PhD Dissertation at the College of Medicine, University of Babylon, on Patients with Tuberculosis
The Department of Microbiology at the College of Medicine, University of Babylon, discussed the PhD dissertation of student Iyad Jawad Kazem Imran Al-Birmani, titled:
“Genetic Diversity of Mycobacterium tuberculosis Isolates from Patients with Tuberculosis in Babylon Province.”
The dissertation was supervised by Prof. Dr. Lamees Abdul Razzaq Abdul Latif and Prof. Dr. Ahmed Hussein Jassim.
The defense was attended by the Dean of the College, Prof. Dr. Muhannad Abbas Al-Shallah, the Associate Dean for Scientific Affairs, Asst. Prof. Dr. Ashraf Mohammed Ali Hussein, in addition to faculty members from the department, academics, and postgraduate students.
During his defense, the researcher explained that in this study, 134 suspected TB cases were referred to the Tuberculosis Control Center. Out of the 134 suspected cases:
• 32 cases were confirmed positive using Acid-Fast Bacilli (AFB) staining,
• 38 cases were confirmed using both bacterial culture and the GeneXpert test.
DNA was extracted from the 38 positive samples, followed by Polymerase Chain Reaction (PCR), and the products were analyzed using hybridization techniques to detect mutated or wild-type gene bands.
Key findings included:
• 12 isolates had mutations in the rpoB gene, associated with rifampicin resistance, and 7 isolates lacked the wild-type rpoB gene.
• katG gene mutations were found in 8 isolates, with absence of the wild-type gene in 5 isolates, indicating isoniazid resistance.
• inhA gene mutations appeared in 6 isolates, and the gene was absent in 4 isolates.
• gyrA gene mutations linked to moxifloxacin resistance were detected in 5 isolates, and one isolate lacked the gene.
• gyrB gene mutations related to levofloxacin resistance were found in 6 isolates, with absence of the gene in 3 isolates.
• 13 isolates had mutations in the rrs gene, associated with aminoglycoside resistance, with no loss of the wild-type gene.
• Mutations in the Eis gene were linked to amikacin resistance.
Antibiotic susceptibility testing was performed using solid media, a traditional method that is labor-intensive and poses health risks.
The results showed high levels of resistance to first-line anti-TB drugs:
• Rifampicin: 50% resistance
• Isoniazid: 42%
• Streptomycin: 55%
For second-line drugs:
• Moxifloxacin: 13% resistance
• Levofloxacin: 18%
• Amikacin: Highest resistance at 85.7%
Three isolates showed discordance between genotypic and phenotypic features:
1. One isolate had an rpoB mutation but was sensitive to rifampicin.
2. Another had an Eis gene mutation but was sensitive to amikacin.
3. A third showed a gyrB mutation but remained sensitive to levofloxacin.