis (PTB) matched for age, sex and residential district. Isolates resistant to isoniazid or rifampicin (RMP) were sequenced in the rpoB and katG genes, inhA promoter and oxyR-ahpC intergenic regions. RESULTS: While drug resistance rates were lower in the CSF (2.5% MDR) than pulmonary isolates (5.9% MDR), the difference was not significant. The most commonly mutated codons were 531, 526 and 516 in rpoB and 315 in katG. Four novel triple mutants in rpoB were identified. CONCLUSION: RMP resistance is a good surrogate marker for MDR-TBM in this setting. However, probes directed against these three codons would have a maximum sensitivity of only 65%. A rapid phenotypic detection test may be more applicable for the diagnosis of MDR-TBM.

Original languageEnglish
Pages (from-to)202-208
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume11
Issue number2
Publication statusPublished - 1 Feb 2007
Externally publishedYes

Keywords

  • Meningitis
  • Multidrug-resistant
  • Tuberculosis
  • Vietnam

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