Identification Of RPOB, CATG And EMBB Mutation Causes Of Multidrug Resistance Tuberculosis At The Adam Malik Central General Hospital (RSUP)
Identification of RPOB, CATG, and EMBB Mutation Causes of Multidrug Resistance Tuberculosis at Adam Malik Central General Hospital (RSUP)
Discussion Category: Magister Theses, Education, Journal, Thesis, University, Student, Campus
Introduction
The increasing cases of resistance to tuberculosis drugs (TB) have become a serious challenge in the prevention of this disease, especially for multidrug resistance tuberculosis (MDR-TB). Mycobacterium tuberculosis (M. tuberculosis) has the natural ability to develop resistance to antibiotics caused by genetic mutations. This study aims to identify mutations to RPOB, CATG, and EMBB genes that contribute to resistance to Rifampicin, Isoniazid, and Ethambutol in MDR-TB patients in the Central General Hospital (RSUP) Adam Malik Medan, and compare local mutation patterns with patterns global.
Research Background
Microbial resistance, especially in M. Tuberculosis, is a big challenge for TB control programs throughout the world. Antibiotics commonly used are not always effective against all bacterial strains, and in some cases, bacteria can experience mutations that make them immune to these drugs. This study identified genetic mutations that could trigger resistance, with a focus on the period August to November 2016 at the Adam Malik Haji Hospital.
The Importance of Identifying Genetic Mutations in MDR-TB
The emergence of MDR-TB has become a significant concern in the fight against TB. The World Health Organization (WHO) has reported that MDR-TB cases have increased by 20% in the past decade, making it a major public health concern. The ability of M. tuberculosis to develop resistance to antibiotics is a major challenge in the treatment of TB. By identifying the genetic mutations that contribute to resistance, healthcare providers can develop more effective treatment strategies and prevent the spread of MDR-TB.
Research Methods
This study is observational and is carried out prospectively for MDR-TB patients who are confirmed through the results of positive genetic mtb/rif for rifampicin resistance. Sputum sampling is carried out from patients who meet the criteria, then detected using the Polymerase Chain Reaction (PCR) method in the Integrated Laboratory of the Faculty of Medicine, University of North Sumatra. PCR product analysis is carried out with electrophoresis gel to determine the size of DNA and verify the presence of gene mutations.
The Role of PCR in Identifying Genetic Mutations
PCR is a powerful tool in identifying genetic mutations. This method allows for the amplification of specific DNA sequences, making it possible to detect even small mutations. In this study, PCR was used to detect mutations in the RPOB, CATG, and EMBB genes. The results of the PCR analysis were then verified using electrophoresis gel to determine the size of the DNA and confirm the presence of gene mutations.
Research Findings
The results showed that the RPOB gene mutation located in the Rifampicin resistance (RRDR) determinants had the highest percentage in Kodon 516 (100%), followed by Kodon 531 (96.77%) and Kodon 526 (90.32%). Conversely, mutations in Kodon 533 are found with the lowest percentage (12.90%). In addition, as many as 83.87% of samples experience mutations in the CATG gene in Kodon 315, which results in resistance to isoniazid (INH), where the sample also shows resistance to rifampicin. Mutations in the EMBB gene in Kodon 306A are found in 29.03% of the total sample, which causes resistance to ethambutol.
The Significance of the Findings
The findings of this study are significant in understanding the genetic mutations that contribute to resistance to Rifampicin, Isoniazid, and Ethambutol in MDR-TB patients. The high percentage of RPOB gene mutations in Kodon 516, 531, and 526 suggests that these mutations are a major contributor to resistance to Rifampicin. The high percentage of CATG gene mutations in Kodon 315 suggests that these mutations are a major contributor to resistance to Isoniazid. The presence of EMBB gene mutations in Kodon 306A suggests that these mutations are a major contributor to resistance to Ethambutol.
Analysis and Implications
This finding shows that the characteristics of genetic mutations among MDR-TB patients in Adam Malik Hospital Medan Medan are very in line with the identified global pattern. This provides valuable insights for the development of treatment and prevention strategies at the local level. Specific identification of mutations can help in designing more effective therapy and establish preventive measures to reduce the spread of MDR-TB.
The Importance of Tailoring Treatment to Genetic Mutations
The findings of this study highlight the importance of tailoring treatment to genetic mutations. By identifying the specific mutations that contribute to resistance, healthcare providers can develop more effective treatment strategies. This study suggests that treatment should be tailored to the specific genetic mutations present in each patient.
Conclusion
This study confirms the importance of genetic testing in determining the cause of drug resistance in TB. By understanding the mutations that occur in the RPOB, CATG, and EMBB genes, health care providers can make more appropriate decisions in the treatment of MDR-TB. Further research is needed to monitor the development of mutations and the effectiveness of therapy at Adam Malik Hajj Hospital and other institutions in Indonesia.
Future Directions
This study highlights the need for further research in the area of genetic testing for MDR-TB. Future studies should focus on developing more effective treatment strategies that take into account the specific genetic mutations present in each patient. Additionally, further research is needed to monitor the development of mutations and the effectiveness of therapy at Adam Malik Hajj Hospital and other institutions in Indonesia.
Q&A: Identification of RPOB, CATG, and EMBB Mutation Causes of Multidrug Resistance Tuberculosis at Adam Malik Central General Hospital (RSUP)
Frequently Asked Questions
We have received many questions from readers regarding the identification of RPOB, CATG, and EMBB mutation causes of multidrug resistance tuberculosis (MDR-TB) at Adam Malik Central General Hospital (RSUP). Below are some of the most frequently asked questions and their answers.
Q: What is the significance of identifying genetic mutations in MDR-TB?
A: The emergence of MDR-TB has become a significant concern in the fight against TB. The ability of M. tuberculosis to develop resistance to antibiotics is a major challenge in the treatment of TB. By identifying the genetic mutations that contribute to resistance, healthcare providers can develop more effective treatment strategies and prevent the spread of MDR-TB.
Q: What is the role of PCR in identifying genetic mutations?
A: PCR is a powerful tool in identifying genetic mutations. This method allows for the amplification of specific DNA sequences, making it possible to detect even small mutations. In this study, PCR was used to detect mutations in the RPOB, CATG, and EMBB genes. The results of the PCR analysis were then verified using electrophoresis gel to determine the size of the DNA and confirm the presence of gene mutations.
Q: What are the implications of the findings of this study?
A: The findings of this study are significant in understanding the genetic mutations that contribute to resistance to Rifampicin, Isoniazid, and Ethambutol in MDR-TB patients. The high percentage of RPOB gene mutations in Kodon 516, 531, and 526 suggests that these mutations are a major contributor to resistance to Rifampicin. The high percentage of CATG gene mutations in Kodon 315 suggests that these mutations are a major contributor to resistance to Isoniazid. The presence of EMBB gene mutations in Kodon 306A suggests that these mutations are a major contributor to resistance to Ethambutol.
Q: What are the limitations of this study?
A: This study has several limitations. The study was conducted in a single hospital and may not be representative of the entire population. Additionally, the study only examined a limited number of genetic mutations and may not have identified all the mutations that contribute to resistance to Rifampicin, Isoniazid, and Ethambutol.
Q: What are the future directions of this research?
A: This study highlights the need for further research in the area of genetic testing for MDR-TB. Future studies should focus on developing more effective treatment strategies that take into account the specific genetic mutations present in each patient. Additionally, further research is needed to monitor the development of mutations and the effectiveness of therapy at Adam Malik Hajj Hospital and other institutions in Indonesia.
Q: How can healthcare providers use the findings of this study in their practice?
A: Healthcare providers can use the findings of this study to develop more effective treatment strategies for MDR-TB patients. By identifying the specific genetic mutations present in each patient, healthcare providers can tailor treatment to the individual needs of the patient. This may involve using more effective antibiotics or adjusting the dosage of existing antibiotics.
Q: What are the implications of this study for public health policy?
A: The findings of this study have significant implications for public health policy. The study highlights the need for more effective treatment strategies for MDR-TB patients and the importance of monitoring the development of mutations and the effectiveness of therapy. This information can be used to inform public health policy and develop more effective strategies for preventing the spread of MDR-TB.
Q: How can readers access the full text of this study?
A: The full text of this study is available online through the journal's website. Readers can access the study by searching for the title of the study and clicking on the link to the full text.