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  • PA-201 Species identification and drug susceptibility testing of non-tuberculous mycobacteria isolated among presumptive tuberculosis patients in Lambaréné, Gabon

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PA-201 Species identification and drug susceptibility testing of non-tuberculous mycobacteria isolated among presumptive tuberculosis patients in Lambaréné, Gabon
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  1. Micheska Epola Dibamba Ndanga1,
  2. Jabar Babatundé Pacome Achimi Agbo Abdul1,
  3. Jean Ronald Edoa1,
  4. Guy Arnault Rogue Mfoumbi Ibinda1,
  5. Bayodé Romeo Adegbite1,2,
  6. Rhett Chester Mevyann1,
  7. Christopher Mebiame Biyogho1,
  8. Jocelyn Mahoumbou3,
  9. Stredice Manguinga3,
  10. Nina Mbenga Roguet3,
  11. Bertrand Lell1,4,5,
  12. Peter G Kremsner1,4,5,
  13. Abraham Sunday Alabi1,6,
  14. Martin Peter Grobusch1,2,4,5,7,8,
  15. Ayola Akim Adegnika1,4,5,9,10
  1. 1Centre De Recherches Médicales de Lambaréné, Gabon
  2. 2Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Netherlands
  3. 3Programme National de Lutte contre la Tuberculose, Gabon
  4. 4Institut für Tropenmedizin, Universität Tübingen, Germany
  5. 5German Center for Infection Research, Germany
  6. 6Health Focus GmbH, Germany
  7. 7Masanga Medical Research Unit, Sierra Leone
  8. 8Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa
  9. 9Fondation pour la Recherche Scientifique, Bénin
  10. 10Department of Parasitology, Leiden University Medical Center, Netherlands

Abstract

Background Non-tuberculous mycobacteria are increasingly recognised as causative agents of opportunistic and device-associated infections in humans. In Gabon, data is scarce, as species identification and drug susceptibility are not performed in most laboratories. The objectives of our study were to identify the relative frequencies of non-tuberculous mycobacteria species circulating and to determine their genotypic susceptibility pattern regarding the antibiotics most commonly used to treat NTM infections among presumptive tuberculosis patients.

Methods This cross-sectional prospective study was conducted at the CERMEL TB laboratory from January 2020 to December 2022 to generate drug susceptibility data on NTM species identified from presumptive TB patient specimen sent to the National TB Reference Laboratory. The drug susceptibility to macrolides and aminoglycosides and the NTM subspecies identification were performed using the genotype NTM-DR kit.

Results Among 524 culture-positive specimen, 146 (28%) were NTM. The predominant group was Mycobacterium avium complex, MAC 80/146 (54.8%), of which M. intracellular 53/146 (36.3%) and M. avium 27/146 (18.5%)); followed by Mycobacterium abscessus complex, MABC 38/146 (26.0%), of which M. abscessus subsp. abscessus 20/146 (13.6%); M. abscessus subsp. massiliense 10/146 (7.0%); and M. abscessus subsp. bolletii 8/146 (5.4%)). All MAC were genotypically fully susceptible to macrolides and aminoglycosides. All five isolates of MABC showed polymorphisms both of the erm (41) and rrl genes, both coding for macrolide resistance.

Conclusion All MAC isolates were fully susceptible to macrolides and aminoglycosides, thus confirming their role in NTM treatment. However, resistance-conferring polymorphisms indicate limited susceptibility of M. abscessus complex isolates against both drug classes; requiring further investigation to comprehensively determine M. abscessus drug susceptibility. The study results presented here shall guide clinicians to better manage treatment. Routine susceptibility testing is not available.

https://doi.org/10.1136/bmjgh-2023-EDC.118

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