Журнал инфекционных заболеваний и профилактической медицины
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Drug Resistant Mycobacterium tuberculosis Complex Isolates among Patients with Tuberculous Lymphadenitis

Nagat Ibrahim Elhag, Eltahir AG Eltahir, Ahamed Mohamed Elhassan, Ahamed Modawi Musa, Alfatih Aljaafarie, Sara Hassab Algawi and Omima Abed Aziz

Objectives: Seventy five patients with lymphadenopathy who were referred to the Clinic of Lymphadenopathy at the Institute of Endemic Diseases, University of Khartoum were enrolled in our study to detect gene mutation that associated with drug resistance to streptomycin and rifampicin.

Materials and methods: Seventy five patients of lymphadenopathy were enrolled for Fine needle aspiration cytology and polymerase chain reaction (PCR). PCR-single strand confirmation polymorphism (PCR-SSCP) for gene mutation was used to detect gene mutation for tuberculous lymphadenitis group.

Results: Cytomorphologically, thirty cases showed necrotizing granulomatous tuberculous lymphadenitis (40%) while twenty cases (26%) showed reactive lymph nodes changes. The remaining twenty five cases (34%) had secondary lymph nodes deposits. All cases of tuberculous lymphadenitis group showed similar patterns to H37 Rv with a fragment size of 123 bp when amplified with IS6110 gene primers specific for M. tuberculosis complex, while other groups (reactive and malignant nodes) were negative.

For rpsl 43 gene detection, twenty seven cases (27/30) had DNA band patterns identical to H37 while three cases (3/30) were identical to mutant strain that were associated with drug resistance to streptomycin. For the rpoB, all isolates gave identical patterns to H37 Rv strain.

Conclusion: PCR is useful to detect Mycobacterium tuberculosis isolates in tuberculous lymphadenitis cases. PCR-SSCP is useful for detection of gene mutation targeting drugs for tuberculosis cases; however, it needs more supportive tools such as sequencing method to confirm the resistance Tb cases.