PA-201 Species identification and drug susceptibility testing of non-tuberculous mycobacteria isolated among presumptive tuberculosis patients in Lambaréné, Gabon

• Published in: BMJ global health 2023-12, Vol.8 (Suppl 10), p.A48-A48
• Main Authors: Dibamba Ndanga, Micheska Epola, Pacome Achimi Agbo Abdul, Jabar Babatundé, Edoa, Jean Ronald, Rogue Mfoumbi Ibinda, Guy Arnault, Adegbite, Bayodé Romeo, Mevyann, Rhett Chester, Biyogho, Christopher Mebiame, Mahoumbou, Jocelyn, Manguinga, Stredice, Roguet, Nina Mbenga, Lell, Bertrand, Kremsner, Peter G, Alabi, Abraham Sunday, Grobusch, Martin Peter, Adegnika, Ayola Akim
• Format: Article
• Language: English
• Subjects: Abstracts of Poster and e-Poster Presentations; Antibiotics; Laboratories; Tuberculosis
• ISSN: 2059-7908
• DOI: 10.1136/bmjgh-2023-EDC.118

BackgroundNon-tuberculous mycobacteria are increasingly recognised as causative agents of opportunistic and device-associated infections in humans. In Gabon, data is scarce, as species identification and drug susceptibility are not performed in most laboratories. The objectives of our study were to identify the relative frequencies of non-tuberculous mycobacteria species circulating and to determine their genotypic susceptibility pattern regarding the antibiotics most commonly used to treat NTM infections among presumptive tuberculosis patients.MethodsThis cross-sectional prospective study was conducted at the CERMEL TB laboratory from January 2020 to December 2022 to generate drug susceptibility data on NTM species identified from presumptive TB patient specimen sent to the National TB Reference Laboratory. The drug susceptibility to macrolides and aminoglycosides and the NTM subspecies identification were performed using the genotype NTM-DR kit. ResultsAmong 524 culture-positive specimen, 146 (28%) were NTM. The predominant group was Mycobacterium avium complex, MAC 80/146 (54.8%), of which M. intracellular 53/146 (36.3%) and M. avium 27/146 (18.5%)); followed by Mycobacterium abscessus complex, MABC 38/146 (26.0%), of which M. abscessus subsp. abscessus 20/146 (13.6%); M. abscessus subsp. massiliense 10/146 (7.0%); and M. abscessus subsp. bolletii 8/146 (5.4%)). All MAC were genotypically fully susceptible to macrolides and aminoglycosides. All five isolates of MABC showed polymorphisms both of the erm (41) and rrl genes, both coding for macrolide resistance.ConclusionAll MAC isolates were fully susceptible to macrolides and aminoglycosides, thus confirming their role in NTM treatment. However, resistance-conferring polymorphisms indicate limited susceptibility of M. abscessus complex isolates against both drug classes; requiring further investigation to comprehensively determine M. abscessus drug susceptibility. The study results presented here shall guide clinicians to better manage treatment. Routine susceptibility testing is not available.