Contributions of GeneXpert® to TB diagnosis in Myanmar.

BACKGROUND: Xpert® MTB/RIF, a rapid, molecular TB diagnostic assay, can detect Mycobacterium tuberculosis and rifampin resistance directly from clinical sputum samples in <2 h with high sensitivity and specificity. The added diagnostic value of Xpert over smear microscopy at a national level in Myanmar has not been previously reported.METHODS: We evaluated 339,358 Xpert and demographic records captured from January 2015 to December 2018 as part of the Myanmar National TB Program Data Utilization and Connectivity Project to examine the additional diagnostic yield of Xpert relative to smear for the detection of M. tuberculosis for TB diagnosis in Myanmar, with a focus on people living with HIV (PLHIV) and sample type.RESULTS: Use of Xpert increased TB case detection by 40% compared to smear microscopy results. Among PLHIV, use of Xpert increased TB case detection by almost 100% compared to smear microscopy results.CONCLUSION: Xpert testing identified more patients with TB than smear microscopy alone, particularly in cohorts with significant proportions of PLHIV. The use of Xpert as a screening tool in countries with a high burden of TB could lead to significantly increased diagnosis of TB at a regional and national level.

Clonal diversity of Acinetobacter baumannii clinical isolates in Myanmar: identification of novel ST1407 harbouring blaNDM-1.

Recent Acinetobacter baumannii clinical isolates in a teaching hospital in Myanmar comprised three major sequence types (ST2, ST16 and ST23) and two sporadic STs, showing a high resistance rate to carbapenem associated with blaOXA-23 . The NDM-1 encoding gene was identified in only one isolate exhibiting novel ST1407 (a triple-locus variant of ST16).

First detection of the mcr-1 colistin resistance gene in Escherichia coli from a patient with urinary tract infection in Myanmar.

Colistin-resistance gene mcr-1 was detected in an Escherichia coli sample among 442 clinical isolates collected in a tertiary-care hospital in Yangon, Myanmar, in 2018. This isolate was classified into phylogroup A-ST23 complex and harboured bla CTX-M-15 and bla TEM-1, associated with multiple mutations in quinolone-resistance-determining regions in gyrA and parC.

National anti-tuberculosis drug resistance survey, 2002, in Myanmar.

SETTING: Thirty townships of Myanmar. OBJECTIVES: To determine the proportions of drug-resistant tuberculosis (TB) in new and previously treated pulmonary tuberculosis (PTB) cases in Myanmar. DESIGN: A cross-sectional study. Drug susceptibility was tested by the proportion method at the National Tuberculosis Reference Laboratory, Yangon. RESULTS: Of 874 TB patients included from 30 sites, 849 isolates obtained from individual patients (733 from new cases and 116 from previously treated cases) were tested for susceptibility to four primary anti-tuberculosis drugs. Of 733 isolates tested from new TB patients, 10% were resistant to any one of the anti-tuberculosis drugs, 6.5% to isoniazid (INH), 4.6% to rifampicin (RMP) and 4.0% were multidrug-resistant (MDR). Of the 116 previously treated patients, 30.2% were resistant to any one of the drugs, 26.7% to INH, 15.5% to RMP and 15.5% were MDR. Previous anti-tuberculosis treatment of more than 1 month was strongly associated with the development of MDR-TB (adjusted OR 4.8, 95% CI 2.5-9.1). CONCLUSION: The first national drug resistance survey in Myanmar revealed 4% and 15.5% MDR-TB among new and retreatment cases, respectively. Previous antituberculosis treatment was an important risk factor for MDR-TB. Continuous monitoring of drug resistance trends is needed