Primary multi-drug resistant Mycobacterium tuberculosis complex isolates among patients with tuberculous lymphadenitis
Primary multi-drug resistant Mycobacterium tuberculosis complex isolates among patients with tuberculous lymphadenitis
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Date
2007-06
Authors
Ibrahim, Nagat
Journal Title
Journal ISSN
Volume Title
Publisher
University of Khartoum
Abstract
Tuberculosis has been and continues to be a major health problem in Sudan. Multidrug-
resistant tuberculosis [MDR-TB] is a serious problem that affects both treatment
and control programs.
Study objective: the objective of this study was to detect the mutant genes that are
associated with drug resistance to Streptomycin and Rifampicin in M.tuberculosis
isolates from Sudanese patients with tuberculous lymphadenitis.
Patients & methods: Following informed consent, seventy five patients with
lymphadenopathy who were referred to the Lymphadneopathy Clinic at the Institute
of Endemic Diseases, University of Khartoum, were enrolled in the study. Fine needle
aspiration cytology (FNAC) has been conducted for all patients as routine clinic
procedure. Cytomorphologically, thirty cases showed necrotizing granulomatous
tuberculous lymphadenitis (30/75; 40 %) while twenty cases (20/75; 26.7 %) showed
reactive lymph nodes changes. The remaining twenty five cases had secondary lymph
nodes deposits. Aspiration material was subjected to PCR using the IS6110 gene
primers to identify M.tuberculosis complex. All cases of tuberculous lymphadenitis
group showed similar patterns to H37 Rv with a fragment size of 123 bp while other
groups (reactive & malignant nodes) were non-reactive. To detect mutations that are
associated with drug-resistance to streptomycin and rifampicin, two set of primers
directed towards rpsl 43 and rpoB 531 loci in a PCR-SSCP system were used. For the
rpsl 43, twenty seven cases (27/30) showed DNA band patterns identical to H37 Rv
(native) while three cases (3/30; 10%) showed different DNA band patterns to H37 Rv,
but identical to mutant strain that were associated with drug resistance to
streptomycin. For the rpoB, all isolates gave identical patterns to H37 Rv (native).
Description
Keywords
Pathology & Clinical Manifestations,Resistance to Streptomycin (SM),Fine Needle Aspiration Cytology (FNAC),Post-primary TB