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Revista Peruana de Medicina Experimental y Salud Publica
versión impresa ISSN 1726-4634
Resumen
SANTOS-LAZARO, David; PUYEN, Zully M. y GAVILAN, Ronnie G.. Genetic structure of drug-resistant Mycobacterium tuberculosis strains in Peru based on haplotypes obtained from a line probe assay. Rev. perú. med. exp. salud publica [online]. 2021, vol.38, n.4, pp.577-586. Epub 20-Dic-2021. ISSN 1726-4634. http://dx.doi.org/10.17843/rpmesp.2021.384.7834.
Objective.
To determine the genetic structure of drug-resistant strains of Mycobacterium tuberculosis that circulated throughout Peru during the years 2011-2015, by using haplotypes obtained from a line probe assay.
Materials and methods.
A total of 6589 samples that were admitted to the Instituto Nacional de Salud for routine diagnosis using the GenoType® MTBDRplus v2 assay were analyzed during the study period. Resistant haplotypes were created by concatenating 21 polymorphic sites of the evaluated genes using the line probe assay; and the association analysis was carried out with phenotypes obtained by the 7H10 agar ratio method.
Results.
The most frequent mutations were: rpoB S531L (55.4%) and rpoB D516V (18.5%) for rifampicin resistance, and katG S315T (59.5%) and inhA c-15t (25.7%) for isoniazid resistance. We obtained 13 representative haplotypes (87.8% of analyzed samples), 6 corresponded to the multidrug-resistant genotype, 4 to the isoniazid mono-resistant genotype and 3 to the rifampicin mono-resistant genotype. Eighteen regions and the province of Callao showed high haplotype diversity; four showed moderate diversity and two showed low diversity.
Conclusions.
Most regions showed high haplotype diversity; in addition, most drug-resistant strains of Mycobacterium tuberculosis were concentrated in the cities of Lima and Callao. Likewise, drug-resistant Mycobacterium tuberculosis strains circulating in Peru mainly contain the genetic markers with the highest prevalence worldwide, which are associated with resistance to rifampicin and isoniazid.
Palabras clave : Tuberculosis; Drug Resistance, Bacterial; Molecular Diagnostic Techniques; Molecular Epidemiology; Genetic Variation; DNA, Bacterial; Genotype; Haplotypes; Point Mutation; Peru.