Molecular epidemiology and drug susceptibility profiles of Mycobacterium tuberculosis complex isolates from Northern Ghana

Acquah, Samuel Kobina Ekuban; Asare, Prince; Osei-Wusu, Stephen; Morgan, Portia; Afum, Theophilus; Asandem, Diana Asema; Danso, Emelia Konadu; Otchere, Isaac Darko; Ofori, Linda Aurelia; Obiri-Danso, Kwasi; Kock, Richard; Asante-Poku, Adwoa; Yeboah-Manu, Dorothy

Abstract

Objective: We conducted a cross-sectional study in the five administrative regions of Northern Ghana to determine the diversity of Mycobacterium tuberculosis complex (MTBC) sub/lineages and their susceptibil- ity to isoniazid (INH) and rifampicin (RIF). Methods: Sputum specimens were collected and cultured from 566 pulmonary tuberculosis patients re- porting to 17 health facilities from 2015 to 2019. Mycobacterial isolates obtained from solid cultures were confirmed as members of the MTBC by PCR amplification of IS 6110 and rpoßand assigned lineages and sub-lineages using spoligotyping. Results: Of 294 mycobacterial isolates recovered, MTBC species identified were: M. tuberculosis sensu stricto (Mtbss) 241 (82.0%), M. africanum 41 (13.9%) and M. bovis four (1.4%) with eight (2.7%) unidentified. The human-adapted lineages (L) identified (N = 279) were L1 (8/279, 2.9%), L2 (15/279, 5.4%), L3 (7/279, 2.5%), L4 (208/279, 74.5%), L5 (13/279, 4.7%) and L6 (28/279, 10.0%) with three unidentified lineages. Among the 208 L4, the dominant sub-lineages in the region were the Cameroon 120/208 (57.7%) and Ghana 50/208 (24.0%). We found 4.4% (13/294) and 0.7% (2/294) of the patients infected with MTBC iso- lates resistant to INH only and RIF only, respectively, with 2.4% (7/294) being infected with MDR strains. Whereas L6 was associated with the elderly, we identified that the Ghana sub-lineage of L4 was associ- ated with both INH and MDR (p < 0.05), making them important TB pathogens in Northern Ghana and a growing public health concern.

Citation

Acquah, S. K. E., Asare, P., Osei-Wusu, S., Morgan, P., Afum, T., Asandem, D. A., Danso, E. K., Otchere, I. D., Ofori, L. A., Obiri-Danso, K., Kock, R., Asante-Poku, A., & Yeboah-Manu, D. (2021). Molecular epidemiology and drug susceptibility profiles of Mycobacterium tuberculosis complex isolates from Northern Ghana. International Journal of Infectious Diseases, 109, 294-303. https://doi.org/10.1016/j.ijid.2021.07.020

• Journal Article Type: Article
• Acceptance Date: Jul 3, 2021
• Publication Date: 2021-08
• Deposit Date: Oct 6, 2021
• Publicly Available Date: Nov 1, 2021
• Journal: International Journal of Infectious Diseases
• Print ISSN: 1201-9712
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 109
• Pages: 294-303
• DOI: https://doi.org/10.1016/j.ijid.2021.07.020
• Keywords: Infectious Diseases; Microbiology (medical); General Medicine
• Public URL: https://rvc-repository.worktribe.com/output/1551489
• Additional Information: This article is maintained by: Elsevier; Article Title: Molecular epidemiology and drug susceptibility profiles of Mycobacterium tuberculosis complex isolates from Northern Ghana; Journal Title: International Journal of Infectious Diseases; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.ijid.2021.07.020; Content Type: article; Copyright: © 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.