Magnitude of Phenotypic and MTBDRplus Line Probe Assay First-Line Anti-Tuberculosis Drug Resistance Among Tuberculosis Patients;Northwest Ethiopia

Background: Mycobacterium tuberculosis (Mtb) drug resistance is a key challenge in ending TB Objective: The study aimed to determine anti-TB drug resistance and compare the discordance between phenotypic and genotypic drug-susceptibility testing (DST) Methods: Prospective enrollment and sputum collection from patients suspected of active pulmonary TB from May 2018 to December 2019 at the University of Gondar Hospital Phenotypic DST study for streptomycin, isoniazid, rifampin, and ethambutol was done by MGIT 360 SIRE Kit Genotypic resistance for isoniazid and rifampin was performed by MTBDRplus v2 line probe assay (LPA) and compared to phenotypic drug resistance Results: A total of 376 patients, median age 32 years, and 53 7% male were enrolled Mtb was isolated from 126 patients 106/126 (84%) patients were newly diagnosed with TB and 20 patients with prior TB treatment Seventy (66 0%) were susceptible to all anti‐TB drugs tested Twenty-five (19 8%) of the isolates were resistant to isoniazid, 12 (9 5%) to rifampicin and six (5%) were multidrug resistant Among previously treated TB patients, 4 (20 0%) and 5 (25 0%) were mono-resistant and poly-resistant, respectively The sensitivity and specificity of LPA resistance for isoniazid were 94 4% and 100%, and for rifampin was 75 0% and 100%, respectively Conclusion: The frequency of mono- and poly-drug resistance among both newly diagnosed and previously treated TB patients was high to the rest of the nation MTBDRplus showed excellent concordance for isoniazid and rifampin We concluded that DST should be performed for all patients to improve management and decrease spread of drug-resistant Mtb strains in the community