Proportion of isoniazid resistance-associated genes of Mycobacterium tuberculosis complex detected by Xpert MTB/XDR assay in Regional Health 3
Keywords:
Isoniazid, Xpert MTB/XDR, genes associated with H-resistantAbstract
The declining trend of Isoniazid (H)-sensitive Mycobacterium tuberculosis (MTB) complex in Regional Health 3 from the fiscal year 2015 to 2024, decreasing from 83% to 68%. This trend reflects a rising prevalence of drug-resistant MTB. Various genes are associated with H-resistant MTB. This study aimed to determine the proportion of genes associated with H-resistant MTB among MTB-positive samples in Regional Health 3, using Xpert MTB/XDR (N = 655). The results showed that the proportion of mutations in katG, inhA, fabG1, and oxyR-ahpC was 72%, 23%, 4%, and 1%, respectively. The proportion of H-resistant isolates was higher among males than females; however, no significant differences were observed across age groups. The katG and inhA mutations were found in every province (Kamphaeng Phet, Phichit, Nakhon Sawan, Uthai Thani, and Chainat), while the fabG1 mutation was detected in Kamphaeng Phet and Phichit, and the oxyR-ahpC mutation was found only in Chinat. Additionally, fabG1 and oxyR-ahpC mutations were more frequently observed among newly diagnosed patients. These results indicate that the distribution patterns of H-resistant MTB vary by region, especially for genes with lower mutation frequencies. These findings can help identify transmission linkages among patient groups, genders, age groups, and geographic areas. This information is valuable for MTB investigations, which remain highly challenging at present.
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