CHARACTERISTICS OF rpoB GENE MUTATION IN RIFAMPICIN-RESISTANT PULMONARY TUBERCULOSIS PATIENTS AT CAN THO TUBERCULOSIS AND LUNG DISEASE HOSPITAL
Main Article Content
Abstract
Background: Currently, multidrug-resistant tuberculosis (MDR-TB)/rifampicin-resistant tuberculosis (RR-TB) remain major public health challenges, leading to prolonged treatment duration and increased healthcare costs due to difficulties in early detection of drug resistance in Mycobacterium tuberculosis. Rifampicin resistance (RR) have been associated with mutations in the rpoB gene of the Mycobacterium tuberculosis. Objectives: To describe the characteristics of rpoB gene mutations in drug-resistant tuberculosis and analyze factors related to rpoB gene mutations in patients with Rifampicin-resistant pulmonary tuberculosis admitted to Can Tho Tuberculosis and Lung Disease Hospital. Materials and method: A cross-sectional descriptive study was conducted on 70 patients with Rifampicin-resistant pulmonary tuberculosis admitted to Can Tho Tuberculosis and Lung Disease Hospital. Results: The majority of patients were male (74.3%), with the highest proportion aged between 40-60 years. The prevalence of Rifampicin-resistant pulmonary tuberculosis was 54.3% in previously of patients with a history of previous TB treatment and 45.7% in compared to newly diagnosed cases. Mutations in the rpoB gene were detected in 81.4% of cases, with the majority occurring at Ser531Leu (49.1%). Other significant mutations included Asp516Pro (1.75%), His526Tyr (3.52%), Leu511Pro (8.77%), and Leu533Pro (7.03%). Double mutations in the rpoB gene were observed as follows: His526Tyr & Ser531Leu (1.75%) and His526Lys & Lys527Glu (1.75%). Some less common mutations were also identified at a frequency of 3.52%. A statistically significant association was observed between rpoB gene mutations in Rifampicin-resistant pulmonary tuberculosis patients and factors such as living standards (p<0.05). Conclusions: Rifampicinresistant pulmonary tuberculosis predominantly affects middle-aged males, most of whom had undergone prior treatment. A high rate of rpoB gene mutations was observed, primarily in the "hotspot mutation" region.
Keywords
Pulmonary tuberculosis, Rifampicin-resistant tuberculosis, Sanger sequencing, rpoB gene mutation
Article Details
References
2. World Health Organization. Global Tuberculosis report factsheet 2023. 2023. https://www.who.int/publications/m/item/global-tuberculosis-report-factsheet-2023.
3. Dương Thế Long, Đỗ Tấn Khang, Trần Ngọc Dung, Dương Thị Loan, Đinh Thị Hương Trúc và cộng sự. Đặc điểm đột biến gene kháng thuốc Rifampicin và Isoniazide của vi khuẩn Lao (Mycobacterium Tuberculosis) ở tỉnh Đồng Tháp. Tạp Chí Khoa học Đại học Cần Thơ. 2024. 60(2), 106-112, https://doi.org/10.22144/ctujos.2024.273.
4. Welekidan L.N., Skjerve E., Dejene T.A., Yimer S.A., Brynildsrud O., et al. Frequency and patterns of first- and second-line drug resistance-conferring mutations in Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in a cross-sectional study in Tigray Region, Ethiopia. J Glob Antimicrob Resist. 2021. 24, 6-13, https://doi.org/10.1016/j.jgar.2020.11.017.
5. Bộ Y tế. Quyết định về việc ban hành Hướng dẫn chẩn đoán, điều trị và dự phòng bệnh lao. Quyết định số 162/QĐ-BYT của Bộ trưởng Bộ Y tế. 2024. https://luatvietnam.vn/y-te/quyetdinh-162-qd-byt-2024-huong-dan-chan-doan-dieu-tri-va-du-phong-benh-lao-292589-d1.html.
6. Su F.,Cao L., Ren X., Hu J., Wang X. et al. RpoB Gene Mutation Characteristics of Rifampicinresistant Tuberculosis in Anqing, China. Jundishapur J Microbiol. 2022. 15(9), e127306, https://doi.org/10.5812/jjm-127306.
7. Nguyễn Thị Minh Hạnh, Thanh Hùng Trần và cộng sự. Nghiên cứu yếu tố dịch tễ, đặc điểm lâm sàng, cận lâm sàng của bệnh nhân lao phổi kháng Rifampicin tại Bệnh viện Lao và Bệnh phổi Cần Thơ. Tạp Chí Y Dược học Cần Thơ. 2024. 72, 137-143, https://doi.org/10.58490/ctump.2024i72.2276.
8. Hoàng Hà, Thị Thu Uyên Lưu, Thị Hoài Ngô. Bệnh lao kháng Rifampicin tại Thái Nguyên, Tạp Chí Y Học Việt Nam. 2021. 500(2), 16-20, https://doi.org/10.51298/vmj.v500i2.347.
9. Alamgir M., Sajjad M., Baig M. S., Noori M. Y.. Mutational Frequencies in Mycobacterial rpoB gene using GeneXpert/MTB Rif Assay in Rifampicin Resistant patients at a tertiary care setting in Urban Sindh, Pakistan: Analysis from a Five-Year Period. Pakistan Journal of Medical Sciences. 2021. 37(4), https://doi.org/10.12669/pjms.37.4.3875.
10. Ngabonziza J.C.S., Decroo T., Migambi P., Habimana Y.M., Deun A.V., et al. Prevalence and drivers of false-positive rifampicin-resistant Xpert MTB/RIF results: a prospective observational study in Rwanda. The Lancet Microbe. 2020. 1(2), 74-83, https://doi.org/10.1016/S26665247(20)30007-0.
11. Torokaa PR, Majigo MV, Kileo H, Urio L, Mbwana MR, Monah MC, et al. The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania. PLoS One. 2024. 19(8), e0296563, https://doi.org/10.1371/journal.pone.0296563.