Molecular Detection of Resistance to Rifampin and Isoniazid among Patients Eligible for Retreatment Regimen in Côte d’Ivoire in 2012


Drug-resistant tuberculosis is an important health problem in Cote d’Ivoire. Patients of category I treatment are based on 2RHZE/4RH regimen. For the patients of category II, the 2RHZES/1RHZE/5HRE regimen is systematically initiated. Study objective was to describe the susceptibility profile to Rifampin and Isoniazid among previously treated patients who are eligible for retreatment and who had received the 2RHZES/1RHZE/5HRE regimen in Cote d’Ivoire with a molecular method in 2012. Two sputum samples were collected to each patient recruited in the reference regional centres for tuberculosis. Sputum samples were decontaminated by NALC method. The DNA extraction was realized with 500 μl of decontaminated sputum sample with smear-positive. MTBDRplus assay version 1.0 was performed according to the manufacturer’s instruction. An internal quality control program with positive and negative controls was implemented for interpretation of results. A total of 278 patients were enrolled, 148 (53.2%) were recurrent TB cases, 118 (42.5%) failure cases, and 12 (4.3%) defaulters. From sputum of previously treated patients, mutli-drug resistant tuberculosis was diagnosed for 60 (69.8%, 95% IC, 60% - 80%) treated with the 2RHZE/4RH regimen, 24 (75%, 95% IC, 60% - 90%) with the 2RHZES/1RHZE/5HRE regimen, 60 (41%, 95% IC, 33% - 49%) recurrent TB cases, and 4 (33.3%) defaulters. The comparison of resistance rates to Rifampin estimated from sputum samples in the categories of treatment failures and the recurrence TB cases showed a statistically significant difference. In Cote d’Ivoire, genotype? MTBDRplus assay has permitted to estimate the prevalence of MDR-TB in categories of previously treated patients for tuberculosis.

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K. N’Guessan, T. Ouassa, J. Assi, A. Tehe, J. Assande, A. Guei and J. Kouakou, "Molecular Detection of Resistance to Rifampin and Isoniazid among Patients Eligible for Retreatment Regimen in Côte d’Ivoire in 2012," Advances in Infectious Diseases, Vol. 3 No. 2, 2013, pp. 65-70. doi: 10.4236/aid.2013.32010.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] The World Health Organization (WHO)–International Union against Tuberculosis and Lung Disease (IUATLD), “Global Project on Antituberculosis Drug Resistance Surveillance. Anti-Tuberculosis Drug Resistance in the World,” Fourth Global Report, World Health Organization, Geneva, 2008.
[2] K. N’guessan, I. Nahoua, M. San Koffi, J. Kouakou and M. Dosso, “Primary Resistance to Antituberculosis Drugs: Trends in Cote d’Ivoire from 1996 to 2006,” Médecine et Maladies Infectieuses, Vol. 38, No 4, 2008, pp. 231-232.
[3] T. Dalton, P. Cegielski, S. Akksip, L. Ascencios, J. Campos Caoili, S.N. Cho et al., “Prevalence of and Risk Factors for Resistance to Second-Line Drugs in People with Multidrug-Resistant Tuberculosis in Eight Countries: A Prospective Cohort Study,” Lancet, Vol. 380, No. 20, 2012, pp. 1406-1417. doi:10.1016/S0140-6736(12)60734-X
[4] M. Arévalo, J. Solera, D. Cebrian, J. Bartolomé and P. Robles, “Risk Factors Associated with Drug-Resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain),” European Respiratory Journal, Vol. 9, No. 2, 1996, pp. 274-278. doi:10.1183/09031936.96.09020274
[5] F. Brossier, N. Veziris, C. Truffot-Pernot, V. Jarlier and W. Sougakoff, “Performance of the Genotype MTBDR Line Probe Assay for Detection of Resistance to Rifampin and Isoniazid in Strains of Mycobacterium tuberculsosis with Low and High Level Resistance,” Journal of Clinical Microbiology, Vol. 44, No. 10, 2006, pp. 3659-3664. doi:10.1128/JCM.01054-06
[6] P. Miotto, F. Piana, V. Penati, F. Canducci, G. B. Migliori and D. M. Cirillo, “Use of Genotype MTBDR Assay for Molecular Detection of Rifampin and Isoniazid Resistance in Mycobacterium tuberculosis Clinical Strains Isolated in Italy,” Journal of Clinical Microbiology, Vol. 44, No. 7, 2006, pp. 2485-2491. doi:10.1128/JCM.00083-06
[7] M. Bates, J. O’Grady, M. Maeurer, J. Tembo, L. Chilukutu, C. Chabala, et al., “Assessment of the Xpert MTB/RIF Assay for Diagnosis of Tuberculosis with Gastric Lavage Aspirates in Children in Sub-Saharan Africa: A Prospective Descriptive Study,” The Lancet Infectious Diseases, Vol. 13, No. 1, 2013, pp. 36-42. doi:10.1016/S1473-3099(12)70245-1
[8] D. Garcia de Viedma, “Rapid Detection of Resistance in Mycobacterium tuberculosis: A Review Discussing Molecular Approaches,” Clinical Microbiology and Infection, Vol. 9, No. 5, 2003, pp. 349-359. doi:10.1046/j.1469-0691.2003.00695.x
[9] P. P. Banada, S. K. Sivasubramani, R. Blakemore, C. Boehme, M. D. Perkins, K. Fennelly, et al., “Containment of Bioaerosol Infection Risk by the Xpert MTB/RIF Assay and Its Applicability to Point-of-Care Settings,” Journal of Clinical Microbiology, Vol. 48, No. 10, 2010, pp. 3551-3557. doi:10.1128/JCM.01053-10
[10] D. Bang, “The Management of Tuberculosis: Epidemiology, Resistance and Monitoring,” Ph.D. Dissertation, University of Copenhagen, Danemark, 2010.
[11] World Health Organization, International Union against Tuberculosis and Lung Disease, Royal Netherlands Tuberculosis Association, “Revised International Definitions in Tuberculosis Control,” The International Journal of Tuberculosis and Lung Disease, Vol. 5, No. 3, 2001, pp.213-215.
[12] H. L. Rieder, A. V. Deun, K. M. Kam, T. M. Chonde, A. Trébucq and R. Urbanczik, “Priorités Pour les Services de Bactériologie de la Tuberculose Dans les Pays à Faibles Revenus,” Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Paris, 2007.
[13] M. Barnard, L. Parsons, P. Miotto, D. Cirillo, K. Feldmann, C. A. Gutierrez, et al., “ Molecular Detection of Drug-Resistant Tuberculosis By Line Probe Assay: Laboratory Manual for Resource-Limited Settings,” Foundation for innovative New Diagnostics, Geneva, 2012.
[14] World Health Organization, “Toman’s Tuberculosis: Case Detection, Treatment and Monitoring: Questions and Answers,” World Health Organization, Geneva, 2004, WHO/HTM/TB/2004.334. H. D. N. Nyamogoba, G. Kikuvi, G. Mbuthia, S. Mpoke, A. A. Obala, R. Biegon, et al., “A High rate Of Recurrent Tuberculosis in Western Kenya Independent of Human Immunodeficiency Virus Infection,” African Health Sciences, Vol. 20, No. 1-2, 2012, pp. 62-68.
[15] A. van Rie, R. Warren, M. Richardson, T. C. Victor, R. P. Gie, D. A. Enarson et al., “Exogenous Reinfection as a Cause of Recurrent Tuberculosis after Curative Treatment,” The New England Journal of Medicine, Vol. 341, No. 6 1999, pp. 1174-1179.
[16] N. Tukvadze, R. R. Kempker, I. Kalandadze, E. Kurbatova, M. K. Leonard, R. Apsindzelashvili, et al., “ Use of Molecular Diagnostic Test in AFB Smear Positive Tuberculosis Suspects Greatly Reduces Time to Detection of Multidrug Resistant Tuberculosis” PloS One, Vol. 7, No. 2, 2012, Article ID: e31563. doi:10.1371/journal.pone.0031563
[17] R. Anek-vorapong, C. Sinthuwattanawibool, L. J. Podevwils, K. McCarthy, K. Ngamlert, B. Promsarin, et al., “Validation of the Genotype MTBDRplus Assay for Detection of MDR-TB in a Public Health Laboratory in Thailand,” BMC Infectious Diseases, Vol. 10, 2010, Article ID: e123. doi:10.1186/1471-2334-10-123
[18] J. H. Chia, T. L. Wu, L. H. Su, A. J. Kuo and H. C. Lai, “Direct Identification of Mycobacteria from Smear-Positive Sputum Samples Using an Improved Multiplex Polymerase Chain Reaction Assay,” Diagnostic Microbiology and Infectious Disease, Vol. 72, No. 4, 2012, pp. 340-349. doi:10.1016/j.diagmicrobio.2011.12.008
[19] N. Kiraz, I. Saglik, A. Kiremitci, N. Kasifoglu and Y. Akgun, “Evaluation of the GenoType Mycobacteria Direct Assay for Direct Detection of the Mycobacterium tuberculosis Complex Obtained from Sputum Samples,” Journal of Medical Microbiology, Vol. 59, No. 8, 2010, pp 930-934. doi:10.1099/jmm.0.013490-0
[20] T. Wu, J. H. Chia, A. J. Kuo, L. H. Su, T. S. W and H. C. Lai1, “Rapid Identification of Mycobacteria from Smear-Positive Sputum Samples by Nested PCR-Restriction Fragment Length Polymorphism Analysis,” Journal of Clinical Microbiology, Vol. 46, No. 11, 2008, pp. 3591-3594. doi:10.1128/JCM.00856-08
[21] K. Horo, N. B. Koffi, B. A. Kouassi, V. C. Brou-Godé, B. J. M. Ahui and Y. Silué, “Antituberculous Retreatment in Case of Failure to Category I Regimen;” Revue de Maladies Respiratoires, Vol. 27, No. 9, 2010, pp. 1055-1061. doi:10.1016/j.rmr.2010.04.016
[22] H. Traoré, K Fissette, I. Bastian, M. Devleeschouwer and F. Portaels, “Detection of Rifampicin Resistance in Mycobacterium Tuberculosis Isolates from Diverse Countries by a Commercial Line Probe Assay as an Initial Indicator of Multidrug Resistance,” The International Journal of Tuberculosis and Lung Disease, Vol. 4, No. 5, 2000, pp. 481-484.

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