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Mycobacterium tuberculosis complex lineages and drug resistance patterns among tuberculosis patients with or without diabetes mellitus in southern Ghana

Article scientifique 2025 Anglais

Résumé

Drug-resistant (DR) tuberculosis (TB) and diabetes mellitus (DM) are intersecting epidemics that complicate management of both diseases and worsen patient outcomes. We conducted a prospective cohort study of 758 GeneXpert-confirmed pulmonary TB patients, of whom 75 had DM. Demographic, clinical, radiographic, and anthropometric data were collected at baseline. Sputum samples were cultured for mycobacterial isolation, and the obtained isolates were characterized for Mycobacterium tuberculosis complex (MTBC) lineage and drug-susceptibility testing using spoligotyping and microplate alamar blue assay. The TB-diabetes (TB-DM) comorbid cohort was older [TB-DM: 53/75 (70.7%) vs. 241/683 (35.3%) aged 41-60 years) (p < 0.001), included a higher proportion of females [TB-DM: 31/75 (41.3%) vs. TB-only: 150/683 (22.0%), p < 0.001], and had greater mean BMI (TB-DM: 23.36 ± 0.99 vs. TB-only: 19.97 ± 0.45 kg/m², p = 0.003). Analysis of 501 (TB-only: 448, TB-DM: 53) MTBC isolates revealed that TB-DM patients are more likely to get TB caused by L6 [TB-DM: 10/53 (18.9%) vs. TB-only: 37/448 (8.3%), p = 0.022] compared to the general TB population Lineage 4 [TB-DM: 36/53 (67.9%) vs. TB-only: 362/448 (80.8%), p = 0.046], Mycobacterial strains from TB-DM exhibited higher isoniazid mono-resistance [TB-DM: 15/50 (30.0%) vs. 42/288 (14.6%), p = 0.012] and harbored more multidrug-resistant TB [TB-DM: 5/50 (10.0%) vs. TB-only: 16/288 (5.6%), p = 0.215] although this did not reach statistical significance. These findings indicate that DM not only predisposes individuals to TB but may also shift the spectrum of infecting lineages and promotes the emergence of DR strains. Integrated TB-DM screening, lineage-aware diagnostics, and tailored treatment protocols are urgently needed in high-burden settings to address this dual threat.

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Danso, E., Asare, P., Tetteh, A., Tetteh, P., Boadu, A., Lamptey, I., Sylverken, A., Obiri‐Danso, K., Afriyie-Mensah, J., Adjei, A., Yeboah‐Manu, D. (2025). Mycobacterium tuberculosis complex lineages and drug resistance patterns among tuberculosis patients with or without diabetes mellitus in southern Ghana. https://doi.org/10.1371/journal.pone.0338498

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Auteur(s)

Emelia Konadu Danso Prince Asare Amanda Yaa Tetteh Phillip Tetteh Augustine Asare Boadu Ivy Naa Koshie Lamptey Augustina Angelina Sylverken Kwasi Obiri‐Danso Jane Sandra Afriyie-Mensah Abraham Adjei Dorothy Yeboah‐Manu

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