Drug Resistance Conferring Mutation and Genetic Diversity of Mycobacterium tuberculosis Isolates in Tuberculosis Lymphadenitis Patients; Ethiopia

Figures & data

Table 1 Demographic Characteristics of Study Participants from Different Places in Ethiopia, 2016–2017

Variables	Frequency	Number
Sex
Male	37	40.7%
Female	54	59.3%
Age Group
9–21	30	32.9%
22–31	20	21.9%
32–41	6	6.6%
42–51	21	23.1%
>51	14	15.4%
Patient Category
New Case	71	78%
Retreatment	17	18.7%
Unknown	3	3.3%

Table 2 Mutations Identified in Isoniazid and Rifampicin Resistant M. tuberculosis Strains

Anti-TB Drugs	Gene	Pattern of Gene Mutations (WT/MUT)	Amino Acid Change	Resistance Pattern	SIT
Rifampicin	rpoB	ΔWT8/MUT3	S531L	RIF^R	SIT149, SIT25
Isoniazid	KatG	ΔWT/MUT1	S315T1	INH^R	SIT149, SIT25, SIT50
		ΔWT/MUT2	S315T2	INH^R	SIT149
	inhA	ΔWT1/MUT1	C15T	INH^R	SIT26
		ND/MUT1	unknown	INH^R	Orphan

Note: SIT149 and SIT25 were MDR strains (resistant to INH and RIF).

Abbreviations: Δ, deletion; WT, wild type; MUT, mutant; ND, no mutation detected at wildtype probe; RIF^R, rifampicin resistant; INH^R, Isoniazid resistant; SIT, spoligotype international types.

Figure 1 Spoligotypes and major lineage classifications of clinical M. tuberculosis strains isolated from TBLN patients in different places in Ethiopia, 2016–2017.

Table 3 M. tuberculosis Lineage Distribution in Different Sample Collection Places in Ethiopia, 2016–2017

Collection Site	Total Number of Isolates	L1 N/%	L3 N/%	L4 N/%	L7 N/%
Bishoftu	35	0	8/22.8	27/77.1	0
Gondar	27	0	18/66.7	8/29.6	1/3.7
Mekele	21	2/9.5	11/52.3	7/33.3	1/4.8
Hawassa	8	0	1/12.5	7/87.5	0
Total no. of isolates/%	91/100	2/2.2	38/41.7	49/53.8	2/2.2

Abbreviations: N, number; L, lineage.

Table 4 Cluster Distribution Among Different Mycobacterium tuberculosis Lineages

Lineage	Total Isolate	Cluster Strains	Cluster %	Cluster Number	Cluster Size	SIT Number
L1	2	2	100%	1	2	SIT 726
L3	38	31	81.5%	3	19	SIT 25
					8	SIT 26
					4	SIT 2339
L4	49	30	61.2%	4	11	SIT 149
					9	SIT 53
					6	SIT 37
					2	SIT 54
					2	SIT 52

Abbreviations: AHRI, Armauer Hansen Research Institute; EPTB, extrapulmonary tuberculosis; ETHICOBOTs, Ethiopia Control of Bovine Tuberculosis; INH, isoniazid; INH^R, isoniazid resistant; MDR, multidrug resistant; MTBC, Mycobacterium tuberculosis complex; MUT, mutant; PTB, pulmonary tuberculosis; RIF, rifampicin; RIR^R, rifampicin resistant; TB, tuberculosis; TBLN, tuberculosis lymphadenitis; SIT, Spoligo International Type; WHO, World Health Organization, WT; wild type.