Incidence and Drug Resistance of Zoonotic Mycobacterium bovis Infection in Peshawar, Pakistan

Abstract

Prevalence of zoonotic Mycobacterium bovis (bTB) disease in human population is underreported from the North of Pakistan. Here, we report on the proportion of human bTB disease among the overall TB patients, drug resistance pattern of bTB isolates, and knowledge, attitude, and practices (KAP)-based analysis of bTB disease. For this purpose, sputum samples from a total of 300 clinically diagnosed TB patients and 100 randomly selected school children suspected of pulmonary TB were processed by culture as well as polymerase chain reaction (PCR) for isolation, identification, and confirmation of Mycobacterium tuberculosis (mTB) and bTB species. Isolates of bTB were processed for drug susceptibility tests. Data on KAP regarding TB were obtained on a pretested questionnaire. Sputum-based PCR results indicated that 288/300 (96%) were confirmed as mTB, while 12/300 (4%) were found as bTB diseases. Interestingly, none of the school child was declared positive for either mTB or bTB. Notably, 274/300 (91.3%) positively cultured samples were identified as mTB, 13/300 (4.3%) as bTB, while 5/300 (1.7%) as mixed containing both. Importantly, except one, all of the bTB isolates were found resistant to pyrazinamide. Surprisingly, most of the bTB isolates (~70%) were found resistant to a broad range of first- and second-line anti-TB drugs. SplitsTree and recombination analysis indicated no evidence of intergenic recombination. Finally, residence, occupation, presence of animals at home, and sleeping alongside animals were found significantly associated with occurrence of bTB disease. To the best of our knowledge, we report for the first time on the high (4%) burden of bTB disease in human TB patients in Peshawar, Pakistan.

The Under Reported Issue of Antibiotic-Resistance in Food-Producing Animals in Pakistan

“…Although, causalities due to the overuse of antibiotics in animals is hard to establish, however, evidence of close association-between livestock-associated resistant bugs in animals and human (Vieira et al, 2011;Khattak et al, 2018), level of use of antimicrobials and prevalence of resistant bacteria in animals (Aarestrup, 2005), and in humans (Schwarz et al, 2001) exist. For prevention of diseases, antimicrobials are continuously administered in drinking water or added in daily feed for a longer period at lower doses (Wegener, 2003), while growth promoters are supplemented on routine basis in feed or drinking water at low level (Stokstad and Jukes 1950), potentially encouraging growth of selected resistant bacteria (Alexander et al, 2008).…”

Multidrug Resistant Carbapenemase-Producing Escherichia coli from Chicken Meat Reveals Diversity and Co-Existence of Carbapenemase Encoding Genes

“…Antimicrobial resistance (AMR) is challenging our current progress in health. AMR is increasingly reported from all over the world (Nordmann et al, 2011;Mohsin et al, 2017;Khattak et al, 2018;ur Rahman et al, 2018a). The scenario seems even more challenging for developing countries mainly due to unrestricted use of antimicrobials and lack of surveillance programs to monitor emergence of drug resistance (Khan et al, 2010;Mitema 2010;ur Rahman et al, 2018a).…”

The potential risk of international spread of Mycobacterium bovis associated with movement of alpacas

“…Transmission of M. bovis from an alpaca to a veterinarian has been reported, resulting in cutaneous TB ( 35 ). As previously reported, infections in farmers and other animal handlers may be associated with a lack of awareness about zoonoses ( 2 , 14 ).…”