Antibiotic Susceptibility Patterns and Mutations Associated with Isoniazid and Rifampicin Resistance in Non-Tuberculosis Mycobacterium Isolates from HIV-1 Infected and Uninfected Patients in Western Kenya

Primarily among immunocompromised people, notably those living with HIV/AIDS, antimicrobial resistance (AMR) among non-tuberculous mycobacteria (NTM) has become a major public health issue. Though the main pathogen in such populations is Mycobacterium tuberculosis, the importance of NTM in causing AMR and complicating treatment plans is becoming more well known. Still, the causes of medication resistance in NTM especially in relation to HIV co-infection remain mostly unknown. This study sought to ascertain the antimicrobial susceptibility patterns of NTM isolates and identify genetic alterations linked with isoniazid and rifampicin resistance among HIV-1 infected and uninfected patients in Western Kenya. Adult HIV-1 infected individuals showing suspected pulmonary tuberculosis were subject to a cross-sectional analytical laboratory analysis. Samples of sputum were gathered; NTM isolates were grown and identified. The broth microdilution technique was used for antimicrobial susceptibility testing. Line probe tests aiming at the rpoβ, katG, and inhA genes helped to find genetic alterations linked to medication resistance. Of 167 participants, 59 NTM isolates were found; most often occurring species were M. intracellularae and M. fortuitum. Observed in 12.1%, 15.2%, and 15.2% of isolates respectively were resistance to isoniazid, rifampicin, and streptomycin. HIV-positive individuals had more frequent mutations in the rpoβ, katG, and inhA genes; medication resistance and HIV status had clear correlation. The study emphasises how different treatment resistance patterns and genetic alterations cause NTM infections in HIV-positive patients to be difficultly managed. Especially in resource-limited environments, these results highlight the importance of customised treatment plans and continuous monitoring of AMR in NTM.