TY - JOUR
T1 - Drug resistant Mycobacterium tuberculosis in Oman
T2 - resistance-conferring mutations and lineage diversity
AU - Al Mahrouqi, Sara
AU - Gadalla, Amal
AU - Al Azri, Saleh
AU - Al-Hamidhi, Salama
AU - Al-Jardani, Amina
AU - Balkhair, Abdullah
AU - Al-fahdi, Amira
AU - Al Balushi, Laila
AU - Al Zadjali, Samiya
AU - Al Marhoubi, Asmahan Mohammed Nasser
AU - Babiker, Hamza A.
N1 - Funding Information:
We express our sincere appreciation to the staff of the Central Public Health Laboratories, MOH, Oman for their cooperation and help. We are grateful to staff of the Biochemistry Department of the College of Medicine in SQU for facilitating laboratory work.
Funding Information:
This study was funded by Research Council, Oman, Project RG/MED /BIOC/19/01. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2022. Al Mahrouqi et al.
PY - 2022
Y1 - 2022
N2 - Background. The Sultanate of Oman is country a low TB-incidence, with less than seven cases per 105 population detected in 2020. Recent years have witnessed a persistence in TB cases, with sustained incidence rate among expatriates and limited reduction among Omanis. This pattern suggests transmission from the migrant population. The present study examined the genetic profile and drug resistance-conferring mutations in Mycobacterium tuberculosis collected from Omanis and expatriates to recognise possible causes of disease transmission. Methods. We examined M. tuberculosis cultured positive samples, collected from Omanis (n D 1,344) and expatriates (n D 1,203) between 2009 and 2018. These isolates had a known in vitro susceptibility profile to first line anti-TB, Streptomycin (SM), Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) and Pyrazinamide (PZA). The diversity of the isolates was assessed by spacer oligo-typing (spoligotyping). Drug resistance-conferring mutations resulted from full-length sequence of nine genes (katG, inhA, ahpc, rpoB, rpsL, rrs, embB, embC, pncA) and their phenotypic relationship were analysed. Results. In total, 341/2192 (13.4%), M. tuberculosis strains showed resistance to any drug, comprising mono-resistance (MR) (242, 71%), poly-resistance (PR) (40, 11.7%) and multi-drug resistance (MDR) (59, 17.3%). The overall rate of resistance among Omanis and expatriates was similar; however, MDR and PZAR were significantly higher among Omanis, while INHR was greater among expatriates. Mutations rpsL K43R and rpoB S450L were linked to Streptomycin (SMR) and Rifampicin resistance (RIFR) respectively. Whereas, katG S315T and inhA -C15T/G-17T were associated with Isoniazid resistance (INHR). The resistance patterns (mono-resistant, poly-resistant and MDR) and drug resistance-conferring mutations were found in different spoligo-lineages. rpsL K43R, katG S315T and rpoB S450L mutations were significantly higher in Beijing strains. Conclusions. Diverse drug resistant M. tuberculosis strains exist in Oman, with drug resistance-conferring mutations widespread in multiple spoligo-lineages, indicative of a large resistance reservoir. Beijing's M. tuberculosis lineage was associated with MDR, and multiple drug resistance-conferring mutations, favouring the hypothesis of migration as a possible source of resistant lineages in Oman.
AB - Background. The Sultanate of Oman is country a low TB-incidence, with less than seven cases per 105 population detected in 2020. Recent years have witnessed a persistence in TB cases, with sustained incidence rate among expatriates and limited reduction among Omanis. This pattern suggests transmission from the migrant population. The present study examined the genetic profile and drug resistance-conferring mutations in Mycobacterium tuberculosis collected from Omanis and expatriates to recognise possible causes of disease transmission. Methods. We examined M. tuberculosis cultured positive samples, collected from Omanis (n D 1,344) and expatriates (n D 1,203) between 2009 and 2018. These isolates had a known in vitro susceptibility profile to first line anti-TB, Streptomycin (SM), Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) and Pyrazinamide (PZA). The diversity of the isolates was assessed by spacer oligo-typing (spoligotyping). Drug resistance-conferring mutations resulted from full-length sequence of nine genes (katG, inhA, ahpc, rpoB, rpsL, rrs, embB, embC, pncA) and their phenotypic relationship were analysed. Results. In total, 341/2192 (13.4%), M. tuberculosis strains showed resistance to any drug, comprising mono-resistance (MR) (242, 71%), poly-resistance (PR) (40, 11.7%) and multi-drug resistance (MDR) (59, 17.3%). The overall rate of resistance among Omanis and expatriates was similar; however, MDR and PZAR were significantly higher among Omanis, while INHR was greater among expatriates. Mutations rpsL K43R and rpoB S450L were linked to Streptomycin (SMR) and Rifampicin resistance (RIFR) respectively. Whereas, katG S315T and inhA -C15T/G-17T were associated with Isoniazid resistance (INHR). The resistance patterns (mono-resistant, poly-resistant and MDR) and drug resistance-conferring mutations were found in different spoligo-lineages. rpsL K43R, katG S315T and rpoB S450L mutations were significantly higher in Beijing strains. Conclusions. Diverse drug resistant M. tuberculosis strains exist in Oman, with drug resistance-conferring mutations widespread in multiple spoligo-lineages, indicative of a large resistance reservoir. Beijing's M. tuberculosis lineage was associated with MDR, and multiple drug resistance-conferring mutations, favouring the hypothesis of migration as a possible source of resistant lineages in Oman.
KW - Drug resistance genes
KW - Mycobacterium tuberculosis
KW - Oman
KW - Spoligotypes
UR - http://www.scopus.com/inward/record.url?scp=85136112633&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85136112633&partnerID=8YFLogxK
U2 - 10.7717/peerj.13645
DO - 10.7717/peerj.13645
M3 - Article
C2 - 35919400
AN - SCOPUS:85136112633
SN - 2376-5992
VL - 10
JO - PeerJ Computer Science
JF - PeerJ Computer Science
M1 - e13645
ER -