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The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania
Antimicrobial resistance in Mycobacterium tuberculosis (MTB) poses a significant challenge to tuberculosis (TB) management worldwide. Rifampicin resistance (RR) has been associated with the rpoB gene mutation. No study was conducted in Tanzania to determine the commonest mutation. The inconsistent f...
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| Published in: | PloS one 2024-08, Vol.19 (8), p.e0296563 |
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| creator | Torokaa, Peter Richard Majigo, Mtebe V Kileo, Heledy Urio, Loveness Mbwana, Mariam R Monah, Mariam C Ntibabara, Sephord Saul Kimambo, Jasper Seleman, Paschal Franklin, Collins Balama, Robert Kisonga, Riziki M Joachim, Agricola |
| description | Antimicrobial resistance in Mycobacterium tuberculosis (MTB) poses a significant challenge to tuberculosis (TB) management worldwide. Rifampicin resistance (RR) has been associated with the rpoB gene mutation. No study was conducted in Tanzania to determine the commonest mutation. The inconsistent findings from various studies support the need to determine whether reported mutation patterns are applicable in our setting. We determined the frequency of rpoB gene mutation and factors associated with RR, which were detected using GeneXpert MTB/RIF assay.
We conducted a retrospective cross-sectional study involving data from the National Tuberculosis and Leprosy Program database from 2020 to 2022 for cases investigated using GeneXpert MTB/RIF assay. Descriptive analysis was performed to determine the frequency of categorical variables. The chi-square test and logistic regression analysis assessed the relationship between the independent variables and outcome. The 95% confidence interval and a significance level of p |
| doi_str_mv | 10.1371/journal.pone.0296563 |
| format | article |
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We conducted a retrospective cross-sectional study involving data from the National Tuberculosis and Leprosy Program database from 2020 to 2022 for cases investigated using GeneXpert MTB/RIF assay. Descriptive analysis was performed to determine the frequency of categorical variables. The chi-square test and logistic regression analysis assessed the relationship between the independent variables and outcome. The 95% confidence interval and a significance level of p<0.05 were used to assess the strength of association.
A total of 56,004 participants had a status of MTB and RR, where 38,705/56,004 (69.11%) were males. Probe E mutation (codon 529-533), 89/219 (40.64%) was predominant. Human immunodeficiency virus (HIV)-positive patients had a higher gene mutation, 134/10601 (1.26%) than HIV-negative, 306/45016 (0.68%) (p<0.001). Patients with both pulmonary and extra-pulmonary TB had about four times greater odds of developing rifampicin resistance (AOR 3.88, 95%CI: 1.80-8.32). RR was nearly nine times higher in previously treated patients than new patients (AOR 8.66, 95% CI: 6.97-10.76). HIV-positive individuals had nearly twice the odds of developing RR than HIV-negative individuals (AOR 1.91, 95%CI: 1.51-2.42).
The rate of RR was lower compared to other studies in Tanzania, with probe E mutations the most prevalent. Patients with disseminated TB, HIV co-infection and those with prior exposure to anti-TB had more risk of RR. The findings highlight the need to strengthen surveillance of multidrug-resistant TB among high risk patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0296563</identifier><identifier>PMID: 39186753</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Analysis ; Antibiotics, Antitubercular - pharmacology ; Antibiotics, Antitubercular - therapeutic use ; Antimicrobial resistance ; Assaying ; Bacterial Proteins - genetics ; Biology and Life Sciences ; Care and treatment ; Causes of ; Chi-square test ; Child ; Complications and side effects ; Confidence intervals ; Cross-Sectional Studies ; Diagnosis ; DNA-Directed RNA Polymerases - genetics ; Drug resistance ; Drug Resistance, Bacterial - genetics ; Female ; Gene mutations ; Genetic aspects ; Health facilities ; HIV ; Human immunodeficiency virus ; Humans ; Independent variables ; Leprosy ; Male ; Medicine and Health Sciences ; Microbial Sensitivity Tests ; Middle Aged ; Multidrug resistance ; Mutation ; Mycobacterium tuberculosis ; Mycobacterium tuberculosis - drug effects ; Mycobacterium tuberculosis - genetics ; Patient outcomes ; Patients ; Point mutation ; Public health ; Regression analysis ; Retrospective Studies ; Rifampin ; Rifampin - pharmacology ; Rifampin - therapeutic use ; Risk groups ; RNA polymerase ; RpoB protein ; Statistical analysis ; Tanzania - epidemiology ; Tuberculosis ; Tuberculosis, Multidrug-Resistant - drug therapy ; Tuberculosis, Multidrug-Resistant - epidemiology ; Tuberculosis, Multidrug-Resistant - genetics ; Tuberculosis, Multidrug-Resistant - microbiology ; Variables ; Young Adult</subject><ispartof>PloS one, 2024-08, Vol.19 (8), p.e0296563</ispartof><rights>Copyright: © 2024 Torokaa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Torokaa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Torokaa et al 2024 Torokaa et al</rights><rights>2024 Torokaa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-3726-2816 ; 0009-0003-3843-3434</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3097454232/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3097454232?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39186753$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Torokaa, Peter Richard</creatorcontrib><creatorcontrib>Majigo, Mtebe V</creatorcontrib><creatorcontrib>Kileo, Heledy</creatorcontrib><creatorcontrib>Urio, Loveness</creatorcontrib><creatorcontrib>Mbwana, Mariam R</creatorcontrib><creatorcontrib>Monah, Mariam C</creatorcontrib><creatorcontrib>Ntibabara, Sephord Saul</creatorcontrib><creatorcontrib>Kimambo, Jasper</creatorcontrib><creatorcontrib>Seleman, Paschal</creatorcontrib><creatorcontrib>Franklin, Collins</creatorcontrib><creatorcontrib>Balama, Robert</creatorcontrib><creatorcontrib>Kisonga, Riziki M</creatorcontrib><creatorcontrib>Joachim, Agricola</creatorcontrib><title>The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Antimicrobial resistance in Mycobacterium tuberculosis (MTB) poses a significant challenge to tuberculosis (TB) management worldwide. Rifampicin resistance (RR) has been associated with the rpoB gene mutation. No study was conducted in Tanzania to determine the commonest mutation. The inconsistent findings from various studies support the need to determine whether reported mutation patterns are applicable in our setting. We determined the frequency of rpoB gene mutation and factors associated with RR, which were detected using GeneXpert MTB/RIF assay.
We conducted a retrospective cross-sectional study involving data from the National Tuberculosis and Leprosy Program database from 2020 to 2022 for cases investigated using GeneXpert MTB/RIF assay. Descriptive analysis was performed to determine the frequency of categorical variables. The chi-square test and logistic regression analysis assessed the relationship between the independent variables and outcome. The 95% confidence interval and a significance level of p<0.05 were used to assess the strength of association.
A total of 56,004 participants had a status of MTB and RR, where 38,705/56,004 (69.11%) were males. Probe E mutation (codon 529-533), 89/219 (40.64%) was predominant. Human immunodeficiency virus (HIV)-positive patients had a higher gene mutation, 134/10601 (1.26%) than HIV-negative, 306/45016 (0.68%) (p<0.001). Patients with both pulmonary and extra-pulmonary TB had about four times greater odds of developing rifampicin resistance (AOR 3.88, 95%CI: 1.80-8.32). RR was nearly nine times higher in previously treated patients than new patients (AOR 8.66, 95% CI: 6.97-10.76). HIV-positive individuals had nearly twice the odds of developing RR than HIV-negative individuals (AOR 1.91, 95%CI: 1.51-2.42).
The rate of RR was lower compared to other studies in Tanzania, with probe E mutations the most prevalent. Patients with disseminated TB, HIV co-infection and those with prior exposure to anti-TB had more risk of RR. The findings highlight the need to strengthen surveillance of multidrug-resistant TB among high risk patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis</subject><subject>Antibiotics, Antitubercular - pharmacology</subject><subject>Antibiotics, Antitubercular - therapeutic use</subject><subject>Antimicrobial resistance</subject><subject>Assaying</subject><subject>Bacterial Proteins - genetics</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Causes of</subject><subject>Chi-square test</subject><subject>Child</subject><subject>Complications and side effects</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Diagnosis</subject><subject>DNA-Directed RNA Polymerases - genetics</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial - genetics</subject><subject>Female</subject><subject>Gene mutations</subject><subject>Genetic aspects</subject><subject>Health facilities</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Independent variables</subject><subject>Leprosy</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Multidrug resistance</subject><subject>Mutation</subject><subject>Mycobacterium tuberculosis</subject><subject>Mycobacterium tuberculosis - drug effects</subject><subject>Mycobacterium tuberculosis - genetics</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Point mutation</subject><subject>Public health</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Rifampin</subject><subject>Rifampin - pharmacology</subject><subject>Rifampin - therapeutic use</subject><subject>Risk groups</subject><subject>RNA polymerase</subject><subject>RpoB protein</subject><subject>Statistical analysis</subject><subject>Tanzania - epidemiology</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Tuberculosis, Multidrug-Resistant - epidemiology</subject><subject>Tuberculosis, Multidrug-Resistant - genetics</subject><subject>Tuberculosis, Multidrug-Resistant - microbiology</subject><subject>Variables</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNklFv0zAQgCMEYmPwDxBYQkLw0C6OEzd-QtvERqVNk0ZBvEUX-9J6SuzMdhDlj_B3cbuAWrQHlAfH5-8--06XJC9pOqVsRo9v7eAMtNPeGpymmeAFZ4-SQypYNuFZyh7v_B8kz7y_TdOClZw_TQ6YoCWfFeww-bVYIekhBHSG2Ia43p6SJRok3RAgaLuNXq2lrUFGSA8dCUONTg6t9doTMIr0DpWWwTq_VegGul5LbYjDiAQwEonCgFGgSL0mF9H_rUcXyNXi9Phmfk7Ae1iTmLEA8xOMhufJkwZajy_G9Sj5cv5xcfZpcnl9MT87uZyovKRhUogmZZmkXGaiFEqJZpYKWlPViLxRKGGW8hoyLGQDDecQNzUri1qVKa1lydlR8vre28dyqrGnvmKpmOVFnrEsEvN7Qlm4rXqnO3DryoKutgHrlhW4oGWLVZFxFFQhL8o6F8BqSmmqimYmpBScqej6MN421B0qiSY4aPek-ydGr6ql_V5RynIuis17340GZ-8G9KHqtJfYtmDQDuPDRcZzFtE3_6APlzdSS4gVaNPYeLHcSKuTMuURFCKP1PQBKn4KOy3jBDY6xvcS3u8lRCbgj7CEwftq_vnm_9nrr_vs2x12hdCGlbftsJlUvw--2m313x7_GX32G3QeBn0</recordid><startdate>20240826</startdate><enddate>20240826</enddate><creator>Torokaa, Peter Richard</creator><creator>Majigo, Mtebe V</creator><creator>Kileo, Heledy</creator><creator>Urio, Loveness</creator><creator>Mbwana, Mariam R</creator><creator>Monah, Mariam C</creator><creator>Ntibabara, Sephord Saul</creator><creator>Kimambo, Jasper</creator><creator>Seleman, Paschal</creator><creator>Franklin, Collins</creator><creator>Balama, Robert</creator><creator>Kisonga, Riziki M</creator><creator>Joachim, Agricola</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3726-2816</orcidid><orcidid>https://orcid.org/0009-0003-3843-3434</orcidid></search><sort><creationdate>20240826</creationdate><title>The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania</title><author>Torokaa, Peter Richard ; Majigo, Mtebe V ; Kileo, Heledy ; Urio, Loveness ; Mbwana, Mariam R ; Monah, Mariam C ; Ntibabara, Sephord Saul ; Kimambo, Jasper ; Seleman, Paschal ; Franklin, Collins ; Balama, Robert ; Kisonga, Riziki M ; Joachim, Agricola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-d481t-59f032c16c2989dd9f7091b1df94fdeca706ba2e5cfaf66a6bab385bd801bc863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis</topic><topic>Antibiotics, Antitubercular - 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Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Torokaa, Peter Richard</au><au>Majigo, Mtebe V</au><au>Kileo, Heledy</au><au>Urio, Loveness</au><au>Mbwana, Mariam R</au><au>Monah, Mariam C</au><au>Ntibabara, Sephord Saul</au><au>Kimambo, Jasper</au><au>Seleman, Paschal</au><au>Franklin, Collins</au><au>Balama, Robert</au><au>Kisonga, Riziki M</au><au>Joachim, Agricola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-08-26</date><risdate>2024</risdate><volume>19</volume><issue>8</issue><spage>e0296563</spage><pages>e0296563-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Antimicrobial resistance in Mycobacterium tuberculosis (MTB) poses a significant challenge to tuberculosis (TB) management worldwide. Rifampicin resistance (RR) has been associated with the rpoB gene mutation. No study was conducted in Tanzania to determine the commonest mutation. The inconsistent findings from various studies support the need to determine whether reported mutation patterns are applicable in our setting. We determined the frequency of rpoB gene mutation and factors associated with RR, which were detected using GeneXpert MTB/RIF assay.
We conducted a retrospective cross-sectional study involving data from the National Tuberculosis and Leprosy Program database from 2020 to 2022 for cases investigated using GeneXpert MTB/RIF assay. Descriptive analysis was performed to determine the frequency of categorical variables. The chi-square test and logistic regression analysis assessed the relationship between the independent variables and outcome. The 95% confidence interval and a significance level of p<0.05 were used to assess the strength of association.
A total of 56,004 participants had a status of MTB and RR, where 38,705/56,004 (69.11%) were males. Probe E mutation (codon 529-533), 89/219 (40.64%) was predominant. Human immunodeficiency virus (HIV)-positive patients had a higher gene mutation, 134/10601 (1.26%) than HIV-negative, 306/45016 (0.68%) (p<0.001). Patients with both pulmonary and extra-pulmonary TB had about four times greater odds of developing rifampicin resistance (AOR 3.88, 95%CI: 1.80-8.32). RR was nearly nine times higher in previously treated patients than new patients (AOR 8.66, 95% CI: 6.97-10.76). HIV-positive individuals had nearly twice the odds of developing RR than HIV-negative individuals (AOR 1.91, 95%CI: 1.51-2.42).
The rate of RR was lower compared to other studies in Tanzania, with probe E mutations the most prevalent. Patients with disseminated TB, HIV co-infection and those with prior exposure to anti-TB had more risk of RR. The findings highlight the need to strengthen surveillance of multidrug-resistant TB among high risk patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39186753</pmid><doi>10.1371/journal.pone.0296563</doi><tpages>e0296563</tpages><orcidid>https://orcid.org/0000-0003-3726-2816</orcidid><orcidid>https://orcid.org/0009-0003-3843-3434</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-08, Vol.19 (8), p.e0296563 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3097454232 |
| source | PubMed (Medline); Publicly Available Content Database |
| subjects | Adolescent Adult Analysis Antibiotics, Antitubercular - pharmacology Antibiotics, Antitubercular - therapeutic use Antimicrobial resistance Assaying Bacterial Proteins - genetics Biology and Life Sciences Care and treatment Causes of Chi-square test Child Complications and side effects Confidence intervals Cross-Sectional Studies Diagnosis DNA-Directed RNA Polymerases - genetics Drug resistance Drug Resistance, Bacterial - genetics Female Gene mutations Genetic aspects Health facilities HIV Human immunodeficiency virus Humans Independent variables Leprosy Male Medicine and Health Sciences Microbial Sensitivity Tests Middle Aged Multidrug resistance Mutation Mycobacterium tuberculosis Mycobacterium tuberculosis - drug effects Mycobacterium tuberculosis - genetics Patient outcomes Patients Point mutation Public health Regression analysis Retrospective Studies Rifampin Rifampin - pharmacology Rifampin - therapeutic use Risk groups RNA polymerase RpoB protein Statistical analysis Tanzania - epidemiology Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - epidemiology Tuberculosis, Multidrug-Resistant - genetics Tuberculosis, Multidrug-Resistant - microbiology Variables Young Adult |
| title | The pattern of rpoB gene mutation of Mycobacterium tuberculosis and predictors of rifampicin resistance detected by GeneXpert MTB/RIF assay in Tanzania |
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