@article{fdi:010081158,
  title = {{R}esistance to second-line anti-{TB} drugs in {C}ambodia : a phenotypic and genetic study},
  author = {{C}heng, {S}. and {H}ide, {M}. and {P}heng, {S}. {H}. and {K}erleguer, {A}. and {D}elvallez, {G}. and {S}am, {S}. and {M}ao, {T}. {E}. and {N}guyen, {T}. {V}. {A}. and {B}anuls, {A}nne-{L}aure},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {D}ue to the emergence of {M}ycobacterium tuberculosis ({M}.tb) clinical isolates resistant to most potent first-line drugs ({FLD}), second-line drugs ({SLD}) are being prescribed more frequently. {W}e explore the genetic characteristics and molecular mechanisms of {M}.tb isolates phenotypically resistant to {SLD}, including pre-extensively drug-resistant (pre-{XDR}) and extensively drug-resistant ({XDR}) isolates. {M}ethods: {D}rug-resistant ({DR}) {M}.tb isolates collected from 2012 to 2017 were tested using sequencing and phenotypic drug susceptibility testing. {G}enotypes were determined to explore their links with {SLD} resistance patterns. {R}esults: {O}f the 272 {DR} {M}.tb isolates, 6 non-multidrug resistant (non-{MDR}) isolates were fluoroquinolones ({FQ})-resistant, 3 were {XDR} and 16 were pre-{XDR} (14 resistant to {FQ} and 2 to second-line injectable drugs). {T}he most frequent mutations in {FQ}-resistant and second-line injectable drugs resistant isolates were gyr{A} {D}94{G} (15/23) and rrs a1401g (3/5), respectively. {S}eventy-five percent of pre-{XDR} isolates and 100% of {XDR} isolates harbored mutations conferring resistance to pyrazinamide. {A}ll {XDR} isolates belonged to the {B}eijing genotype, of which one, named {XDR}+, was resistant to all drugs tested. {O}ne cluster including pre-{XDR} and {XDR} isolates was observed. {C}onclusion: {T}his is the first description of {SLD} resistance in {C}ambodia. {T}he data suggest that the proportion of {XDR} and pre-{XDR} isolates remains low but is on the rise compared to previous reports. {T}he characterization of the {XDR}+ isolate in a patient who refused treatment underlines the risk of transmission in the population. {I}n addition, genotypic results show, as expected, that the {B}eijing family is the main involved in pre-{XDR} and {XDR} isolates and that the spread of the {B}eijing pre-{XDR} strain is capable of evolving into {XDR} strain. {T}his study strongly indicates the need for rapid interventions in terms of diagnostic and treatment to prevent the spread of the pre-{XDR} and {XDR} strains and the emergence of more resistant ones.},
  keywords = {{M}ycobacterium tuberculosis ; extensively drug-resistant tuberculosis ; pre-extensively drug-resistant tuberculosis ; fluoroquinolone ; second-line injectable drugs ; {CAMBODGE}},
  booktitle = {},
  journal = {{I}nfection and {D}rug {R}esistance},
  volume = {14},
  numero = {},
  pages = {1089--1104},
  ISSN = {1178-6973},
  year = {2021},
  DOI = {10.2147/idr.{S}289907},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081158},
}