Abstract

Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem in Nepal. Despite the implementation of a successful TB control program in Nepal, notifications of MDR-TB are increasing, yet the reasons are unknown. The objective of this study was to understand the genetic diversity and epidemiological characteristics of MDR-Mycobacterium tuberculosis (MTB) isolates in Nepal. We isolated and genotyped 498 MDR-MTB isolates collected from April 2009 to March 2013 and analyzed the patients’ background information. Our results showed that the lineage 2 (Beijing family) was the most predominant lineage (n = 241; 48.4%), followed by lineage 3 (n = 153, 30.7%). Lineage 4 was the third most prevalent (n = 73, 14.5%) followed by lineage 1 (n = 32, 6.4%). The lineages were significantly associated with geographic region, ethnic group, age and sex of patients. The Beijing genotype was found to have an important role in transmitting MDR-TB in Nepal and was significantly associated with the eastern region, mongoloid ethnic group and younger age group. We conclude that early diagnosis and treatment including molecular-epidemiological surveillance of MDR-TB cases will help to control transmission of MDR-TB in Nepal.

Details

Title
Genetic diversity and distribution dynamics of multidrug-resistant Mycobacterium tuberculosis isolates in Nepal
Author
Maharjan, Bhagwan 1 ; Nakajima, Chie 2 ; Isoda, Norikazu 3 ; Thapa, Jeewan 4 ; Poudel, Ajay 5 ; Shah, Yogendra 4 ; Yamaguchi, Tomoyuki 4 ; Shrestha, Bhabana 6 ; Hoffmann, Harald 7 ; Avsar, Korkut 8 ; Shrestha, Ashish 9 ; Gordon, Stephen V 10   VIAFID ORCID Logo  ; Suzuki, Yasuhiko 2   VIAFID ORCID Logo 

1  German Nepal TB Project (GENETUP/NATA), Kathmandu, Nepal; Division of Bioresources, Hokkaido University, Research Center for Zoonosis Control, Hokkaido, Japan 
2  Division of Bioresources, Hokkaido University, Research Center for Zoonosis Control, Hokkaido, Japan; Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan 
3  Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan; Unit of Risk Analysis and Management, Research Center for Zoonosis Control, Hokkaido, Japan 
4  Division of Bioresources, Hokkaido University, Research Center for Zoonosis Control, Hokkaido, Japan 
5  Department of Microbiology, Chitwan Medical College Teaching Hospital, Chitwan, Nepal 
6  German Nepal TB Project (GENETUP/NATA), Kathmandu, Nepal 
7  WHO-Supranational Reference Laboratory of Tuberculosis, Gauting, Germany; KuratoriumTuberkulose in der Welt e.V, München-Gauting, Germany 
8  KuratoriumTuberkulose in der Welt e.V, München-Gauting, Germany; Asklepios Klinik, Gauting, Germany 
9  National Tuberculosis Center, Thimi, Bhaktapur, Nepal; World Health Organization, Kathmandu, Nepal 
10  Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Hokkaido, Japan; UCD School of Veterinary Medicine, University College Dublin, Dublin, Ireland 
Pages
1-10
Publication year
2018
Publication date
Nov 2018
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-018-34306-w
ProQuest document ID
2131595631
Copyright
© 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.